Retirement Estimate Request Form


To process your retirement, you must meet with Krysten Wallace. She will contact you shortly after reciept of this form.


If you are a long way off and just daydreaming of when you can retire, you can get an idea of what your retirement benefit will be by going to our retirement calculation page. Retirement requests are intended for those individuals who are within a year of retiring from their position.




Please, complete the following

Name on our records
Social Security Number
Your spouse's name, if unmarried write in NA
Your spouse's date of birth

Street Address
City
      State
Zip code

Phone number
Email address

When and where do you plan to retire from?

Date you are planning to retire
Age on retirement date
Years of service
Highest salary averaged from 3 consecutive earning years
      Current Employer

Please check one:

Group 1 Group 2 Group 4


By selecting below, you are agreeing that this information is accurate and that you are the person responsible for this pension account.

I Agree I Disagree

Comments? Please inform us of any concerns you may have so that Krysten Wallace can begin to prepare for your meeting.