Retiree Information Forms

Forms - Retiree Information

Forms may be downloaded by clicking the corresponding form number below. The "Request Forms" e-mail is for ordering hardcopy forms only. For all other inquiries, please contact MainePERS directly.

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CL-0715⁺	Application for Service Retirement Benefits	Request Form
H0027	Additional Service Retirement Information
AC-0400	Authorization Agreement for Electronic Direct Deposit	Request Form
GU-1021	Confidentiality Election Form - Home Contact Information	Request Form
GU-1015	Continuing Health Insurance Coverage	Request Form
CL-0888⁺	Consent Form Designating Authorized Representatives	Request Form
GU-1020	Important Notice to New Benefit Recipients	Request Form
MM-0002+	Member/Benefit Recipient Data Update	Request Form
GU-1016	Payment or Award at Retirement Certification Form	Request Form
H0036	Retiring and Returning to Work for the Same Employer
CL-0078	Social Security Benefits and MainePERS Benefits	Request Form
H0032	Taxes and Your First Benefit Payment
GI-0003	Thinking of Your Future / Pre-Retirement Planning	Request Form
H0019	How the Taxable Portion of Your Service Retirement Benefit is Determined
W-4P	Withholding Certificate for Pension or Annuity Payments
W-4ME	Employees Maine Withholding Allowance Certificate

Package	Service Retirement Application Package	Request P ackage

+ Forms indicated with "+" may be viewed and completed on the screen using a recent version of Adobe^® Reader^®, printed, and mailed to the MainePERS. You may click on any line to complete that area or use TAB to move forward and SHIFT-TAB to move back. Forms cannot be saved or altered.