Election to Exclude Military Retirement Benefits - Nebraska ... 2026

1. Click ‘Get Form’ to open the Election to Exclude Military Retirement Benefits form in the editor.
2. Begin by entering your First Name, Initial, and Last Name in the designated fields. Ensure that you print clearly for accurate processing.
3. Fill in your Current Mailing Address, including Number and Street or PO Box, City, State, and Zip Code.
4. Provide your Social Security Number and Date of Birth. This information is crucial for identification purposes.
5. Indicate your Date of Retirement by referencing your DD Form 214 or equivalent documentation.
6. Choose between Option 1 (40% exclusion for seven years) or Option 2 (15% exclusion starting at age 67) based on what benefits you wish to elect.
7. Attach any required official documentation proving your retirement date and eligibility. This may include a copy of your DD Form 214 or retirement orders.
8. Sign and date the form where indicated, providing your daytime phone number and email address for any necessary follow-up from the Department.

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