Contact PERAC
Send RFP Notice
FAQ's
Forms
Staff
General Laws of
Mass
Training Materials
Privacy Policy
Accessibility
Download Tools
GENERAL MEMBERSHIP FORMS INDEX
Adobe Versions
You will need Adobe Reader Software to read the documents presented here.
These forms may be printed. However, due to privacy concerns, they may not be filled in from this website.
GENERAL MEMBERSHIP FORMS INDEX
Employer's Certification of Creditable Service and Regular Compensation in Connection with Shift Substitution (October, 2011) (PDF)
Application for Withdrawal of Accumulated Total Deductions (June, 2011) (PDF)
Pre-Tax Rollover Acknowledgement Form (PDF)
Beneficiary Selection Form
(If Member Dies Before Retirement)
(PDF)
Notice of Election of Benefits Under G.L. c. 32, § 12(2)(d)
(PDF)
Notice of Potential Benefits Pursuant to G.L. c. 32, §4(1)(h)
(PDF) (April 2011)
Application by Member Requesting to Continue Retirement Contributions Beyond the Age of 70 Pursuant to G.L. c. 32, § 90(G)(¾)
(PDF)
Notice to the Public Employee Retirement Administration Commission of the Granting of Benefits Under G.L. c. 32, § 12(2)(d)
(PDF)
Application for Reinstatement to Service from Superannuation / Termination Retirement Pursuant To G.L. c. 32, § 105 (not a template) (PDF)
Special Tax Notice Regarding Lump Sum Distributions for Distributions Made After January 1, 2002 (PDF)
New Member Enrollment Form (PDF)
Beneficiary Change Form (Option B) (If Member Dies After Retirement)
(PDF)
Application for Voluntary Superannuation Retirement (November, 2011)
(PDF)
Choice of Retirement Option Form at Retirement (PDF)
Affidavit to be Filed with the Retirement Board by Spouse Seeking Member Survivor Benefits (PDF)
Application for Member Survivor Benefits Under G.L. c. 32, § 12A (PDF)
Termination Retirement Transmittal to the Commission (PDF)
Employer's Certification in Connection with Termination Retirement Allowance Pursuant to G.L. c. 32, § 10(2) to be Filed with the Retirement Board (PDF)
Employer's Request for Information (PDF)
Statement concerning Your Employment in a Job Not Covered by Social Security (SSA-1945) (PDF)
Disability Retirement Benefits for Veterans, Chapter 157 of the Acts of 2005 (Also includes cover memo.) (PDF)
SEARCH
In PERAC
in Mass.Gov
GENERAL MEMBERSHIP FORMS INDEX 
