Member Information FormThis form is for new and returning employeeshired into retirement-eligible positions for PERS,SERS or TRS.
c Plan 2
c Plan 3 — Also complete Section 4 on back.
Signature Date
Section 1: Personal InformationName (Last, First, Middle) Social Security NumberMailing Address City State ZIPEmail Address Phone NumberThe Department of Retirement Systems (DRS) requires that you provide your Social Securit...
Allowed
Adobe Portable Document Format (.pdf) - application/pdf
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