Division of Pensions and Benefits

Governor Chris Christie • Lt.Governor Kim Guadagno



	Disclaimer

CHANGE OF ADDRESS FORM FOR RETIREES

PLEASE NOTE! Retirees who are registered users of the Member Benefits Online System (MBOS) should use the "Change of Address" application in MBOS. Registered MBOS Users Log on Here! or find out how to Register for MBOS!

If you are retired and currently receive a monthly retirement check, use this form to send a change of address to the New Jersey Division of Pensions and Benefits.
If you have applied for and are pending retirement, but have not yet received your first retirement check, please use the Pending Retirees' Change of Address form.

Enter all information and press the "Submit" button 1. MEMBER INFORMATION
Name: (First/MI/Last/Suffix)
Retirement Number: (Found on pension check stub)	- -
Social Security Number: (Last 4 digits only)	XXX-XX-
Date of Birth: (Month/Day/Year)	/ /
Home Phone Number: (Include Area Code)	- -
E-mail Address:
2. OLD ADDRESS
Street:
Apt. or P.O.Box:
City:
State:
Zip Code:	-
3. NEW ADDRESS
Street:
Apt. or P.O.Box:
City:
State:
Zip Code:	-

Last update: May 14, 2012

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