Get Il 3934 2019-2026

Filling out the IL 3934 form is a crucial step for members of the State Employees’ Retirement System seeking to authorize the release of information regarding their eligibility for disability benefits. This guide provides a clear, step-by-step process for completing the form online, ensuring that users can efficiently navigate the necessary fields and submit their information.

Follow the steps to complete the IL 3934 form online:

1. Press the ‘Get Form’ button to access the IL 3934 form and open it in the designated editor.
2. In the 'Member information' section, begin by entering your name in the format of last name, first name, and middle name.
3. Provide the last four digits of your Social Security Number (SSN) or your Member ID in the designated field.
4. Fill in your address, including the street, city, state, and zip code.
5. Enter your primary phone number in the 'Phone number(s)' section, ensuring to specify if it is your home or cell number.
6. Include your email address in the 'Email address' field.
7. Indicate your date of birth in the provided space.
8. Carefully read the authorization statement regarding the release of your medical and employment records and ensure you understand the implications.
9. Sign your name in the 'Member signature' section to certify that the information provided is accurate.
10. Add the date of your signature in the provided space.
11. If applicable, have a witness (anyone over the age of 18) sign in the 'Witness signature' section and include the date.
12. Once all fields are filled out, review the form for accuracy before saving changes, downloading, printing, or sharing the completed form.

Complete your documentation online today to ensure timely processing of your requests.