Home
Forms Library
USE THIS FORM IF YOU ARE TRYING TO - NDPERS

USE THIS FORM IF YOU ARE TRYING TO - NDPERS 2026

USE THIS FORM IF YOU ARE TRYING TO - NDPERS Preview on Page 1

See details

4.8 out of 5

57 votes

The document is a form for verifying the eligibility of a grandchild for coverage under the North Dakota Public Employees Retirement System (NDPERS). It requires member information, details about the grandchild and their parent, and certification of dependency criteria. The form emphasizes the need for supporting documentation, the obligation to notify NDPERS of any changes in eligibility, and the consequences of providing false information.

Here's how it works

01. Edit your form online

Type text, add images, blackout confidential details, add comments, highlights and more.

02. Sign it in a few clicks

Draw your signature, type it, upload its image, or use your mobile device as a signature pad.

03. Share your form with others

Send it via email, link, or fax. You can also download it, export it or print it out.

How to use or fill out USE THIS FORM IF YOU ARE TRYING TO - NDPERS with our platform

Ease of Setup

DocHub User Ratings on G2

Ease of Use

DocHub User Ratings on G2

Click ‘Get Form’ to open it in the editor.
Begin by filling out Part A, which includes your personal information. Enter your name, NDPERS Member ID, last four digits of your Social Security Number, and date of birth.
Next, provide details about the adult dependent and grandchild. Fill in the names and dates of birth for both the adult dependent (parent of the grandchild) and the grandchild.
Move to Part B for member verification. Check all applicable criteria that confirm your grandchild's eligibility for coverage under the plan.
If applicable, enter the name and address of the college or school where your adult dependent is a full-time student.
Finally, review all entered information for accuracy. Sign and date the form to certify that all information is true and correct before submitting it along with any required documentation.

Start using our platform today to easily complete your NDPERS form online for free!

be ready to get more