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Forms - Survivor Benefits |
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Forms may be
downloaded by clicking the corresponding form number below.
The "Request Forms" e-mail is for ordering hardcopy forms
only. For all other inquiries, please contact MainePERS
directly.
To use these forms you will need Adobe Reader®.
If you don't have Reader, you can get it free by clicking
here. |
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CL-0888+ |
Consent Form Designating Authorized Representatives |
Request Form |
CL-0722+
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Designation of Beneficiary Pre-Retirement
Death Benefits
(Individuals completing this form might also consider completing
the
Change of Beneficiary Group Life Insurance form.)
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Request Form
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CL-0722A |
Information Regarding
Designation of Beneficiary Pre-Retirement Death Benefits |
Request Form |
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CL-0720+ |
Designation of Option One Beneficiary (NOTE: This form should be
used ONLY if you are retired under option 1)
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Request Form |
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CL-0065+ |
Survivor Benefits Recipient's Certification |
Request Form |
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+ Forms indicated with "+" may be viewed and completed on the
screen using a recent version of Adobe
Reader printed, and
mailed to the MainePERS. 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. |
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