Employment Status Questionnaire

Completion of this form is required for any participant who applies for retirement and will be under age 65 on his retirement date. This form is used when the participant is no longer working in covered employment but indicates he is continuing to work in non-covered employment.

Employment Status Questionnaire

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.)

Having trouble seeing this PDF form? Click here for more information.