Box 349 Augusta, ME 04332-0349 Telephone: (207) 512-3100 Toll-free: 1-800-451-9800 Fax: (207) 512-31-2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by entering your name in the designated field. Ensure that you print clearly for accurate processing.
3. Next, input your Social Security Number in the provided space. This is crucial for identification purposes.
4. Select one of the two choices regarding your retirement benefit. Make sure to read each option carefully before making your selection.
5. Indicate the employer you have returned to work with in the specified area. This helps clarify your employment status.
6. Sign and date the form at the bottom. Your signature confirms your election choice and understanding of its implications.
7. Finally, download or save your completed form and return the original to MainePERS Retirement Services Unit while keeping a copy for your records.

Start using our platform today to streamline your document editing and signing process for free!