Pension Forms
- Act 125 Summary(PDF, 189KB) - Notification for employees hired after February 21, 2014
- Allegheny County Retirees Association (ACRA) Enrollment Form(PDF, 627KB) - Use for initial enrollment and to pay yearly dues
- Application for Membership(PDF, 860KB) - Completed during new employee orientation
- Application for Retirement(PDF, 316KB) - Monthly pension benefit election
- Beneficiaries - Contribution(PDF, 326KB)
- Beneficiaries - Life Insurance(PDF, 593KB)
- Beneficiaries - Life Insurance Extra Coverage Election(PDF, 149KB)
- Beneficiaries - Spousal Acknowledgement(PDF, 307KB)
- Beneficiaries - Survivorship(PDF, 344KB)
- Change of Name or Address(PDF, 283KB)
- Direct Deposit Form(PDF, 319KB)
- Federal W-4P - For use if tax information has changed
- Military - Active Duty(PDF, 3MB)
- Military - Service Prior to Employment(PDF, 2MB)
- Pension Benefit Estimate Form(PDF, 251KB)
- Previous Contribution Withdrawal Repayment(PDF, 313KB)
- Qualified Domestic Relations Order (Sample)(PDF, 30KB) | Guidelines for Domestic Relations Order(PDF, 136KB)
- Re-Employment - Act 125 Acknowledgement Form(PDF, 189KB)
- Re-Employment - Deferred Vested(PDF, 84KB)
- Re-Employment - Non-Vested(PDF, 81KB)
- Re-Employment - Retiree(PDF, 85KB)
- Right to Know Policy(PDF, 201KB)
- Right to Know Request Form
- Six-Month Waiver Repayment(PDF, 321KB)
- Workers' Compensation Deduction(PDF, 336KB) - Authorization for retirement contribution deduction
For more information about which forms to use, please review Member Benefits.