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Click ‘Get Form’ to open the nmerb in the editor.
In Section I, provide your Member Information. Select whether this is a New Form or a Beneficiary Change, and fill in your personal details including Last Name, First Name, Previous Name (if applicable), Address, City, State, Zip, Telephone Number, SSN, Employer, DOB, and Marital Status.
Choose either Section II or III for Beneficiary Information. If you want your beneficiary to have the option of a lump sum or monthly benefit upon your death, complete Section II. Otherwise, if you prefer a lump sum only and wish to reject Option B coverage, fill out Section III.
In the selected section (II or III), enter the Beneficiary's Name, Social Security Number, Relationship to you, Date of Birth, Address, Telephone Number, City, State and Zip.
Complete Section IV by signing the form in front of a notary public. Ensure that all information is accurate and true.
If married, have your spouse complete Section V for Spousal Consent in front of a notary as well.

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Versions	Form popularity	Fillable & printable
2012	4.8 Satisfied (83 Votes)

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