Pers disability retirement mississippi 2026

1. Click ‘Get Form’ to open the Pre-Application for Disability Retirement Benefits in the editor.
2. Begin with the Member Information section. Fill in your first name, middle initial, last name, gender, social security number, birth date, email address, and mailing address. Ensure all details are accurate.
3. Indicate your disability type by selecting either 'Non-Duty Related' or 'Duty Related'. If you served in the U.S. Armed Forces, check 'Yes' and attach Form DD214.
4. Select your applicable retirement plan from the options provided. This is crucial for processing your application correctly.
5. List potential beneficiaries for estimation purposes only. Include their names, social security numbers, birth dates, and relationships to you.
6. Sign and date the Applicant Authorization section. If someone else is signing on your behalf, attach proof of authority.
7. The Employer Certification section must be completed by an authorized representative of your employer. Ensure they provide all necessary information accurately.

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