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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information, including your name, address, Social Security number, and date of birth. Ensure accuracy as this information is crucial for processing.
Indicate if you have a new address by checking the appropriate box. This helps maintain updated records with PSERS.
Select the type of pension account affected by this form by checking the relevant box(es) for your retirement benefit, survivor annuitant benefit, or divorce benefit.
In the Federal Income Tax Withholding Information section, choose either Section 1 (no withholding) or Section 2 (withholding). If selecting Section 2, complete both required items A and B regarding marital status and allowances.
If desired, specify an additional amount to be withheld in the optional box. This can help manage your tax obligations more effectively.
Finally, sign and date the form to certify that all provided information is accurate before submitting it back to PSERS.
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