State of NJ - Department of the Treasury - Division of Pensions and Benefits

Governor Chris Christie • Lt.Governor Kim Guadagno



	Disclaimer

PENDING RETIREE CHANGE OF ADDRESS FORM

If you have applied for and are pending retirement, use this form to send a change of address to the New Jersey Division of Pensions and Benefits.
If you are already retired and receive a monthly retirement check, please use these Retiree Change of Address methods.

Technical Note: If you are unable to use this form, you can change your address by writing to the Division of Pensions and Benefits, Retirement Section, P.O. Box 295, Trenton, NJ 08625-0295 or by calling (609) 292-MOVE (292-6683) Monday through Friday, 8:30 a.m. to 4:00 p.m. (except State holidays).

Enter all information and press the "Submit" button 1. MEMBER INFORMATION
Name: (First/MI/Last/Suffix)
Pending Retirement Date: (Month/Day/Year)	/ 1 /
Pension Membership Number: (Found on your pay stub)	-
Social Security Number: (last 4 digits only)	XXX-XX-
Date of Birth: (Month/Day/Year)	/ /
Home Phone Number: (Include Area Code)	- -
E-mail Address:
Have you contacted us before on this matter:
If "Yes" Please enter your Confirmation Number
2. OLD ADDRESS
Street:
Apt. or P.O.Box:
City:
State:
Zip Code:	-
3. NEW ADDRESS
Street:
Apt. or P.O.Box:
City:
State:
Zip Code:	-

Last update: August 30, 2012

Pensions and Benefits: Home | Employer Manual | Health Benefits | Forms and Publications | Counseling Appointments

Statewide: NJ Home | Services A to Z | Departments/Agencies | FAQs

This site is maintained by the Division of Pensions and Benefits.