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Get 63rd Street, Suite 305 Oklahoma City, Oklahoma 73116-7335 1 (405) 840-3555 / 1 (800) 347-6552

TH NOT IN LINE AND DEATH BENEFIT Surviving Beneficiary SSN Birthdate Deceased Member SSN City Retired Comes now surviving beneficiary of deceased. And hereby makes application to the Oklahoma Police Pension and Retirement Board for a pension and respectfully submits the following: 1 . Please check one: That applicant is a surviving spouse of said officer and was married to said officer for a period of thirty (30) continuous months or more immediately preceding the officer s death. That.

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