All members of the State Pension Plan will need to fill out this form whenever they change their address or status within the State Pension System. Any member who has moved since entering the plan and is not currenty receiving their annual statement should submit this form. Any questions please contact Joseph Malloy.

For a change of addresss only please print "Change of Address" on the top of the form. (5/27/05) 

EMPLOYEE ACTUARIAL INFORMATION.pdf