Employee Forms

Retirement

Employees who wish to request an estimate of benefits (must be within 3 years of retirement); cost calculations for air time, with drawn service, or military service; prepare a service credit verification or request a PERA Retirement Kit should submit a PERA Request Form (PDF). This form may be mailed directly to PERA.

Related Documents

Employee

  1. Company Nurse - On the Job Injury
  2. Employee Application for Leave (PDF)
  3. Request to Receive Donated Leave
  4. Leave Donation Form
  5. FMLA - Employee
  1. FMLA - Family
  2. New Health Insurance Marketplace Coverage Options (Notice of exchange DOL form) (PDF)
  3. Authorization-for-Direct-Deposit-Form-PDF
  4. W4 2022

Retirement

  1. Change in PERA record (PDF)
  1. PERA Request Form (PDF)