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Get PA PSRS-1259 2012-2024

Rvice PSERS Health Insurance Program Membership PSRS-1259 (08/2012) Multiple service membership is the election to combine PSERS and SERS account information at retirement, which usually enhances the retirement benefit for members who elect multiple service membership. If you are not electing multiple service membership, do not return this form. A Member Information Member Correspondence Address Member Name Social Security Number Sex Check here if new address Street Address City Date of B.

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