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.
 

All forms are in the Adobe Acrobat format. NPERS recommends using the Adobe Reader to properly view them. 3rd party viewers or web browser viewers may not properly view or print data from fillable fields. Download it here if you do not already have it.

NOTE: Most of NPERS forms contain fillable 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 or change an existing account.


  • 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.


  • Rollover to Financial Institution (pdf): (Enhanced Form - see above) This form is required in order for NPERS to process a rollover. NPERS cannot process a rollover until we are in receipt of a completed, signed and notarized, Request for Distribution or Refund form.


  • Rollover to Financial Institution for Beneficiary (pdf): (Enhanced Form - see above) This form is required in order for NPERS to process a rollover for a beneficiary. NPERS cannot process a rollover until we are in receipt of a completed, signed and notarized, Request for Distribution or Refund form.


  • 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.


  • School Member - Early Retirement Inducement & Termination Certification (pdf) (Enhanced Form - see above) All terminating School plan members should complete this form and submit to NPERS.


  • Address & Name Change Form (pdf): (Enhanced Form - see above) Terminated members can submit this form to update their address, or notify our office of name changes. If you are actively employed by the Nebraska School, State, County, Judges or State Patrol, these demographic changes must be submitted to your employer.


  • Patrol Member - Verification of Service Request (pdf) Patrol plan members may submit this form to NPERS to request a tentative verification of service from NPERS up to one year but no less than 180 days prior to retirement or entering DROP.

Employer Forms


State & County Plan Forms

School Plan Forms

Deferred Compensation Plan Forms

Judges Plan Forms

State Patrol Plan Forms