Get Npers Form

Filling out the Npers Form online can seem daunting, but with this guide, you will have a clear understanding of each section and field. This form is essential for notifying the Nebraska Public Employees Retirement Systems about changes in employment status.

Follow the steps to accurately complete the form:

1. Press the ‘Get Form’ button to obtain the form and open it for editing.
2. Begin by entering your personal information. Fill in your Last, First, and Middle name along with your Date of Birth. Ensure that your Social Security Number is noted accurately without any missing digits.
3. Next, provide your Address details including City, State, Zip, and County. This information is crucial for accurate identification.
4. Select the Plan Type by checking the appropriate box to indicate whether you are a State/County Non-Contributing Member.
5. In the Ceased Employment section, indicate the Termination Date and the Date of Final Pay. Make sure to include the Gross Final Pay amount along with confirming whether an Emergency Warrant was issued.
6. Choose the Reason for Termination by checking one of the provided options such as Resigned, Deceased, Disability, or Retired. If applicable, provide details regarding any Transfer.
7. If you were dismissed, indicate whether there is a grievance or appeal pending by selecting Yes or No.
8. In the Leave or Intermittent Status section, document your Last Pay Date and select the Reason for Change in Status from options like Military Leave or Family Medical.
9. If you anticipate returning to work, provide the Anticipated Date of Return. Ensure all information is filled accurately.
10. Finally, certify the information by signing in the Agency/County Signature field, along with the Date, Typed name of Agency Contact, Title, and Telephone Number.
11. Once you have filled out the form, you can save your changes, download a copy, print it, or share it with your relevant agency.

Complete your Npers Form online today to ensure a smooth process for your employment status changes.