Employers' Pensions and Benefits Administration Manual (EPBAM)
   

 

Shortcuts

Information by Employer Task

 

Police and Firemen's Retirement System
Retirement Forms and Instructions


Instructions for the Request for Retirement Estimate

  • Estimates for a retirement allowance must be completed online through MBOS, or by calling the Division’s Automated Information System at (609) 292-7524.
  • To access the application online, click the “Retirement” button on your MBOS Home Page, then the “Retirement Estimate” button on the MBOS Sub-Application Menu.
The member is under no obligation to retire when an estimate is obtained. In fact, it is not unusual to obtain multiple estimates for several different dates. The only limitation is that the estimate is calculated before a projected retirement date, and not more than two calendar years in advance.

 

Name, Membership Number, and Birth Date

Your Name and Membership Number should automatically be filled in when you access the Retirement Estimate Calculator through your MBOS. Enter your Date of Birth by month, day, and year.

Retirement Type

The member must choose the “type” of retirement for which an estimate is needed. Discussion of the several types of retirement are listed on the PFRS Retirements page.

If a member is eligible for more than one type of retirement, a separate estimate may be requested for each type.

If a member is eligible for more than one type of retirement, a separate estimate may be requested for each type.  A separate estimate form is required for each type of retirement selected.

Retirement Date

All retirements under the PFRS must commence on the first of the month. An estimate may be generated up to two calendar years in advance of the date of request.

Termination Date

For a retirement to be approved, a retirement applicant must have terminated the relationship with the employer no later than the day before the date of retirement. In other words, all service must have ceased before the retirement date, even if there are still payments outstanding in the payroll system.

Most members plan to work until immediately before retirement. Some members, however, may choose to terminate their employer/employee relationship well in advance; for example, a member contemplating a Deferred Retirement. Because the date of termination of employment will affect the accumulation of service credit in a member’s account, be sure to include the anticipated date of termination on the estimate request.

Add Beneficiary

There are specific survivor benefits for the spouse, civil union partner, or eligible same sex partner of a PFRS retiree. By providing this information, the member can receive an estimate of any survivor benefits after retirement. If the member is single or divorced, no beneficiary information should be included.

BACK TO TOP


Instructions for the PFRS Application for Retirement Allowance

  • PFRS Applications for Retirement Allowance must be completed online through MBOS.

  • Mail photocopies of the verification documentation at the time the online retirement application is submitted to:

    Retirement Bureau,
    Division of Pensions and Benefits
    PO Box 295
    Trenton, NJ 08625-0295

BACK TO TOP



Retirement Application - PFRS
The PFRS Application for Retirement Allowance is completed
in its entirety by the member online using MBOS.

Part One: Member Information, Retirement Date and Type, Spouse/Civil Union Partner/Eligible Same-sex Domestic Partner/Dependent Information

The membership number is the first item required on the application.

Items 1-8. Member Information

The items on the first page of the application request the member's name, address, employer name, job title, Social Security number, date of birth (proof of age will be required from the member if it has not already been submitted), and the member's phone numbers at home and work.

Item 9. Outstanding Loans

The member needs to inform the Division if an outstanding loan will be "carried" into retirement or will be paid in full prior to retirement.

  • All retirees may 'carry' their loans into retirement at the same monthly repayment level as when they were active members.
  • Biweekly loan payment schedules are converted to monthly payments by multiplying the biweekly payment by 2.175. 
  • The member may choose to pay off the loan in a lump sum. 
  • Interest will continue to accrue at 4.00% if the member chooses to "carry" the loan into retirement.

Item 10. Effective Retirement Date of Member 

Provide t he effective date of the retirement (always the first of a month). The application must be received in the Division prior to the member's effective retirement date.

Item 11. Type of Retirement Requested

Service: Age 55, any number of years of service credit. Click here for more information about Service Retirement.

Special: Twenty-five (25) years of service credit, regardless of age. Click here for more information about Special Retirement.

Deferred: Ten or more years of Service Credit but under age 55. Click here for more information about Deferred Retirement.

Item 12. Member's Marital Status.

Items 13-15. Spouse/Domestic Partner/Eligible Same-sex Domestic Partner's Name, Maiden Name, Social Security Number and Birth Date

This information is required if either married, in a civil union, or in an eligible same-sex domestic partnership; or separated.  If not married, in a civil union, or in an eligible same-sex domestic partnership at the time of retirement, this space may be left blank, or write "N/A."

Item 16. Name, Gender, Birth Date and Social Security Number of Eligible Dependent Children

List all dependent children who are under age 18, or those who are mentally or physically handicapped regardless of age.  Copies of birth certificates, adoption papers, and medical documentation proving disability are required for each child listed.

If additional space is needed, the member may attach additional sheets.  If additional sheets are needed to list dependent children, these also must be notarized.

Part Two: Designation of Group Life Insurance Beneficiaries

Group Life Insurance

Non-disability retirees must have at least 10 years service credit to qualify for group life insurance death benefits. Disability retirees qualify upon retirement approval if they have life insurance as active members.

Primary Beneficiary(ies)

Those listed here receive the group life insurance, if any, at the time of death. If the member chooses multiple primary beneficiaries and one beneficiary predeceases the member, the remaining beneficiary(ies) will usually share that beneficiary's portion. Some special designations are allowable, but uncommon. Unless otherwise stated, if multiple beneficiaries are listed, "share and share alike" generally applies. If the member had no active group life insurance coverage through the retirement system, then the member will not have group life insurance coverage as a retiree.

The following information should be provided: 

  • Beneficiary's name 
  • Relationship to the member (spouse, civil union partner, same-sex domestic partner, daughter, son, father, mother, friend, grandchild, etc.)
  • Birth date of the beneficiary, and;
  • Social Security number of the beneficiary. (This is optional, but helps the benefit processing at the time of member's death.) 

    If no beneficiary is listed, the death benefits will be payable to the member's estate. The name and address of the executor or administrator of the estate should be included here.

Contingent Beneficiaries

Contingent beneficiaries are paid only if all the primary beneficiaries predecease the member. The same information is needed for these beneficiaries as for the primary beneficiary(ies).

Additional primary or contingent beneficiaries can be listed on an attached and signed sheet.

Signature of Applicant

The application must be signed or it cannot be processed. If any additional sheets for the retirement application are attached, then these additional sheets must also be signed.

Retirement applications no longer need to be notarized, effective June 1, 2001.

 

BACK TO TOP


Certification of Service and Final Salary, PFRS Retirements

The certification form is completed by the member's employer. 

BACK TO TOP


Completing the Certification of Service and Final Salary

Item 1. Name of Member  

Item 2. Membership Number

Item 3. Social Security Number

Item 4a. Name of Employing Agency

Item 4b. Pension Location Number

May be obtained from the PFRS Quarterly Report of Contributions or any Certification for Payroll Deductions received from the Division of Pensions and Benefits.

Item 5. Date of Termination of Service

This certifies that the member will not render any service or earn any salary after this date.

Item 6a. Is the member currently on suspension?  

If this is answered YES, the employer is to state the date suspension began and mark the box stating if the member is PAID or UNPAID while on suspension.

Item 6b. Is the applicant facing disciplinary action or indictment?  

If this is answered YES, a detailed explanation must be submitted by the employer. The Division will review the explanation to determine if it is sufficient for continued processing, if additional information is needed, or if submission to the PFRS Board of Trustees is required.

IF either 6a or 6b are answered with YES, copies of the preliminary and final notices of disciplinary action, or the equivalents, or a copy of the indictment should be included.

Item 7. Unpaid Leaves of One Month or More, within the Last Twelve Working Months 

This information shows when there are gaps in service due to leaves of absence (LOA). Some LOAs can be purchased by the member. A LOA for a work-related incident may indicate a possible Worker's Compensation claim. If Worker's Compensation is determined, the employer may be required to submit pension contributions until retirement, on the member's behalf.

Item 8. Base Salary Subject to Pension Fund Contributions Paid for the Last Full Year of Service. 

The last 12 months of salary must be indicated. Salary should be reported by the number of months at a given salary, the amount of the monthly base salary, the beginning and ending dates of that salary and the total base salary for the period. Salary is being certified in advance.  Therefore salary not yet paid is to be projected to the best of the employer's ability.

Item 9. Has the member received a significant annual salary increase in the last three years of employment?

If the answer is yes, the employer must furnish cause for the increase, with documentation. The Division may approve the increase, if justifiable, deny the increased salary, or forward the case to the Board of Trustees for determination.

Item 10. Has there been any retroactive salary paid to the employee within the past three years?

A retroactive salary increase can falsely inflate a member's salary if it is not properly credited back to the correct dates. Retroactive salaries can also incorrectly show a single salary increase, when in fact it may cover several years of increases. The beginning and ending dates should show for each retroactive increase along with the corresponding new annual base salary.

If the member receives a retroactive raise after the original Certification has been sent to the Division, a new Certification must be sent in. The new Certification should state 'Amended' or 'Revised for Retroactive Increase.'

Item 11. Pension Deductions for Final Three Quarters

Enter the pension deductions that have been made or will be made by the member in the three quarters prior to retirement, including the quarter in which the member retires.  This will allow the Division of Pensions and Benefits to calculate the member's retirement allowance in advance and pay the retiree in a timely manner.  

State employers must attach a screen print of the member's TREADHOC biweekly certification, with salaries projected until termination date, in lieu of completing Item 11.

Completed By:     

Denotes who actually completed the form.

Phone Number

The Division requires the phone number of the person who completed the form. This number allows us to directly contact the employer for any follow up questions we may have on the Certification.

Signature of Certifying Officer      

The Certifying Officer is the individual who certifies that this information is correct. Each location has one Certifying Officer. This signature must be an original signature and cannot be a stamped signature.

Date     

Please give the date when the form was signed by the Certifying Officer. The date signed is helpful when more than one Certification is received by ensuring that the most recent Certification is used. Usually more than one Certification is received when there is a retroactive raise (marked "Revised for Retro" or "Retroactive Raise"), or a change in the Certification (marked "Amended").

NOTE CONCERNING WORKERS' COMPENSATION: If the member is receiving periodic payments from Workers' Compensation, the employer may be required to pay the member's pension contributions until the member's effective date of retirement. No loan payments, back deductions, or arrears payments are required from the member or the employer while the member is on Workers' Compensation. Whenever possible, an official statement of the Workers' Compensation award, showing the amount of the periodic benefits and the beginning and ending dates of the benefits awarded, should be attached or mailed in under separate cover.

BACK TO TOP


Instructions for the PFRS Application for Disability Retirement


Instructions for Completing the
PFRS Application for Disability Retirement

The Application For Disability Retirement is completed in its entirety by the member. The member's signature must be present. The signature will be verified when the application is keyed into the Division's system.

Items 1-6. Basic Member Information

Items 1-6 request basic member information, including membership number, Social Security Number (SSN), member's name, date of birth, (proof of age will be required from the member if it has not already been submitted), member's home mailing address, and home and work phone numbers.

Item 7. Member's Official Work Title

Item 7 asks for with the official work title under which the member is currently employed.

Item 8. Type of Disability Retirement 

The type of disability retirement requested: Accidental Disability versus Ordinary Disability. (See also Fact Sheet #16.)

Item 9: I declare that I am incapacitated for further service in the work title listed in Item 7 due to the following reasons:

This question should be answered by the member, explaining in what way a disabling condition prevents continued service in the job title listed in Item 7.  This should be completed in the member's own words, and should reflect the pertinent job duties that fall under the specific job title.

Item 10. Retirement Effective Date 

The effective date of the retirement (always the first of a month) should be provided. The application must be received by the Division prior to the member's effective retirement date.

Item 11. If you will have an outstanding loan balance at retirement, how do you want to pay the loan off? 

  • All retirees can 'carry' their loans into retirement at the same monthly repayment level as when they were an active member.
  • Biweekly loan payments are converted to monthly payments by multiplying the biweekly payment by 2.175.
  • The member can still pay off the loan in a lump sum. 
  • Interest will continue to accrue at 4.00% if the member chooses to 'carry' the loan into retirement.

Item 12. Are you currently under departmental charges of formal indictment?  

If the member is under charges or formal indictment, additional information will be required from the employer and/or the member. Delay in receiving this information could delay the processing of the member's pension.

Item 13. Employer Name

Enter the official name of your current employer.

Item 14. County

In which county is your employer located?

Items 15 and 16 must be completed for Accidental Disability Only.

Item 15. Date of Accident and Description  

The date of accident will be the date of the traumatic event that directly caused the totally and permanently disabling condition.  

The accident description and list of witnesses provides the member the opportunity to tell in his or her own words valuable information that may prove helpful in determining eligibility for an Accidental Disability Retirement.  

Item 16. Has a Claim Been Filed for Workers' Compensation?  

If yes, then the member must attach a copy of the award. The member should complete questions 16a, 16b and 16c:

  • Amount of Periodic Benefits (stated as a weekly dollar amount), 
  • Beginning Date of Award (when the award was effective) and 
  • Ending Date of Award (when the award's benefit concludes).

If the member has filed for Workers' Compensation and the award is still pending, the member should forward the information to the Division as soon as possible. (See Fact Sheet #45)

PART TWO: MARITAL STATUS AND CHILDREN

Item 17. Marital Status    

Indicate here the member's marital status: married, in a civil union partnership or eligible same sex domestic partnership, separated, dissolution of civil union partnership or same-sex domestic partnership.

Item 18. Name of Spouse/Civil Union Partner/Same-sex Domestic Partner

Leave blank or write N/A if none. This information is needed for the letter to the member's spouse/civil union partner/eligible same-sex domestic partner, notifying him or her if the member takes the Maximum Allowance pension benefit (sent certified mail). Divorced or ex-spouses/civil union partners/same-sex domestic partners do not need to be listed.

Item 19. Social Security Number of Spouse/Civil Union Partner/Same-sex Domestic Partner

Not required, but helpful information in the event the retired member predeceases the spouse/civil union partner/same-sex domestic partner. This information will enable the Division of Pensions and Benefits to process a claim for death benefits as quickly as possible.

Item 20. Address of Spouse/Civil Union Partner/Same-sex Domestic Partner  

Only needed if it is different than the member's mailing address.

Item 21. Name, Gender and Birth Date of Eligible Dependent Children

List all dependent children who are under age 18, or who are mentally or physically handicapped regardless of age. Copies of birth certificates, adoption papers, and medical documentation proving disability are required for each child listed.

If more space is needed, the member may attach additional sheets.  If additional sheets are needed to list dependent children, they also must include all necessary information.

While not specifically requested, inclusion of the Social Security numbers of dependent children can be helpful in the event a death claim will be paid to them upon the member's death.

PART THREE: DESIGNATION OF  GROUP LIFE INSURANCE BENEFICIARY

Item 22. Primary Beneficiary(ies) 

The primary beneficiary(ies) listed will receive the member's group life insurance. The coverage amount varies according to the fund and level of coverage as an active member. 

The following information is needed: beneficiary's name, address, date of birth and the beneficiary's relationship to the member (spouse, daughter, son, father, mother, friend, grandchild, etc.).

If the member chooses multiple primary beneficiaries and one beneficiary predeceases the member, the remaining beneficiary(ies) will usually split that beneficiary's share. Some unusual designations are allowable, but uncommon. Unless otherwise stated, if there are multiple beneficiaries listed, they are considered "share and share alike."

Item 23. Contingent Beneficiary(ies)

In the event all primary beneficiaries have predeceased the member, the group life insurance benefit will be paid to all listed contingent beneficiaries on a "share-and-share-alike" basis, unless otherwise provided for.  

In the event all contingent beneficiaries have also predeceased the member, the group life insurance benefit will be paid to the member's estate.

The following information is needed: beneficiary's name, address, date of birth and the beneficiary's relationship to the member (spouse, civil union partner, same-sex domestic partner, daughter, son, father, mother, friend, grandchild, etc.).

Member Signature

The member must sign the application.

BACK TO TOP


Instructions for Medical Examination by
Personal or Treating Physician


Medical Examination By Personal
or Treating Physician
Form

  • The applicant must complete Part One and submit the form to the physician(s) who were or are involved in treating the disabling condition.  

  • A copy of the job description may prove helpful to the physician as the assessment for this claim is made.  

  • If more than one physician's statement is needed, the applicant may make as many copies as necessary.

    While copies of this form are permitted, they must be double sided copies of the original.

After completing Part Two, the physician may forward the form directly to the Division of Pensions and Benefits at the address listed on the top of the first page.  Or it may be submitted with the Disability Retirement application by the member.

It is essential that all relevant medical information be submitted to the Disability Review Section at the Division of Pensions and Benefits before adequate determination of eligibility for Disability Retirement can be made.  Any delay in receiving this (or any) form will only delay processing of the retirement.

BACK TO TOP



Authorization for Release of Medical Records

BACK TO TOP


Instructions for the
Authorization for Release of Medical Records
Form

Medical records pertaining to any hospitalization(s) related to the disabling condition must also be submitted to the Division of Pensions and Benefits.

  • If no hospitalization occurred, then medical examination reports from at least two physicians must be submitted before a determination of disability can be made.  This form is still required by the Division of Pensions and Benefits even if there was no hospitalization.

  • The member may make as many copies of this form as necessary in order to obtain records from more than one hospital.

  • The member must submit this form directly to the hospital requesting the needed records.

  • The member also assumes all responsibility for any charges levied by the hospital for reproducing and/or forwarding these records to the Division of Pensions and Benefits.

BACK TO TOP


Employer Certification for Disability Retirement

BACK TO TOP


Instructions for Employer Certification for Disability Retirement

Item 1. Pension Fund 

Please check to appropriate box denoting the Pension Fund the member belongs to.

Item 2. Basic Member Information 

This is self explanatory. Include name of the employee, job title (including a copy of the job description), Social Security number, name of employing location, employer address and phone number.

Type of Disability Retirement

Check to box that corresponds to the type of Disability Retirement the member is applying for.

Item 3. Employee Status

Please check the box that is appropriate. To determine full-time status, refer to the regulations that pertain to your location. For example, 35 or 40 hours per week.

Item 4. Authorized Leave of Absence

Review attendance records to determine if the member has been on an authorized leave of absence within the past year. Check all that apply. This will help the Division of Pensions and Benefits determine the member's final salary.

Item 5. Unauthorized Leave of Absence

Please indicate if the member was out on an unapproved leave and, if so, the duration of the leave.

Item 6a. Is the member currently on suspension?

It is very important that you answer this question, even if the answer is "No". If the answer is "Yes", be sure to include the date of suspension and any documents that describe the reasons and circumstances surrounding the suspension. By law, the Division cannot process a retirement unless and until all information concerning suspensions are submitted. Be sure to indicate if a suspension is paid or unpaid.

Item 6b. Is the applicant facing disciplinary action or indictment?

Again, it is essential that you answer this question, even if the answer is "No". If the answer is "Yes", you must attach copies of all documents that pertain to the disciplinary action or indictment, including preliminary and final notices of disciplinary action or their equivalents.

Failure to answer questions 6a and 6b will only delay the processing of the applicant's retirement.

Item 7. Was the applicant dismissed?

As with lines 6a and 6b, this question must be answered "yes" or "no". If yes, you must give the reason and date of dismissal. This may have a direct bearing on the outcome of the member's application for retirement.

Item 8. If Employee is Filing for an Accidental Disability Retirement

Since an Accidental Disability Retirement is granted only for those who suffer a "Traumatic Event" during the course of regular job duties, accident reports taken by the employer are exceptionally important. Please answer the questions on the basis of official records relating to the accident.

Be sure to include copies of any pertinent documentation including an accident report, witness statements, etc.

The question concerning Workers' Compensation is very important. If a case has been settled or is still pending, please attach a copy of all documentation you may on file. This is essential information that may corroborate the applicant's eligibility for Accidental Disability Retirement, and may influence the calculation of the member's retirement allowance.

Item 9. Date Employee's Service Terminated

This is the last date on which the employee earned or will earn salary from employment.

Item 10. Base Salary Subject to Pension Fund Contributions

Last 12 months (10 months if applicable) of salary must be indicated. Salary should be reported by the number of months at a given salary, the amount of the monthly base salary, the beginning and ending dates of that salary, and the total base salary for the period. Salary beyond the last reported quarter is to be projected to the best of the employer's ability.

Item 11. Has the member received an annual salary increase of 10% or more in the last three years?

If the answer is yes, the employer must furnish cause for the increase along with documentation. The Division may approve the increase, if justifiable, deny the increased salary, or forward the case to the Board of Trustees for determination.

Item 12. Retroactive Salary Increases in the Last Three Years

A retroactive salary increase can falsely inflate a member's salary if it is not properly credited back to the correct dates. Retroactive salaries can also incorrectly show a single salary increase, when in fact it may cover several years of increases. The beginning and ending dates should show for each retroactive increase and the corresponding new annual base salary.

If the member receives a retroactive raise after the original Certification has been sent to the Division, a new Certification must be sent in. The new Certification should state 'Amended' or 'Revised for Retroactive Raise.'

Item 13. Salary Deductions during Final Quarters

The employer indicates the actual and/or projected base salary subject to pension contributions for the last two quarters preceding the member's termination date. Also noted in this section are the amounts of actual and/or projected payroll deductions for: pension contributions, loan repayment, back deductions (including the number of payments taken), arrears (and/or purchases) deductions, and the total pension deductions taken (and/or projected to be taken) by the employer and remitted to the Division for this member.

State employers must attach a screen print of the member's TREADHOC biweekly certification, with salaries projected until termination date, in lieu of completing Item 11.

Checklist

This is a helpful tool printed on the form to remind you which forms and documents to include with the Disability Retirement Certification.

Be sure to include a letter addressed to the Division of Pensions and Benefits stating that you (the employer) believe that the member is totally and permanently disabled for his or her job title.

Name and Signature of the Certifying Officer

Each location has one Certifying Officer.

The Certifying Officer is the individual responsible for providing this information at each location. The Certifying Officer must sign the Certification of Service and Final Salary confirming that the information is correct. This signature must be an original signature and cannot be a stamped signature.

The date signed is helpful in processing a retirement. When more than one Certification is received, the Division can ensure that the most recent Certification is used for processing. Usually more than one Certification is received when there is a retroactive salary increase, or a correction is made for mistaken information.

 

BACK TO TOP

BACK TO HOME PAGE

 






 



division (internet use only): p&b home | SHBP home | forms and publications | seminars | contact the division
pension funds : PERS | TPAF | PFRS | SPRS | JRS | ABP | other funds | search
Last Updated: July 8, 2016