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Get PA PSRS-1273 2015

Ation for Release of Information PSRS-1273 (06/2015) SS# I, _________________________________________, hereby authorize the Public School Employees' Retirement System Member's printed name (PSERS) to release information which he or she may request in regard to my account to the following individual(s): Name(s) Relationship to Member Business (if applicable) I authorize the foregoing individual(s) access to the following account information – (check items that PSERS may release): Financial .

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