Get 02/08 Pmrb-5a Notification Of Change Important: This Form Is To Request Pmrs To Adjust The Record

This guide offers step-by-step instructions on how to correctly complete the 02/08 PMRB-5A Notification of Change form, designed for users requesting changes to their pension plan records. By following this guide, you will ensure that your information is accurately and effectively communicated to the Pennsylvania Municipal Retirement System (PMRS).

Follow the steps to fill out the form correctly.

1. Press the ‘Get Form’ button to obtain the form and open it in your preferred document editor.
2. Begin by entering the name of the employee or retiree at the top of the form along with the last four digits of their Social Security Number (SSN). Also, include the name of the municipality.
3. Fill in the effective date of adjustment, specifying the exact date using the format MM / DD / YYYY.
4. Enter the municipal code number consisting of three sets of digits, formatted as XXXXX-XXXX-XXX.
5. Indicate the changes requested by checking the appropriate boxes. Provide details for the corrected name, old and new addresses, Social Security number, and date of birth as necessary.
6. If applicable, specify the date of return to active service by referring to the 'Effective Date of Adjustment' entered previously.
7. Complete sections 6, 7, and 8 if documentation is required for reinstating previous service, certifying undocumented service, or requesting to purchase service. Attach any necessary documentation as instructed.
8. Fill out details regarding any leave without pay (LWOP), including start and return dates, and select the type of LWOP. If employment has been terminated, be aware that a different form (PMRB-4) is necessary.
9. Ensure that you have signed the form where indicated, and that the certifying plan official also provides their signature and information.
10. Once completed, save your changes. You may also choose to download, print, or share the filled-out form as needed.

Complete your PMRB-5A form online today to ensure your information is up-to-date.