Forms may be downloaded by clicking the download links below. To request hardcopy forms, please send an email request via the link in the “Request form via email” column next to the form name. 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 the Adobe link above. For information on completing forms with Reader® click here.
Forms cannot be saved or altered.
New: A number of forms are now also available for completion online with your digital signature. We refer to these forms as “Digital Signature Forms.” You do not need to print paper to fill out and submit “Digital Signature Forms.” You do not need to print paper to fill out and submit “Digital Signature Forms.” You will have an option to save an electronic copy of any form you opt to fill out electronically and sign digitally.
The Digital Signature Forms are being made available through “Carahsoft OBO Maine Public Employees Retirement System (MainePERS)” using the DocuSign Platform. These forms are located in the table below.
To select and complete an available digital signature form, click on the link in the box under the “Digital Signature Forms” column for that form. Step-by-step directions are available within the form signing process itself.
Click here for more information on digital signatures
A digital signature means a computer-created electronic signature that is:
- intended by the person using it to have the same force and effect as the use of a manual signature;
- unique to the person using it;
- capable of verification;
- under the sole control of the person using it; and
- linked to data in such a manner that it is invalidated if changes are made to the data.
Digital signatures require creation by specialized software platforms.
|Form Number||Form Name||Download form as PDF||Request form via email||Digital Signature Forms|
|ASC Package||Annual Statement of Compensation Information Package||Download Annual Statement of Compensation Information Package||Request Annual Statement of Compensation Information Package||Download DocuSign Annual Statement of Compensation Information Package
|Review Package||Review for Continuing Disability Information Package||Download Review for Continuing Disability Information Package||n/a|
|CL-0724||Prospective Beneficiary of Member Changing to Service Retirement||Download CL-0724||Request CL-0724|
|CL-0875||Certification of Nature of Termination Retirement Prior to Age 59-1/2 or Normal Retirement Age||Download CL-0875||Request CL-0875|
|CL-0888||Consent Form Designating Authorized Representatives||Download CL-0888||Request CL-0888|
|CL-0888A||Consent Form Designating Authorized Representatives||Download CL-0888A||n/a|
|DC-0003a||Addendum to Application for Disability Retirement Benefits||Download DC-0003a||Request DC-0003a|
|DC-0007||Release of Information to Rehabilitation Providers||Download DC-0007||Request DC-0007|
|DC-0008||Employment Contact Form||Download DC-0008||Request DC-0008|
|DC-0013S||Application for Survivor Benefits||Download DC-0013S SAMPLE||Request DC-0013s|
|DC-0013A||Addendum to Application for Survivor Benefits||Download DC-0013A SAMPLE||Request DC-0013A|
|DC-0482||2022 Annual Statement of Compensation||Download DC-0482||Request DC-0482|
|DC-0603||Consent Form Authorizing Release of Information||Download DC-0603||Request DC-0603|
|DC-0608||Application for Disability Retirement Healthcare Provider Assessment||Download DC-0608||Request DC-0608|
|FS1120||Earnings Limitations for Disability Retirement Recipients||Download FS1120||Request FS1120|