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FULL-TIME STUDENT EXCLUSION CERTIFICATION Public Employees - mnpera

FULL-TIME STUDENT EXCLUSION CERTIFICATION Public Employees - mnpera 2026

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The document is a certification form used by the Public Employees Retirement Association (PERA) to confirm the exclusion of full-time student employees under the age of 23 from PERA membership. It requires completion by the student, their accredited school, and their employer, with signatures needed for validation. The form collects private data for identification and potential refund processing, emphasizing the importance of notifying employers about changes in full-time school attendance.

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Click ‘Get Form’ to open it in the editor.
In Part A, enter your name (Last, First, Middle Initial), the last four digits of your Social Security Number, and your PERA Member Number. Fill in your mailing address including street number, city, state, and zip code.
Notify your employer about any changes in your full-time school attendance as soon as possible.
In Part B, have an official from your accredited school certify your full-time attendance by filling in the name of the school, signing, and providing their title along with the beginning and ending dates of your enrollment.
Finally, in Part C, ensure that an authorized representative from your employer completes this section by providing the employer's name and department (if applicable), PERA Employer ID, signature, title, and date.

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