Public Employees' Retirement Fund - Change Of Name Or Address - Indiana Public Employees' Retirement Fund Form

Public Employees’ Retirement Fund

Change of Name or Address

If you are receiving a monthly benefit, a refund of your contributions, or are an active

contributing member, it is important that you keep your name and address current with

PERF. Failure to do so may cause a delay in payments and/or correspondence with you.

Please print. Be certain to complete all blocks. Be sure to include your Social Security

Number.

If you are requesting a change of name, you must include the appropriate legal

documentation: Marriage License, Divorce Decree, or Court Order.

When you have completed this form, mail the form and any additional documents to the

following address:

Public Employees’ Retirement Fund

143 West Market Street

Suite 800

Indianapolis, IN 46204

0 votes

Parent category: Legal