Form 18-Service Retirement Application Form-Hawaii Employees' Retirement System

Download a blank fillable Form 18-Service Retirement Application Form-Hawaii Employees' Retirement System in PDF format just by clicking the "DOWNLOAD PDF" button.

Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.

Complete Form 18-Service Retirement Application Form-Hawaii Employees' Retirement System with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.

Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.

ADVERTISEMENT

Rev. 1/2017
Instructions for Completing Service Retirement Application
The following instructions will help you complete the Service Retirement Application - Form 18.
I.
PERSONAL DATA
Name: Last, first, and middle name.
Social Security Number: Your 9-digit number.
Mailing or PO Box Address: Address for the receipt of ERS mail. Any change in your mailing address must
be reported to the ERS in writing to ensure proper delivery of notices, statements, and tax forms to you.
st
st
st
Retirement Date: Your retirement date must be the 1
day of a month or the 1
or 31
day of December. It
cannot be the same day as your last day of work.
Date of Birth: The month, day, and year of your birth.
Position Title: Your position or job title.
Department/Division or School: The name of the Department and/or Division you are employed with, and/or
the name of the school where you work.
Employer: Check off whether you work for the State, County (identify which County), or Board of Water
Supply.
Contact Phone Number: Provide the best phone number where the ERS can reach you during our business
hours for any questions regarding your retirement benefits.
Home, Cellular Phone: Check appropriate box(s) for the contact phone number provided.
Email Address: Provide an email address for an optional method of contact.
II.
RETIREMENT OPTIONS
Select your retirement plan and only one retirement option. Enclosed is the “Features of Retirement Plan
Options” which provides an explanation of options available.
You may change your option at any time prior to your retirement date. Option changes are not allowed once
your retirement is effective.
III. BENEFICIARY DESIGNATION
List your beneficiary’s name, social security number, their relationship to you, and their date of birth. If you
select an option that allows designation of multiple beneficiaries, provide the Social Security number of the first
beneficiary. Also, clearly indicate the proportionate share each beneficiary should receive. For example, “In
equal shares or to whoever survives.”
IV. SIGNATURE
You must sign the application in the presence of a Notary or an ERS representative.
1

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go
Page of 3