Official Site of The State of New Jersey. Governor Phil Murphy • Lt. Governor Tahesha Way. NJ.gov; Services; Agencies; ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-7524. Site Maintained by Division of Revenue and Enterprise Services ...12.15.23 The pension loan interest rate for calendar year 2024 has been set by the New Jersey State Treasurer at 11 percent per annum on the declining balance of the loan. The administrative processing fee remains at $15.00 per loan. The interest rate is determined using the Prime Rate (8.5 percent) plus 2.5 percent.Take Five Interview with Christin Deacon. Posted January 29, 2020. Christin Deacon is Director of Health Benefit Operations and Policy and Planning at the New Jersey Division of Pensions and Benefits, Department of Treasury. First, can you tell us about your role in the state’s Division of Pensions and Benefits? 12.15.23 The pension loan interest rate for calendar year 2024 has been set by the New Jersey State Treasurer at 11 percent per annum on the declining balance of the loan. The administrative processing fee remains at $15.00 per loan. The interest rate is determined using the Prime Rate (8.5 percent) plus 2.5 percent. In accordance with N.J.S.A. 18A:66-170, this form must be filed with the New Jersey Division of Pensions & Benefits (NJDPB) within 30 days of the appointment to an eligible Alternate Benefit Program (ABP) position or within 90 days of a job title being declared eligible by the NJDPB. I wish to remain in the Public Employees’ Retirement System ...The Canadian government provides many benefits and assistance programs designed for senior citizens. Several of the programs are developed to provide access to medical care or help... making your enrollment and continued engagement in your health benefits coverage both convenient and informative. Introducing SHBP PO BOX 299 TRENTON, NJ 08625 The New Jersey State Health Benefits Program (SHBP) and the New Jersey Division of Pensions & Benefits (NJDPB) are excited to welcome you to your new online benefits hub. Pensions & Benefits Department of the Treasury Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-7524A copy of the New Jersey Certificate of Domestic Partnership dated prior to February 19, 2007 (or a valid certification from another State or foreign jurisdiction that recognizes same-sex domestic partners) ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295NJ Division of Pensions and Benefits. For information on these pension systems, including the current member handbook, information on their pension …ee0681. State of New Jersey • Department of the Treasury. DIVISION OF PENSIONS & BENEFITS — ENROLLMENT SECTION. P.O. Box 295, Trenton, NJ 08625-0295. ENROLLMENT APPLICATION FOR PUBLIC EMPLOYEES’ RETIREMENT SYSTEM (PERS) AND TEACHERS’ PENSION AND ANNUITY FUND (TPAF) MEMBERS. FOR …New Jersey Division of Pensions & Benefits Legal Affairs Unit P.O. Box 295 Trenton, NJ 08625-0295 The Divorce, Dissolution of a Civil Union and Your Retirement Benefits Fact Sheet can be obtained on our website. This fact sheet has been produced and distributed by: New Jersey Division of Pensions & Benefits P.O. Box 295, Trenton, NJ 08625-0295Welcome to New Jersey Division of Pensions and Benefits. Please enter your Username and Password. All fields marked with an asterisk ( *) are required. …Division of Pensions. and Benefits. PO Box 295. Trenton, NJ 08625-0295. This page is for messages to the Division of Pensions and Benefits Webmaster regarding technical issues with this Web site. Please complete the following form, which will provide us with the information necessary to identify your membership status and process your message.Official Site of The State of New Jersey. Governor Phil Murphy • Lt. Governor Tahesha Way. NJ.gov; Services; Agencies; ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-7524. Site Maintained by Division of Revenue and Enterprise Services ...State of New Jersey • Department of the Treasury DIVISION OF PENSIONS & BENEFITS — ExTErNal auDIT SECTION P.O. Box 295, Trenton, NJ 08625-0295 EE-0904-0318 NOTIFICaTION OF EMPlOYMENT aFTEr rETIrEMENT DO NOT WrITE IN THIS BOx LOCATION NO. MEMBERSHIP NO. This form is to be completed by the employer and …The School Employees’ Health Benefits Program Act is found in the New Jersey Statutes Annotated, Title 52, Article 14-17.46 et seq. Rules governing the operation and administration of the program are found in Title 17, Chapter 9 of the New Jersey Administrative Code. The Division of Pensions and Benefits, specifically the Health …: Get the latest NJ stock price and detailed information including news, historical charts and realtime prices. Indices Commodities Currencies Stocks State of New Jersey • Department of the Treasury DIVISION OF PENSIONS & BENEFITS — BENEFICIARY SERVICES P.O. Box 295, Trenton, NJ 08625-0295 RETIRED MEMBER DESIGNATION OF BENEFICIARY EB-0215-0123 PART 1 — MEMBER INFORMATION Name _____ Official Site of The State of New Jersey. Governor Phil Murphy • Lt. Governor Tahesha Way. NJ.gov; Services; Agencies; ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-7524. Site Maintained by Division of Revenue and Enterprise Services ...12.15.23 The pension loan interest rate for calendar year 2024 has been set by the New Jersey State Treasurer at 11 percent per annum on the declining balance of the loan. The administrative processing fee remains at $15.00 per loan. ... The Division of Pensions & Benefits offers a schedule of webinars to help members of the PERS, TPAF, PFRS ...Get ratings and reviews for the top 6 home warranty companies in Hamilton, NJ. Helping you find the best home warranty companies for the job. Expert Advice On Improving Your Home A...The Division of Pensions & Benefits offers a schedule of webinars to help members of the PERS, TPAF, PFRS, or DCRP understand their benefits on a variety of topics – in addition to planning for retirement. These webinars are live, interactive web presentations hosted by GoToMeeting that conclude with a brief Q&A period. ... Division of ... Pensions & Health Benefits. NJEA believes that the mainstay of a secure retirement is the defined benefit pension plan. In New Jersey, teachers and educational support professionals contribute a percentage of their salary and receive credit for the time they serve public school students in a pension plan that provides a guaranteed income in ... The lower portion of the bill is a payment stub, which includes the return address, that should be returned with the retiree's payment to the SHBP lockbox account maintained by the Division of Revenue (mail to: New Jersey Division of Pensions & Benefits, Health Benefits Bureau, P.O. Box 653, Trenton, NJ 08646-0653), in the window envelope …New Jersey Division of Pensions & Benefits. PO Box 295, Trenton, NJ 08625-0295. Telephone: (609) 292-7524 ▫ E-mail: [email protected] ... NJDPB website: nj.gov/treasury/pensions. Click on +Access Benefitsolver and register. When you log back into your myNewJersey (nj.gov) account you should now see the Benefitsolver button. DISCOVER YOUR SITE Explore the site and learn about your benefits. You’ll find lots of helpful information. ACCESS YOUR BENEFITS WHERE YOU WANT State of New Jersey • Department of the Treasury DIVISION OF PENSIONS & BENEFITS — BENEFICIARY SERVICES P.O. Box 295, Trenton, NJ 08625-0295 RETIRED MEMBER DESIGNATION OF BENEFICIARY EB-0215-0123 PART 1 — MEMBER INFORMATION Name _____ The PERS is a defined benefit plan administered by the New Jersey Division of Pensions & Benefits (NJDPB) . Provisions of law The PERS was established by New Jersey Statute and can be found in the New Jersey Statutes Annotated, Title 43, Chapter 15A . Changes in the law can only be made by an act of the State Legislature . Rules govern-Most qualified retirement plans, including pensions, allow employees to borrow against them and then repay the plan with interest, according to Investopedia. One benefit of taking ...Login ID: Password: Forgot your login ID? Forgot your password? Need help? If you need to register for Unemployment Benefits please go to myunemployment.nj.gov. Unemployment services are only accessed through that site. Otherwise, register for myNewJersey services here: The calculation is based solely on the information you you provide and does not access any of the salary or service information maintained by the Division of Pensions & Benefits; If you are within two years of retirement, obtain an estimate of gross retirement benefits online using the Member Benefits Online System (MBOS). Department of the Treasury Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-752412.15.23 The pension loan interest rate for calendar year 2024 has been set by the New Jersey State Treasurer at 11 percent per annum on the declining balance of the loan. The administrative processing fee remains at $15.00 per loan. ... The Division of Pensions & Benefits offers a schedule of webinars to help members of the PERS, TPAF, PFRS ...Option D, a 25 percent joint and survivor benefit, provides a lifetime monthly payment to you. If your beneficiary is living at the time of your death, your beneficiary will receive 25 percent of your monthly retirement allowance for life. If your beneficiary dies before you, your retirement allowance will increase to the Maximum Option.Depending on the job you have, there can be several benefits that you might be entitled to. One of those benefits is a pension plan if the company you work for offers it. Contribut...Official Site of The State of New Jersey. Governor Phil Murphy • Lt. Governor Tahesha Way. NJ.gov; Services; Agencies; ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-7524. Site Maintained by Division of Revenue and Enterprise Services ...Provisions of the New Jersey Administrative Code — N.J.A.C. 17:1-3.10 — were adopted to comply with USERRA and apply the federal requirements to all the defined benefit and defined contribution retire-ment systems administered by the New Jersey Divi-sion of Pensions & Benefits (NJDPB). IMPORTANT NOTE ON USERRA TIMEFRAMESThe Supplemental Annuity Collective Trust (SACT) of New Jersey. The SACT is a voluntary investment program that provides retirement income separate from, and in addition to, your basic pension plan. The program consists of two separate plans: the SACT-Regular Plan and the SACT-Tax-Sheltered Plan. ... Division of Pensions & Benefits P.O. Box 295 ...care Part D coverage to the New Jersey Division of Pensions & Benefits (NJDPB). If you enroll in another Medicare Part D plan, you will lose your prescription drug benefits provided by the SHBP/SEHBP; however, your medical benefits will continue. Note: If you are enrolled in a Medicare Advantage Plan, you can only waive your prescription drug cov-12.15.23 The pension loan interest rate for calendar year 2024 has been set by the New Jersey State Treasurer at 11 percent per annum on the declining balance of the loan. The administrative processing fee remains at $15.00 per loan. The interest rate is determined using the Prime Rate (8.5 percent) plus 2.5 percent. Login ID: Password: Forgot your login ID? Forgot your password? Need help? If you need to register for Unemployment Benefits please go to myunemployment.nj.gov. Unemployment services are only accessed through that site. Otherwise, register for myNewJersey services here: New Jersey Division of Pensions & Benefits Legal Affairs Unit P.O. Box 295 Trenton, NJ 08625-0295 The Divorce, Dissolution of a Civil Union and Your Retirement Benefits Fact Sheet can be obtained on our website. This fact sheet has been produced and distributed by: New Jersey Division of Pensions & Benefits P.O. Box 295, Trenton, NJ 08625-0295 The Canadian government provides many benefits and assistance programs designed for senior citizens. Several of the programs are developed to provide access to medical care or help...State Employees — To be eligible, you must be a full-time employee of the State of New Jersey or be a full-time appointed or elected officer of the State (this includes employees of a State agency or authority and employees of a State college or university). To be considered full-time you must work at least 35 hours per week. ... Division of ...To file a report regarding fraudulent pension and benefit claims, payments, or participation in one of the State-administered retirement systems or benefit programs, contact the Pension Fraud and Abuse Unit: By phone: 609-633-2925 or. By email: [email protected]. Or you can complete the Information Referral form and …At the bottom of the screen along with your MBOS and EPIC button, you’ll see a new button that reads Benefitsolver. * If you do not have a Benefitsolver button you must visit the NJDPB website: nj.gov/treasury/pensions. Click on +Access Benefitsolver and register. When you log back into your myNewJersey (nj.gov) account you should now see the ...If, after reading this guidebook, you have any ques-tions, comments, or suggestions regarding the infor-mation presented, please write to the New Jersey Di-vision of Pensions & Benefits, P.O. Box 295, Trenton, NJ 08625-0295, call (609) 292-7524, or send email to: [email protected]. RETIREE DENTAL PLANS ELIGIBILITY.of your benefits from your retirement ac-count. The New Jersey Division of Pensions & Benefits (NJDPB) cannot give tax advice. You can find more specific information on the tax treatment of payments from qual-ified employer plans in Internal Revenue Service (IRS) Publication 575 – Pension and Annuity Income, IRS Publication 590TRENTON - The Department of the Treasury reported that January revenue collections for the major taxes totaled $5.094 billion, up $200.9 million, or 4.1 percent over last year. The growth in total revenues was led by higher collections from the Gross Income Tax, the Sales and Use Tax, and the Pass-Through Business Alternative Income Tax.Official Site of The State of New Jersey. Governor Phil Murphy • Lt. Governor Tahesha Way. NJ.gov; Services; Agencies; ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-7524. Site Maintained by Division of Revenue and Enterprise Services ...To file a report regarding fraudulent pension and benefit claims, payments, or participation in one of the State-administered retirement systems or benefit programs, contact the Pension Fraud and Abuse Unit: By phone: 609-633-2925 or. By email: [email protected]. Or you can complete the Information Referral form and return …You must attach a screen print of the member’s TREADHOC biweekly certification with salaries projected until termination date. Submit this certification to: New Jersey Division of Pensions & Benefits Retirement Bureau P.O. Box 295 Trenton, NJ 08625-0295.The NJDPB oversees all Pensions and Benefits for New Jersey. Learn how to access your account online, by phone, or by visiting a campus representative, …On the left side of your myNewJersey home page you will see the “Pensions and Benefits Channel.” Click the “MBOS and EPIC” button to continue to MBOS. Note: If you do not see the Pensions and Benefits Channel on your myNewJersey home page, be sure that the MyNewJersey tab at the top of the page is selected.An Office of the State Comptroller (OSC) investigation has found that the Division of Pension and Benefits (DPB) within the Department of the Treasury has effectively enforced a 2007 law that was enacted to prevent abuses involving professional services providers (PSPs) in the Public Employees’ Retirement System (PERS), the … NJDPB website: nj.gov/treasury/pensions. Click on +Access Benefitsolver and register. When you log back into your myNewJersey (nj.gov) account you should now see the Benefitsolver button. DISCOVER YOUR SITE Explore the site and learn about your benefits. You’ll find lots of helpful information. ACCESS YOUR BENEFITS WHERE YOU WANT Get ratings and reviews for the top 6 home warranty companies in Cherry Hill, NJ. Helping you find the best home warranty companies for the job. Expert Advice On Improving Your Hom...12.15.23 The pension loan interest rate for calendar year 2024 has been set by the New Jersey State Treasurer at 11 percent per annum on the declining balance of the loan. The administrative processing fee remains at $15.00 per loan. The interest rate is determined using the Prime Rate (8.5 percent) plus 2.5 percent.NEW JERSEY DIVISION OF PENSIONS AND BENEFITS NEW JERSEY STATE EMPLOYEES DEFERRED COMPENSATION PLAN AUTHORITY: Unless otherwise expressly noted, all provisions of this Plan were adopted by the New Jersey State Employees Deferred Compensation Board pursuant to authority delegated at N.J.S.A. … Division of Pensions & Benefits. Pensions. Active Employees; Employers; ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-7524. At the bottom of the screen along with your MBOS and EPIC button, you’ll see a new button that reads Benefitsolver. * If you do not have a Benefitsolver button you must visit the NJDPB website: nj.gov/treasury/pensions. Click on +Access Benefitsolver and register. When you log back into your myNewJersey (nj.gov) account you should now see the ...Take Five Interview with Christin Deacon. Posted January 29, 2020. Christin Deacon is Director of Health Benefit Operations and Policy and Planning at the New Jersey Division of Pensions and Benefits, Department of Treasury. First, can you tell us about your role in the state’s Division of Pensions and Benefits?Are you considering going on a cruise vacation? If so, have you thought about departing from Bayonne, NJ? Many travelers are discovering the benefits of cruising from this convenie...state of new jersey page 1 of 3 department of the treasury division of pensions and benefits board list 1 for 08/08/2022 police and firemen's retirement system run-date: 08/04/2022 name effective date . option/ eri-cat service yrs-mos: monthly allowance chap retirement type employer ...Death records are an important source of information for many reasons. In New Jersey, death records are available to the public and can be obtained from the New Jersey Department o...New Jersey Division of Pensions and Benefits (NJDPB) ... The NJDPB oversees all Pensions and Benefits for New Jersey. Go.Disability Retirement — There are two types of PERS Disability Retirement benefits.(select one) Ordinary Disability — You must have a minimum of 10 years of N.J. service credit* and be considered totally and permanently disabled. If you qualify for an Ordinary Disability Retirement, the retirement allowance is 43.6 percent of your Final …24 Apr 2023 ... Current State employees are encouraged to apply. TITLE: Governors Fellow. OPEN TO: General Public. DIVISION: Pensions & Benefits. TITLE CODE: ...23 Sept 2020 ... Once you've received your NJ Pension Confirmation email and copy of your pension certification from our office, you will have the ability to ... Division of Pensions & Benefits. Pensions. Active Employees; Employers; ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-7524. A PUBLICATION OF THE NEW JERSEY DIVISION OF PENSIONS AND BENEFITS Fact Sheet #11 November 2012 — Page 4 School Board and County College Employees If you attained 25 or more years of service credit before June 28, 2011 (the effective date of Chapter 78, P.L.New Jersey Division of Pensions & Benefits Legal Affairs Unit P.O. Box 295 Trenton, NJ 08625-0295 The Divorce, Dissolution of a Civil Union and Your Retirement Benefits Fact Sheet can be obtained on our website. This fact sheet has been produced and distributed by: New Jersey Division of Pensions & Benefits P.O. Box 295, Trenton, NJ 08625-0295 At the end of each calendar year, every pension recipient receives a Form 1099-R from the New Jersey Division of Pensions & Benefits (NJDPB). The Form 1099-R shows the retirement allowance received in the previous calendar year along with other information of use when filing federal or State income tax. You receive three copies of your Form ... Long-term disability insurance benefits may be ex-empt from New Jersey State income tax. Contact the New Jersey Division of Taxation at 1-800-323-4400, or refer to the NJ Gross Income Tax Return Form 1040 instructions to determine how your benefit is taxed. For residents of states other than New Jersey, pleaseState of New Jersey • Department of the Treasury DIVISION OF PENSIONS & BENEFITS — BENEFICIARY SERVICES P.O. Box 295, Trenton, NJ 08625-0295 ... pension benefit section is left blank, and you are a member of PERS or TPAF, the return of member contributions will The Board of Trustees has the general responsibility for the operation of the PERS under N.J.S.A. 43:15A-17. The Board meets monthly at the New Jersey Division of Pensions & Benefits (NJDPB) in Trenton. The statute provides that no employee shall suffer loss of salary or wages because of serving on the Board. 23 Sept 2020 ... Once you've received your NJ Pension Confirmation email and copy of your pension certification from our office, you will have the ability to ...care Part D coverage to the New Jersey Division of Pensions & Benefits (NJDPB). If you enroll in another Medicare Part D plan, you will lose your prescription drug benefits provided by the SHBP/SEHBP; however, your medical benefits will continue. Note: If you are enrolled in a Medicare Advantage Plan, you can only waive your prescription drug [email protected], or write to the New Jersey Division of Pensions & Benefits, P.O. Box 295, Trenton, NJ 08625-0295. Title: Medicare Reimbursement Online Document Submission Author: Division of Pensions & Benefits Subject: Medicare Reimbursement Online Document [email protected], or write to the New Jersey Division of Pensions & Benefits, P.O. Box 295, Trenton, NJ 08625-0295. Title: Medicare Reimbursement Online Document Submission Author: Division of Pensions & Benefits Subject: Medicare Reimbursement Online Document Submission
Official Site of The State of New Jersey. Governor Phil Murphy • Lt. Governor Tahesha Way. NJ.gov; Services; Agencies; ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-7524. Site Maintained by Division of Revenue and Enterprise Services .... Mail cox
of your benefits from your retirement ac-count. The New Jersey Division of Pensions & Benefits (NJDPB) cannot give tax advice. You can find more specific information on the tax treatment of payments from qual-ified employer plans in Internal Revenue Service (IRS) Publication 575 – Pension and Annuity Income, IRS Publication 590Get ratings and reviews for the top 6 home warranty companies in Hamilton, NJ. Helping you find the best home warranty companies for the job. Expert Advice On Improving Your Home A...State of New Jersey Plan Design Comparison Analysis for the SHBP and SEHBP – 5/15/23. Plan Design Comparison Analysis; Mid-Year Experience Analysis for Plan Year 2022. State Employee Group; Local Government Employer Group; ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295A copy of the New Jersey Certificate of Domestic Partnership dated prior to February 19, 2007 (or a valid certification from another State or foreign jurisdiction that recognizes same-sex domestic partners) ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295Department of the Treasury Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-752412.15.23 The pension loan interest rate for calendar year 2024 has been set by the New Jersey State Treasurer at 11 percent per annum on the declining balance of the loan. The administrative processing fee remains at $15.00 per loan. The interest rate is determined using the Prime Rate (8.5 percent) plus 2.5 percent.Official Site of The State of New Jersey. Governor Phil Murphy • Lt. Governor Tahesha Way. NJ.gov; Services; Agencies; ... Division of Pensions & Benefits P.O. Box 295 Trenton, NJ 08625-0295 Call Center 609-292-7524. Site Maintained by Division of Revenue and Enterprise Services ...The Division of Pensions & Benefits (NJDPB) is pleased to announce the addition of six NEW. Webinar topics for retirement system members. These are in ...One State Street Square 1st Floor Trenton, New Jersey. The Division of Pensions and Benefits offers one-on-one counseling services to members ofthe retirement systems and other benefit programs. No appointments are taken. Counselors are available Monday through Friday (except State holidays) from 7:40 a.m. to 4:00 p.m.Retirement is a time of life that many look forward to, but it can also be a time of financial insecurity. With the cost of living rising and pensions not always providing enough t...On behalf of the New Jersey Division of Pensions & Benefits (NJDPB), I am pleased to submit the 67th Annual Comprehensive Financial Report (Annual Report) of the New Jersey State-administered retirement systems and related benefit programs for the fiscal year ended June 30, 2022. The management of the NJDPB is responsibleBoard Secretary - Division of Pensions & Benefits: William Tedder: N/A: Assistant Board Secretary - Division of Pensions & Benefits *Chairperson **Vice-chairperson ... Police and Firemen's Retirement System of New Jersey Board of Trustees - Term effective February 1, 2019. P.L. 2018, c. 55 (Chapter 55), established a new Police and Firemen’s ...MBOS registration and access is for the exclusive use. of pension system members and benefit recipients. If you are not authorized to use this site, please exit. Unauthorized access is subject to prosecution to the fullest extent of. the law. In order to proceed you must have your membership number (active members) or retirement number (retired ... If you have questions about the standard Medicare Part B pension reimbursements or your eligibility for reimbursement, call the Division of Pension and Benefits at (609) 292-7524. 1 If you did not pay an IRMAA surcharge, you will not be reimbursed and do not need to submit a claim. liens, the New Jersey Division of Pensions & Bene-fits (NJDPB) will honor court orders for child support, alimony, or equitable distribution. The New Jersey State-administered retirement sys- ... New Jersey Division of Pensions & Benefits P.O. Box 295, Trenton, NJ 08625-0295 (609) 292-7524Pension benefits are paid and regulated through the Department of Veterans Affairs for veterans receiving living benefits and surviving heirs. Whether a spouse or child will get be...State of New Jersey • Department of the Treasury DIVISION OF PENSIONS & BENEFITS — ExTErNal auDIT SECTION P.O. Box 295, Trenton, NJ 08625-0295 EE-0904-0318 NOTIFICaTION OF EMPlOYMENT aFTEr rETIrEMENT DO NOT WrITE IN THIS BOx LOCATION NO. MEMBERSHIP NO. This form is to be completed by the employer and ….