Get 10 28 84 26

Completing the 10 28 84 26 form online can be a straightforward process with the right guidance. This guide will provide you with clear, step-by-step instructions to ensure you fill out the form accurately and efficiently.

Follow the steps to successfully fill out the 10 28 84 26 form online.

1. Click ‘Get Form’ button to access the form and open it in the online editor.
2. In Part A, provide your participant identification information. Fill in your name (last, first, middle), NDPERS Member ID, last four digits of your Social Security number, date of birth, department or agency, and NDPERS Organization ID.
3. Proceed to Part B, where you will indicate your intention to defer retirement benefits. Enter the month and year you wish for your benefits to begin, and choose whether you are in the Defined Benefit Plan or Defined Contribution Plan.
4. In Section 1 of Part B, select your retirement payment option by checking the appropriate box for either Monthly Benefit Payment or Periodic Payment.
5. In Section 2 of Part B, choose the retiree health credit option that applies to you. If married, make sure to select the corresponding checkbox for your opted choices.
6. If you are a Defined Benefit Plan participant, complete Part C regarding sick leave conversion, indicating whether you wish to purchase unused sick leave into retirement service credit.
7. Finally, in Part D, you must sign and date the authorization to validate your form. Make sure all information is accurate before submission.
8. Once all sections are filled out, save your changes, and download or print the completed form for your records or submission.

Start completing your 10 28 84 26 form online today!