S 9996 Special Power of Attorney (POA) for PERS This form is for all PERS retirement programs. Call or visit our website if this is not the form you need. Section A: Applicant information (Type or print clearly in dark ink. Illegible forms could be returned to you, which could delay your request.) First name MI Last name Social Security number* Mailing address (street or PO box) City PERS number (optional) State Zip Day phone number Country Evening phone number Date of birth (mm-dd-.
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How to use or fill out the OR 459-260 online
Filling out the OR 459-260 form is an important step in managing your Oregon Public Employees Retirement System (PERS) benefits. This guide will help you understand each section of the form and provide clear instructions for completing it accurately and efficiently.
Follow the steps to successfully complete the OR 459-260 online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
- Complete Section A with your personal information. Write your first name, middle initial, and last name clearly. Provide your Social Security number, mailing address, PERS number, birth date, and contact numbers.
- In Section B, provide information about your attorney-in-fact. If you are designating multiple attorneys-in-fact, select whether either may sign or both must sign.
- Fill out the names and mailing addresses for all attorney(s)-in-fact you are appointing. Ensure that they sign where indicated, along with the date they are signing.
- If applicable, list your 1st and 2nd alternate attorney(s)-in-fact with their names and mailing addresses. Include their signatures and signing dates.
- In the principal’s signature section, sign your name and date the document to validate your Power of Attorney.
- Review the completed form for any errors or legibility issues. Once satisfied, you can save your changes, download a copy, print the form, or share it as necessary.
Complete your OR 459-260 form online today to manage your PERS benefits effectively.
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