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PLEASE PRINT LEGIBLY
Effective Date:CHANGE OF ADDRESS / NAME CHANGE FORMSANDOVAL COUNTY
Date of Birth:
Please ensure a ERA Change form is filled out in conjunction with this form or will not be accepted
ACTIONREASON
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What is pera enrollmentchange?
Pera enrollmentchange is a form used to make changes to a member's enrollment in the Public Employees' Retirement Association (PERA).
Who is required to file pera enrollmentchange?
All PERA members who need to make changes to their enrollment information are required to file pera enrollmentchange.
How to fill out pera enrollmentchange?
PERA members can fill out the pera enrollmentchange form online or by contacting PERA directly for assistance.
What is the purpose of pera enrollmentchange?
The purpose of pera enrollmentchange is to update a member's enrollment information with PERA.
What information must be reported on pera enrollmentchange?
PERA members must report changes to their personal information, employment status, beneficiary designation, and other relevant details on the pera enrollmentchange form.
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