Benefit and Retirement Forms

*Some of these forms may require Adobe Acrobat Reader 5.0 or later

403(b) Salary Reduction Agreement

457(b) Salary Deferral Agreement

Change of Address - CMU

Dental Claim Form - Weyco

Dependent Day Care Flexible Spending Account, Request for Reimbursement

Dependent Day Care Receipt Form

Dependent Day Care W-10 form

Fidelity 403b SRA enrollment application (employee contribution)

Fidelity Beneficiary Designation

Fidelity RA enrollment application (university contribution)

FSA Direct Deposit Form

Hartford Evidence of Insurability Form

Health Care Flexible Spending Account, Request for Reimbursement

Maximizing Tax-Deferred Investment Contributions Worksheet

MPSERS Beneficiary Designation

Plan Cost Calculator

Retirement Vendor Allocation Form-R6 (university contribution) for Office Professional, hourly Public Broadcasting

Retirement Vendor Allocation Form-R8 (university contribution) for Service Maintenance, Supervisory Technical, hourly Professional Administrative

Retirement Vendor Allocation Form-R10 (university contribution) for salaried Professional Administrative, salaried Public Broadcasting, Senior Officer, Temp Faculty, Regular Faculty, Police

Retirement Vendor Allocation Form-R12 (university contribution) for employees in the 12% Retirement Plan

Status Change Form

TIAA-CREF 403(b) GSRA enrollment application (employee contribution)

TIAA-CREF 457(b) GSRA enrollment application (employee contribution)

TIAA-CREF Beneficiary Designation Form

TIAA-CREF RA enrollment application (university contribution)

Tuition Waiver