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The "Request Forms" e-mail provided below is for ordering forms only.
For all other inquiries, please contact MainePERS directly.

BY MAIL
  Request Package
AC-0003+
Rollover / Direct Transfer Request / Certification Form (For purchase of service credit)
Request Form
AC-0400
Authorization Agreement for Electronic Direct Deposit
CL-0050
Vacation and Sick Leave Reporting Form for Teacher Members (Click here for instructions)
Request Form
CL-0051
Vacation and Sick Leave Reporting Form for PLD Members (Click here for instructions)
Request Form
CL-0052
Vacation and Sick Leave Reporting Form for State Members (Click here for instructions)
Request Form
CL-0055
Employer Preliminary Benefit Certification Form
Request Form
CL-0078
Social Security Benefits and the Maine Public Employees Retirement System: Their Relationship
Request Form
CL-0704
Certificate of Teaching Service in Maine Public Schools
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CL-0704A
Certificate of Teaching Service in Public or Private Academies, or Parochial Schools
Request Form
CL-0704B
Certificate of Out-of-State Teaching Service
Request Form
CL-0715A
Information Regarding Application for Service Retirement Benefits
Request Form
CL-0715+
Application For Service Retirement Benefits
Request Form
CL-0718
Certification of Spousal Notification
Request Form
CL-0719
Information Regarding Restoration to Service (Election Form) for PLDs with Social Security
Request Form
CL-0863S
Informed Consent to Revision of Beneficiary Designation
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CL-0875
Certification of Bona Fide Termination
Request Form
GU-1016
Payment or Award at Retirement Certification Form
Request Form
W-4P
Witholding Certificate for Pension or Annuity Payments
 
W-4ME
Employees Maine Witholding Allowance Certificate
 

+ Forms indicated with "+" may be viewed and completed on the screen using a recent version of Adobe(R) Reader(R), printed, and mailed to the MSRS. 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.