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Pa application multiple form 2026
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- Click ‘Get Form’ to open the pa application multiple form in the editor.
- Begin by filling out the Member Information section. Enter your full name, Social Security Number, and select your sex. If you have a new address, check the corresponding box and provide your street address, city, state, and zip code.
- Next, input your date of birth and contact information including your email address and daytime/evening phone numbers.
- In the Multiple Service Election section, confirm your election for multiple service membership by checking the appropriate box. Ensure you understand the implications of this election as stated in the form.
- List any previous employment with state agencies along with approximate dates of employment in the designated area.
- Indicate whether you are currently receiving an annuity from SERS by selecting 'Yes' or 'No'.
- Finally, complete the Member Certification section by signing and dating the form to certify that all information is accurate.
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| Versions | Form popularity | Fillable & printable |
|---|---|---|
| 2012 | 4.9 Satisfied (483 Votes) |
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