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This form is used for enrolling in benefit options for retirees and long-term disability participants in the state of Arizona for the years 2009-2010. It includes sections for personal information,
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How to fill out STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD ENROLLMENT FORM 2009-2010

01
Obtain the STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD ENROLLMENT FORM 2009-2010 from the official Arizona state website or your HR department.
02
Carefully read the instructions and guidelines provided on the form.
03
Fill out your personal information at the top of the form, including your name, address, and contact details.
04
Indicate whether you are a retiree or on long-term disability (LTD) in the designated section.
05
Review the benefit options available and select the ones applicable to you by marking the appropriate boxes.
06
Provide any additional information required, such as dependent details if applicable.
07
Double-check all entered information for accuracy to avoid any delays in processing.
08
Sign and date the form at the bottom to certify that the information provided is correct.
09
Submit the completed form by the deadline specified, either electronically or via mail as instructed.

Who needs STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD ENROLLMENT FORM 2009-2010?

01
Retirees of the State of Arizona who are eligible for benefits.
02
Individuals receiving long-term disability (LTD) who wish to enroll in benefit options.
03
Any former employees of the State of Arizona seeking to manage their benefits during retirement or disability.
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The STATE OF ARIZONA BENEFIT OPTIONS RETIREE/LTD ENROLLMENT FORM 2009-2010 is a document used by retirees in Arizona to enroll in benefit options or long-term disability (LTD) programs provided by the state.
Retirees who wish to enroll in the benefit options or long-term disability programs offered by the State of Arizona are required to file this form.
To fill out the form, retirees should provide their personal information, select the desired benefit options, and ensure that all required fields are completed accurately before submitting it.
The purpose of the form is to facilitate the enrollment process for retirees in the benefits and services available through the State of Arizona, ensuring they receive appropriate health and disability coverage.
The form must report personal identification information, selection of benefit options, any required signatures, and other relevant details pertinent to the enrollment process.
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