Welcome to NPERS!
Welcome to NPERS!


        





Forms Download

 
  Welcome to the NPERS Forms Download page.   Downloading and printing forms from this web site ensures you are using the most up-to-date version of the form NPERS has available.
 

All forms are in the Adobe Acrobat format. You will need the reader to view them. Download it here if you do not already have it.

NOTE: NPERS is in the process of upgrading the forms on our website. These enhanced forms contain "open" fields allowing users the option to:
1. Enter information using their computer.
2. Print, sign, date, and notarize (if needed).
3. Then submit to our office.   Note: DCP forms must be submitted to your human resources or payroll department.

Member Forms

  • Beneficiary Designation (pdf):
  •  (Enhanced Form - see above) To designate or change your beneficiaries, complete this form, sign in front of a notary, and submit to NPERS.

  • Federal & Nebraska Tax Withholding - Pension (pdf):  
  • (Enhanced Form - see above) Retired plan members who are receiving a monthly retirement benefit (annuity) may use this form to change their income tax withholding. For more information on Federal withholding, please visit the IRS Website

  • Direct Deposit (pdf):
  •  (Enhanced Form - see above) Plan members who are receiving a monthly retirement benefit may wish to have payments deposited directly into a designated bank account. Use this form to set up a new account, change an existing account, or switch from direct deposit to the prepaid Visa Debit card.

  • Prepaid Visa Debit Card (pdf):
  •  (Enhanced Form - see above) Plan members who wish to have their monthly retirement benefits deposited directly into a ReliaCard prepaid Visa Debit card should complete this form. ReliaCard frequently asked questions.

  • Investment Election Form (Defined Contribution only) (pdf):  (Enhanced Form - see above) State and County members can submit this form to change future investment allocations or transfer existing funds.


  • Investment Election Form (DROP participants only) (pdf): (Enhanced Form - see above) State Patrol DROP members can submit this form to change future investment allocations or transfer existing funds.


  • DCP Plan Change (pdf): (Enhanced Form - see above) Members participating in the Deferred Compensation Plan use this form to change contribution amounts, investment allocations, or transfer funds. NOTE! The completed form must be submitted to your agency payroll personnel for processing.


  • DCP Enrollment Form (pdf): (Enhanced Form - see above) Members who wish to enroll in the Deferred Compensation Plan should complete this form and submit to your agency payroll personnel for processing.


  • Application for Vesting Credit - State & County (pdf): (Enhanced Form - see above) For State and County plan members who are requesting vesting credit for prior participation in another Nebraska Governmental Plan.


  • Application for Vesting Credit - School & Patrol (pdf): (Enhanced Form - see above) For School and Patrol plan members who are requesting vesting credit for prior participation in another Nebraska Governmental Plan.


  • School Refund Application: Click here to be linked to the School Plan Information page. This page provides critical information you should know before applying for a refund, and the required forms.


  • Address & Name Change Form - INACTIVE MEMBERS ONLY pdf): (Enhanced Form - see above) This form is only to be used by terminated members who have deferred or delayed taking distributions from their account (Inactive Member). If you are actively employed by the Nebraska School, State, County, Judges or State Patrol; all demographic changes must be submitted to your employer.

Employer Forms


State & County Plan Forms School Plan Forms Deferred Compensation Plan Forms Judges Plan Forms State Patrol Plan Forms



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