P UBLIC EMPLOYEES RETIREMEN T A SSOCIATION OF N EW MEXICO PUBLIC EMPLOYEES RETIREMENT BOARD P 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out the MEMBER INFORMATION section. Enter your SOCIAL SECURITY NUMBER or PERA ID NUMBER, FIRST NAME, LAST NAME, and MI. Ensure you select the correct ADDRESS TYPE (PERMANENT or TEMPORARY) and provide your STREET ADDRESS, CITY, STATE, and ZIP code.
3. Next, complete the contact information by providing your HOME TELEPHONE NO. and BUSINESS TELEPHONE NO. Select your GENDER and enter your DATE OF BIRTH along with your MARITAL STATUS.
4. Fill in the PLANNED TERMINATION DATE and EFFECTIVE RETIREMENT DATE. Include the NAME OF VOLUNTEER FIRE DEPARTMENT you are associated with.
5. In the BENEFICIARY DESIGNATION INFORMATION section, provide details about your spouse if applicable. This includes their full name, social security number, address, and date of birth.
6. Finally, review the APPLICANT’S STATEMENT carefully before signing and dating it to confirm that all information is accurate.

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