Retiree Defined Benefit Forms

Forms Policy

1. Digital signatures are not accepted by NDPERS.
2. Completed forms must be submitted to NDPERS by fax, by mail, or as a scanned PDF.
3. NDPERS does not accept picture files such as .jpeg, .jpg, .tif, or .png.

Select a form to download:

• Authorization for Direct Deposit for Annuity Payment (SFN 18379)
• Designation of Beneficiary for Group Life Insurance Plan (SFN 53855)
• Designation of Beneficiary for the Group Retirement Plan (SFN 2560)
• Withholding Allowance Election for Pension Payments (SFN 51506) and W-4P

Other general forms:

• Authorization to Release Confidential Information (SFN 61324)
• Notice of Change for Name & Address (SFN 10766)