An Important Note: The Request
for a Retirement Estimate is offered as a planning tool for
members of the State-administered retirement systems. By submitting
a request form, a member is not obligated to retire on the date
listed, nor is the option selection or the beneficiary information
binding. The Division does not notify the employer nor any other
institution or person. A member may submit as many forms as he
or she finds necessary in order to make adequate plans for retirement.
Fund
Check Box
Check the box that corresponds to
the pension fund to which the member belongs.
Member Information
The member should include all information
requested to enable the Division of Pensions and Benefits to provide
a correct estimate of retirement benefits. The Division will mail
the estimate to the address listed on this form. Also, it is very
important for the member to include the exact date of birth and
Social Security number.
Prior Retirement Check Box
If a member is requesting a retirement
estimate and has retired once before from public employment in
New Jersey, it is important that he or she check the appropriate
box here. This information could have a huge effect on the estimate
prepared at the Division of Pensions and Benefits.
Three Highest Years Earnings
Most retirement allowances in the
PERS and the TPAF are calculated using the average of the three
highest years' earnings, called the Final Average Salary (FAS).
Usually the last three years are an employee's highest years of
base salary. But in some cases, members have earned higher salaries
in prior years. If the member indicates the years of highest earnings,
the Division will be able to provide a more accurate estimate
of retirement benefits.
BACK
TO TOP
Retirement
Type
The member is asked to choose which
type of retirement he or she would like an estimate for. If eligible
for more than one type, a member may request an estimate for each
one. For more information concerning types of retirement, click
here.
Planned Retirement Date
An estimate can be calculated for
retirements up to two years in advance. All retirements begin
on the first of a month.
Planned Termination Date
Employees must terminate their employer/employee
relationship prior to the date of retirement. For most persons
retiring under a Service, Early, Veteran or Disability Retirement,
the date of termination will be the last day of the month prior
to their retirement date. For Deferred Retirements and some Service
Retirements, the termination date may be well in advance of the
retirement date. By correctly providing this information, the
Division can correctly estimate the amount of service credit a
member will have upon which to base a retirement benefit.
Beneficiary Information
Should a member desire an estimate
that includes amounts for Options 2, 3, 4, A, B, C, or D, beneficiary
information must be included here. The Division will need the
name and birthdate of the prospective beneficiary in order to
complete these calculations.
BACK
TO TOP
Retirement Application
- TPAF and PERS
The Application
For Retirement Allowance is completed in its entirety
by the member. The member's signature is required on the application
in at least two locations. Certain option and beneficiary choices
require additional member signatures, so please check the application
carefully. Make sure the member has signed in all applicable locations,
in order to prevent delays in processing the retirement application.
The signature will be verified when the application is keyed into
the Division's system.
Please note that the application
no longer requires notarization.
Loan information is also no longer
requested on the retirement application. It is assumed that
if the member has an outstanding loan, it will be 'carried' into
retirement. All retirees can 'carry' their loans into retirement
at the same monthly repayment level as when they were an active
member. (Biweekly loan payments are converted to monthly payments
by multiplying the biweekly payment by 2.175.) Interest will continue
to accrue at 4.00% if the member chooses to 'carry' the loan.
The member may choose to pay off the loan in a lump sum before
retiring, by requesting a loan payoff quote and by making the
quoted total payment by the payoff date given.
PART
ONE: Member Information
Pension
Fund
The member's
pension fund (PERS or TPAF) is required in Item 1.
The member checks the correct box.
Membership
Number
The membership
number should be provided. A member's membership number can
be obtained from the Quarterly Report of Contributions
or from the Division of Pensions and Benefits.
Item 3
is the member's Social Security number.
Member's
Personal Data
In Items
4 - 8 of the application, the member's name, address, e-mail
address at home, and the member's phone numbers at home
and at work are requested.
Retirement
Date of Member
In Item
9, the member indicates his or her effective retirement
date. The effective date of retirement must always be the
first of a month. The application must be received in the Division
prior to the member's effective retirement date.
Date
of Birth
Item
10 is for
the member's date of birth. Include the month, day, and
year of birth. Proof of age will be required from the member if
it has not already been submitted.
Salary
Information
In Item
11, the member provides salary information by answering,
"Were the last 3 years of service also the years during which
you earned the highest salaries?"
If "no",
the member can direct the Division to the three fiscal years (July
1 - June 30) that the member feels are the highest. (Certain Veteran
Retirement calculations are an exception.) Three spaces are provided
for each of the member's three highest fiscal years' salaries.
It is not necessary for the three highest fiscal years to be consecutive.
Purchase
Information
For Item
12, the box provided should be checked if the member has applied
to purchase service credit within six months of filing this retirement
application.
Service credit
purchases cannot be 'carried' into retirement. Prior to retiring
the member must make a lump sum payment for the balance of the
service credit purchase to receive full service credit. If the
member does not wish to pay off the balance, the member will receive
prorated credit for the amount of service that has been paid for.
Spouse
Information
In Item 13, the member writes
his or her spouse's name; Item 14 is for the spouse's
home address, if it is different from the member's. This information
is needed for the letter to the member's spouse notifying the
spouse if the member takes the Maximum Option pension benefit.
This letter is sent by certified mail.
If the member is not married, or
is widowed or divorced, the member should write N/A here, for
not applicable.
PART
TWO: Type of Retirement Requested
In Part Two, the type of retirement
the member wishes to select is indicated. The type of retirement
can be any one of the following as long as the member qualifies:
- Service: Age 60, any number of
years of service credit.
- Early: Under 60, 25 or more years
of service credit.
- Veteran: See "Veteran
Status" in the Enrollments
Procedures Guide for all eligibility criteria.
- Deferred: Age 60, at least 10
years of service credit, not in service with employer at retirement.
BACK
TO TOP
PART
THREE: Pension Payment Options
Available
Payment Options in Retirement.
Here, the member chooses a method
of payment from the nine pension payment options available.
The payment option selected by the
member allows the member to determine the type of survivor's benefit,
if any, that will be payable to a chosen beneficiary upon the
retiree's death. Beneficiary information must be supplied
for Options 1, 2, 3 and 4, and also for Options A, B, C and D
(See Fact Sheet
#5). Selecting any of these options (1, 2, 3, 4, A, B, C,
or D) reduces the member's benefit from the Maximum Option Allowance.
There is no monthly pension survivor benefit when the Maximum
Option is chosen.
Once the benefit is "due and
payable", the payment option cannot be changed. When electing
the Maximum Option Allowance or Options 1, 2, 3, or 4, the member
receives the selected benefit for life. However, if the member
chooses options A, B, C or D, and the chosen beneficiary dies
before the member, the member's monthly benefit is increased to
the amount paid under the Maximum Option.
BACK
TO TOP
Retirement
Option Beneficiary
In this section, the member names
the beneficiary who will receive the retirement benefit determined
by the option selected by the member. The beneficiary's
Name, Address, Relationship, and Date of Birth are
required. The SS# is optional.
Under options 2 , 3, A, B, C and
D, only one primary beneficiary may be listed; multiple beneficiaries
are allowed under Option 1 and Option 4. Multiple beneficiaries
are allowed under the Maximum Option as well, but remember, there
is no monthly pension allowance paid to the beneficiary (ies);
the beneficiary (ies) will only receive a return of contributions
if any remain, and the last check benefit.
Since multiple beneficiaries may
be selected by the member for Option 1 or Option 4,
page four of the "Application for Retirement Allowance"
provides space for additional beneficiary information. If multiple
beneficiaries are chosen to receive a return of any unused contributions
under the Maximum Option, this information can be written on page
four as well. The member must then sign and date page four of
the application.
Page four should not be used for
Options 2, 3, A, B, C, or D.
If more than five primary beneficiaries
are chosen for Option 1 or Option 4, or for any unused pension
contributions under the Maximum Option, the additional beneficiaries
can be listed on an attached sheet, signed and dated by the member.
Primary Beneficiaries receive
the survivor's pension benefit as defined by the option selection
(see Pension Payment Options).
If the member chooses multiple primary beneficiaries under the
Maximum Option or Option
1 and one beneficiary predeceases the member, the remaining
beneficiary(ies) will usually split that beneficiary's share.
Some unusual designations are allowable, but uncommon.
Under Maximum and Option 1, the beneficiary
may be any person(s), an institution, charity, their estate, etc.
If the person listed is not related, "friend" should
be listed. If a charity or institution is listed, an incorporation
date is required in lieu of date of birth. Under Maximum, the
beneficiary(ies) will receive any undistributed contributions
remaining at the member's death. If no beneficiary is listed for
the Maximum or Option 1 benefits, any unused pension benefits
will be payable to the member's estate.
Additional primary beneficiaries
should be listed on page four of the retirement application first;
if the member wishes to name more than five primary beneficiaries
for Options 1, 4, or Maximum, the list should be continued on
an attached sheet signed by the member, as noted above.
Contingent Beneficiaries are
paid only if all the primary beneficiaries predecease the member.
The same information is required for contingent beneficiaries
as for primary beneficiary(ies). Under Options 2, 3 ,4, A, B,
C, and D, the contingent beneficiary would only be entitled
to the return of the member's unused contributions, if any, and
a last check benefit (similar to the benefits under the Maximum
Option). Under Option 1,
the contingent beneficiary would receive the amount of the member's
retirement reserve that remains if none of the named primary beneficiaries
are living.
Contingent beneficiaries can be
listed on an attached sheet which is signed and dated by the member.
Member's Signature.
The member must sign and date below
the beneficiary and retirement option information, indicating
that the information is correct, in order for the retirement application
to be processed.
BACK
TO TOP
PART FOUR: Designation
of GLI Beneficiaries.
Group Life Insurance
Non-disability retirees must have
at least 10 years service credit and life insurance as active
members to qualify for Death Benefits. Disability retirees qualify
upon retirement approval if they have life insurance as active
members.
Primary Beneficiary(ies)
The primary beneficiary receives
the group life insurance, if any. If the member chooses multiple
primary beneficiaries and one beneficiary predeceases the member,
the remaining beneficiary(ies) will usually share that beneficiary's
portion. Some unusual designations are allowable, but uncommon.
Unless otherwise stated, if multiple beneficiaries are listed,
they are considered "share and share alike." If the
member had no active group life insurance coverage through the
pension fund, then the member will not have group life insurance
coverage as a retiree.
The following information should
be provided: Beneficiary's Name, Relationship to the member (spouse,
daughter, son, father, mother, friend, grandchild, etc.), Birth
Date of the beneficiary, and SS# of the beneficiary (this is optional,
but helps the benefit processing at the time of member's death).
If no beneficiary is listed, the death benefits will be payable
to the member's estate.
Contingent
Beneficiaries
Contingent
Beneficiaries are paid only
if all the primary beneficiaries predecease the member. The same
required information is needed for these beneficiaries as for
the Primary Beneficiary(ies).
Additional beneficiaries for either
Primary or Contingent beneficiaries can be listed on an attached,
signed and notarized sheet.
SIGNATURE
OF APPLICANT
If the member's
signature is missing, the application can not be processed. If
any additional sheets for the retirement application are attached,
then these additional sheets must also be signed and dated.
BACK
TO TOP
Certification
of Service and Final Salary - TPAF and PERS Retirements
The certification form is completed
by the member's Employer(s). If the member is active at more than
one employer at retirement, all active locations must submit
a complete "Certification
of Service and Final Salary".
If the member had more than one employer
and was only active at one location at the time of retirement,
only that certification is required in full. The inactive locations
must only submit a certification with question #6 completed.
If the member is not active at retirement,
only the last location's certification is required (minimum of
question # 6 to be answered).
Please
indicate the Pension Fund to which the member belongs.
Line 1. Name of Member
(check to ensure correct member).
Line 2 Membership No.(M/S#)
Line 3. Social Security No.(SS#)
Line 4a. Employing Agency
(name of employer)
Line 4b. Employer Location
No. (Employer's pension ID number)
Line
5. Date Service Terminated:
This is the member's last date of
employment with the employer. The member should not be employed
(on payroll) by this employer after this date. (In some PERS cases,
the member may return to limited employment after retirement with
the same employer after at least a 30 day break in service from
the member's retirement date).
Notable Exception: Elected
Officials.
Line 6. Was the Employee Employed
Part-Time?
Please indicate Full-time or Part-time
status here.
Line 7a. Is the member currently
on suspension?
If this is answered YES, the employer
is to state the date suspension began and mark the box stating
if the member is PAID or UNPAID while on suspension.
Line 7b. Is the applicant facing
disciplinary action or indictment?
If this is answered YES, a detailed
explanation must be submitted by the employer. The Division
will review the explanation to determine if it is sufficient for
continued processing, additional information is needed, or submission
to the system's Board of Trustees (BOT) is required.
IF either 7a or 7b are answered
YES, copies of the preliminary and final notices of disciplinary
action, or the equivalents, or a copy of the indictment should
be included.
Line 8. List unpaid leaves of
one month (pay period for state locations) or more, within the
last 12 working months.
This information shows gaps in service
due to Leave of Absence (LOA). Some LOAs can be purchased by the
member. A LOA for a work related incident may indicate a possible
Worker's Compensation claim. If Worker's Compensation is determined,
the employer may be required to submit pension contributions,
until retirement, on the member's behalf.
BACK
TO TOP
Line 9. Base salary subject to
pension fund contributions paid for the last full year of service....
Last 12 months (10 months if applicable)
of salary must be indicated. Salary should be reported by the
number of months at a given salary, the amount of the monthly
base salary, the beginning and ending dates of that salary and
the total base salary for the period. Salary beyond the last reported
quarter is to be projected to the best of the employer's ability.
Line 10. If the member has received
a significant annual salary increase in the last 3 years of employment.?
If the answer is yes, the employer
must furnish cause for the increase, with documentation.
The Division may approve the increase, if justifiable, deny the
increased salary, or forward the case to the Board of Trustees
for determination.
Line 11. Has there been any retroactive
salary paid to the employee within the past three years?
A retroactive salary increase can
falsely inflate a member's salary if it is not properly credited
back to the correct dates. Retroactive salaries can also incorrectly
show a single salary increase, when in fact it may cover several
years of increases. The beginning and ending dates should show
for each retroactive increase and the corresponding new
annual base salary.
If the member receives a retroactive
raise after the original Certification has been sent to the Division,
a new Certification must be sent in. The new Certification should
state 'Amended' or 'Revised for Retroactive Raise.'
See the Quarterly
Report of Contributions: Revised Certification Section.
Line 12. The following deductions
have been made or will be made from the member's base salary during
the final two quarterly periods including the quarter in which
service terminated.
The employer indicates the actual
and/or projected base salary subject to pension contributions
for the last two quarters preceding the member's termination date.
Also noted in this section are the amounts of actual and/or projected
payroll deductions for: Pension Contributions, Loan Repayment,
Back Deductions (including the number of payments taken), Arrears
(and/or Purchases) deductions, and the Total Pension Deductions
taken (and/or projected to be taken) by the employer and remitted
to the Division for this member.
State employers must attach
a screen print of the member's TREADHOC biweekly certification
with salaries projected until termination date in lieu of completing
Item 11.
Completed by: denotes who
actually completed the form.
Phone number is the phone
number of the person who completed the form. This number allows
us to directly contact the employer for any follow up questions
we may have on the Cert.
Signature of Certifying Officer
is where the individual responsible for this information at each
location signs that this information is correct. Each location
has one Certifying Officer. This signature must be an original
signature and can not be a stamped signature.
Date is when the form
was signed by the Certifying Officer. The date signed is helpful
when more than one Certification is received by ensuring that
the most recent Certification is used. Usually more than one Certification
is received when there is a retroactive raise (marked "Revised
for Retro" or "Retroactive Raise") or a change
in the Certification (marked "Amended").
NOTE Concerning Workers' Compensation:
If the member is receiving
periodic payments from Workers' Compensation, the employer may
be required to pay the member's pension contributions until the
member's effective date of retirement. No loan payments, back
deductions, or arrears payments are required from the member or
the employer while the member is on Workers' Compensation. Whenever
possible, an official statement of the Workers' Compensation award
showing the amount of the periodic benefits and the beginning
and ending dates of the benefits awarded should be attached, or
mailed in under separate cover.
BACK
TO TOP