Get Pers Disability Retirement Mississippi

This guide provides a detailed overview of how to complete the Pers Disability Retirement Mississippi form effectively. Designed to assist users with various levels of familiarity, this document will walk you through each section of the form with clarity and support.

Follow the steps to fill out the Pers Disability Retirement Mississippi form online.

1. Press the ‘Get Form’ button to access the Pers Disability Retirement Mississippi form and open it in your preferred editor.
2. Begin with the member information section. Provide the required details, including your first name, middle initial, last name, gender, social security number, birth date, email, mailing address, and phone number. Select your disability type as either non-duty related or duty related.
3. If applicable, indicate whether you served active duty in the U.S. Armed Forces. If you select yes, be sure to attach Form DD214.
4. Select your retirement plan from the available options. Make sure you choose the appropriate plan: Public Employees’ Retirement System of Mississippi (PERS), Mississippi Highway Safety Patrol Retirement System (MHSPRS), or Supplemental Legislative Retirement Plan (SLRP).
5. In the potential beneficiaries section, provide the name, social security number, birth date, and relationship of a potential beneficiary. If you have a second beneficiary, fill in the corresponding fields.
6. Review and complete the applicant authorization section. Sign and date the form, ensuring that you understand the implications of the authorization. If an authorized representative is signing, attach relevant documentation.
7. The employer certification section must be completed by an authorized employer representative. This includes verifying member information, the position held, and significant dates regarding employment.
8. If applicable, provide information regarding projected unreported gross earnings and leave payments, ensuring to specify all relevant figures accurately.
9. In case of salary increases during the 24-month period prior to retirement, the employer representative must certify these increases with the required details.
10. After ensuring that all sections are completed accurately, save your changes and download or print the completed form for submission.

Complete the Pers Disability Retirement Mississippi form online today to ensure a smooth application process.