Application For Membership (PDF)
Membership application.
Application For Retirement Package (PDF)
Application for retirement and other required documents to be submitted 60 days prior to desired date to begin drawing benefits.
Automatic Dues Payment (PDF)
To instruct your bank to pay your dues electronically.
Change of Address (PDF)
To be completed and submitted every time your address & contact information changes.
Change of Beneficiary (Prior to Retirement) (PDF)
Change of Beneficiary notice.
Change of Status Form
Used by members when transferring their service from one department to another. Also used by members when changing status, such as, from part-time to full-time.
Leave of Absence Request (PDF)
Form used to request a leave of absence, must be renewed every two years.
Non-Vested Death Benefit (PDF)
Submitted by the designated beneficiary upon the death of a member who is not vested.
Part Time Creditable Service Affidavit (PDF)
Required form for part-time firefighters to certify their service.
Purchase of Prior Service Application (PDF)
To be completed and submitted when applying for “Buy Back” time.
Refund Request (PDF)
Used to request a refund of dues paid when no longer a member of the pension fund.
Request For Hearing Form (PDF)
Form used to request a hearing before The Board of Trustees
Retirement Application Form (PDF)
An application for retirement to request retirement at a later date, to be submitted 60 days prior to leaving the fire service.
Retiree Beneficiary Information (PDF)
Used to select your retirement option and name your beneficiary.
Retiree Direct Deposit (PDF)
Used by retirees or surviving beneficiaries to arrange for the automatic deposit of your retirement benefit to your bank account.
Retiree instructions for Northern Trust (PDF)
Instructions for logging into Northern Trust for retirees to view payment activity, change address, change tax withholdings, and request a reprinted 1099R.
Social Security Determination Letter (PDF)
Letter to assist retirees with filing for social security.
Tax Withholding Request and W-4P Certificate (PDF)
Used by retirees or surviving beneficiaries to have or change state and/or federal tax withheld from their benefit payment.
Transfer Form (PDF)
Used by members when transferring their service from one department to another. Also used by members when changing status, such as, from part-time to full-time.
Volunteer Service Affidavit (PDF)
Required form for volunteer firefighters to calculate and certify their service.