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Get Form Aa For Web.qxp - Opers - Opers

St verification of service that was not previously reported to OPERS. Section 1 - Personal Information First Name Social Security Number Last Name Middle Name Apt. Number Street or Mailing Address State City ZIP Code - OH Are you currently a member or have you been a member of any of the following retirement systems? (if applicable, check either Retired or Refunded) Gender Retired Refunded Yes No Male Female State Teachers Retirement System (STRS) Date of Birth or School Employees R.

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