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Maine Public Employees Retirement System
P.O. Box 349, Augusta, ME 04332-0349
toll free: (800) 451-9800 ● local: (207) 512-3100

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Forms
       
  Below are links to frequently used MainePERS forms. These are provided with the understanding that the user will not alter them either in format or content.

Please note that some forms are sample only or may require that you send additional information when you submit them to MainePERS. If the form you are looking for does not appear on our Web site, please call MainePERS at (207) 512-3100 or toll free at 1-800-451-9800.

  Forms
MEMBERS:   PROGRAMS:   QUICK LINKS:
Active Members Disability Benefits Address Change
Retired Members Group Life Insurance Direct Deposit
  Survivor Benefits Refund Application Package
  Employer (Request a hardcopy here.)
   
W-4P - Federal Withholding form 
   
W-4ME - State Withholding form  
         

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Information contained on this Web site is neither a legal reference nor a complete statement of the laws or MainePERS administrative rules. In any conflict between this information and Maine laws or administrative rules, the laws and administrative rules shall prevail.

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