Change Of Address Form - Maryland printable pdf download

Change Of Address Form - Maryland

Maryland Race Track Employees Pension Fund

911 Ridgebrook Road

Sparks, Maryland 21152-9451

Telephone: (410) 683-6500

(800) 638-2972

Change of Address Form

Dear Participant,

Please complete this “Change of Address” form and return to:

Fund Office

Pension Department

911 Ridgebrook Road

Sparks, MD 21152-9451

Old Address: __________________________________________________________________

Street Address

__________________________________________________________________

City/State/Zip Code

*New Address: _________________________________________________________________

Street Address

_________________________________________________________________

City/State/Zip Code

Effective Date of Change: ________________________________________________________

Phone Number with Area Code: ___________________________________________________

Social Security Number: _________________________________________________________

Print Name: ___________________________________________________________________

Signature: ____________________________________________________________________

*Due to a recent change in our procedures, the Fund Office now requires that if you wish for

your check to be mailed to your Post Office Box that you also provide us with a street

address. Be advised that if you provide us with a Post Office Box then your Post Office Box

will be used as your mailing address.

MRT Change of Address Form (Pension)

8/2013 arh

Change Of Address Form - Maryland