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Public Employees Retirement Association of New Mexico
PERA Refund Beneficiary Form
Important Information You Should Know About Completing a PERA
Refund Beneficiary Form
Public Employees Retirement Association of New Mexico
Frequently Asked Questions
A one-time refund benefit is paid by PERA in the event of your non-duty death.
You may only choose either one person or one organization as your Refund Beneficiary.
If you and your beneficiary pass away at the same time your account (your member contributions and the interest) will be refunded to your estate.
Public Employees Retirement Association of New Mexico
Member Information Section
999-99-9999 01/01/1960
Mary Smith
505-222-1234
P. O. Box 111
Albuquerque NM 87000 XX
X
Public Employees Retirement Association of New Mexico
Beneficiary Information Section
John Smith Spouse 888-88-8888 02/02/1959 P. O. Box 111, Albuquerque, NM 87000505-222-1234
ORThe Organization’s Name Address / Telephone Number 123-45-6789
John Smith Mary Smith
The Organization’s Name
January 1, 2008John Smith
Public Employees Retirement Association of New Mexico
Member Authorization Section
Mary Smith 01/01/2008
Santa Fe
Mary Smith 1 January 2008
06/10/2010 505-123-1234
Maria Trujillo
Public Employees Retirement Association of New Mexico
Completing the Form
Once you have completed the form: Make a copy for yourself, Give a copy to your employer, and Send the original form to PERA.
You may check the PERA website www.pera.state.nm.us after 4 - 6 weeks to see if your beneficiary information has been added/changed.
If you have any questions concerning this form or any other issue, please contact PERA at 1-800-342-3422.