Ohio Public Employees Retirement System Membership Form Preview on Page 1

Ohio Public Employees Retirement System Membership Form 2026

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  1. Click ‘Get Form’ to open it in the editor.
  2. Begin with Section 1 - Personal Information. Fill in your Social Security Number, name, address, and contact details. Ensure accuracy, especially for your date of birth and Social Security Number.
  3. Move to Section 2 - Other Retirement System Information. If applicable, check any boxes indicating you are receiving a disability or retirement benefit from other systems.
  4. In Section 3 - Employee Certification, read the statement carefully. Sign the form where indicated; do not print or type your name.
  5. Finally, ensure that Section 4 - Employer Certification is completed by your employer. They must sign and provide necessary details about your employment.

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Ohio Public Employees Retirement System

INSTRUCTIONS. 1. As a public employee you are required to complete and file this Form within 30 days of commencing employment. Failure to do.Read more

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