Retired Member & Benefit Recipient Forms

Authorization For

Deduction of Health Insurance Premiums, Form 117

Release of Information, Form 136

Change of

Mailing Address, Form 116

Name, Form 029

Post Retirement Work

Retired Member Application to Return to Work, Form 143EE 
Pursuant to 19-20-732 MCA

Employer Certification to Employ a Retired Member, Form 143ER
Pursuant to 19-20-732 MCA

Retired Member's and Employer's Notice of Post Retirement Employment, Form 146

Deposit and Withholding

Electronic Deposit Application, Form 114

Montana State Withholding Certificate, Form 115

IRS Withholding Certificate for Periodic Pension or Annuity Payments, Form W-4P

Superintendent Membership

County Superintendent Membership Election, Form 134