Basic Forms (PDFs)
Form | Description |
Certify Service/Salary | Certification of employee compensation and hours. |
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 and 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.
Form | Description |
New employees hired into certain optional positions may elect to join PERS. |
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)
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. |
Membership/Beneficiary Designation Forms (PDFs)
Form | Description |
PERS Membership/Designation of Beneficiary Form | The Public Employee Retirement System membership form is for new hires and for current PERS members who wish to change their designated beneficiaries. |
JRS Membership /Designation of Beneficiary Form | The Judges' Retirement System membership Form is for new hires and for current JRS members who wish to update their statutory beneficiaries or change their designated beneficiaries. |
HPORS Membership /Designation of Beneficiary Form | The Highway Patrol Officers' Retirement System membership form is for new hires and for current HPORS members who wish to update their statutory beneficiaries or change their designated beneficiaries. |
SRS Membership /Designation of Beneficiary Form | The Sheriffs' Retirement System membership form is for new hires and for current SRS members who wish to change their designated beneficiaries. |
GWPORS Membership /Designation of Beneficiary Form | The Game Wardens' and Peace Officers' Retirement System membership form is for new hires and for current GWPORS members who wish to change their designated beneficiaries. |
MPORS Membership /Designation of Beneficiary Form | The Municipal Police Officers' Retirement System membership Form is for new hires and for current MPORS members who wish to update their statutory beneficiaries or change their designated beneficiaries. |
FURS Membership /Designation of Beneficiary Form | The Firefighters' Unified Retirement System membership Form is for new hires and for current FURS members who wish to update their statutory beneficiaries or change their designated beneficiaries. |
VFCA Designation of Beneficiary Form | The Volunteer Firefighters' Compensation Act Designation of Beneficiary Form is for volunteer firefighters to name their statutory beneficiaries. |