Certificate of Complete Severance and Termination of Employment for Employers

Completion of this form is required by an employer for any participant who applies for retirement and will be under age 65 on his retirement date. This form requires the employer to certify that the participant has completely severed and terminated his employment relationship with his company and all businesses affiliated with his company.

Certificate of Complete Severance and Termination of Employment

Once you download the form to your computer, you can fill it in, print it, sign and date it, and mail it back to an Area Administrative Office. (You cannot send the form via e-mail.)

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