Montana Public Employee Retirement Administration

Basic Forms (PDFs)

Basic Forms (PDFs)
Form Description
Designation of Beneficiary-NonStatutory The NonStatutory membership form is for new hires and for current PERS, JRS, GWPORS, and SRS members who wish to change their designated beneficiaries.
Designation of Beneficiary-Statutory The Statutory membership form is for new hires and for current HPORSMPORS, FURS, and VFCA members who wish to update their statutory beneficiaries or change their designated beneficiaries.
Certification of Compensation and Service Hours Certification of employee compensation and hours.
Certification of Service to be Purchased for Out of State Public Service

Certification of Service to be Purchased for Out of State Public Service.

Election and Certification to Purchase Absence This form is for the certification and purchasing of service credit for absent time covered under the Uniformed Services Employment and Re-employment Act (USERRA), and Workers' Compensation.
Health Insurance Authorization A retiring member may authorize MPERA to deduct health insurance premiums from their retirement benefit.
Name Change If your employee changes their name, please have them complete this form, return it to you, the employer, so that you may update your datafile with the new information, and then you, the employer, return it to MPERA.
Portal Access Manager Security Agreement Must be completed by new primary users to access the MPERA Online Payroll Reporting System.
Retirement Fund Information If an employee terminates, please give them this information regarding their retirement funds
VFCA Roster Printable roster for VFCA Fire Chiefs.

 

PERS Optional Membership Form (DocuSign)

DocuSign is a secure online location where you sign in and fill out an MPERA form. Upon completion, the form will automatically be sent to MPERA for processing.

PERS Optional Membership Form (DocuSign)
Form Description

Public Employees' Retirement System (PERS)

New employees hired into certain optional positions may elect to join PERS. 

 

Optional Membership Forms (PDFs)

Optional Membership Forms (PDFs)
Form Description
Public Employees' Retirement System (PERS) New employees hired into certain optional positions may elect to join PERS. 
SD Flowchart Optional Membership flowchart for School District employees.
Non-SD Flowchart Optional Membership flowchart for non-School District employees.
Part-Paid FireFighter Optional Membership form Part-paid firefighters who meet the eligibility requirements may elect to join FURS.

 

Local Elected Official Optional Membership Forms (PDFs)

Local Elected Official Optional Membership Forms (PDFs)
Form Description
Current PERS Member A person who is an active member of PERS may elect to participate in PERS as a local elected official. This applies only to positions with less than 960 hours in a fiscal year.
Retired PERS Member A person who is a retired member of PERS may elect to participate as an active member of PERS as a local elected official.
Non-PERS Member A person who is not a member of PERS may elect to participate in PERS as a local elected official.