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Get ID RS121 2015-2024

Posit of your PERSI benefit payments to a financial institution. Instructions • Read “About Form RS121,” attached. Member Information Name – First, Middle, Last Social Security Number Street or P.O. Box Mailing Address City State Daytime Phone Number (include area code) Email Address Marital Status  Single Zip Code Date of Birth – mm/dd/yyyy Date of Termination – mm/dd/yyyy  Married Name of Last PERSI Employer Effective Date of Retirement - mm/01/yyyy Retireme.

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