Active Members Forms & Documents

NMERB Forms

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Title	Description	Format	DocuSign Links
Application for Purchase of Service Credit Military Service		PDF
Application for Purchase of Service Credit Withdrawn NMERB Service		PDF
Application for Retirement Benefits	For Inactive Members only. If you have been employed within the last 90 days, use the Application for Retirement Benefits (Active Member) form.	PDF	DocuSign (Active) DocuSign (Inactive)
Authorization for Release of Information		PDF
Benefit Estimate Request	Submit only if retiring in 6 – 12 months.	PDF	DocuSign
Change in NMERB Records		PDF	DocuSign
Divorce – Pre-Retirement Model Order with Instructions Dividing ERB Benefits	Download document here	PDF
Divorce – Post-Retirement Model Order with Instructions Dividing ERB Benefits	Download document here	PDF
Independent Contractor Application		PDF
Legal Divorce Release of Claims		PDF
Notice of Appeal (Disability)		Word
Pre-retirement Beneficiary Designation		PDF	DocuSign
Request for Refund and/or Rollover Form (Active Member)	For Active Members only	PDF	DocuSign
Request for Refund and/or Rollover Form (Inactive Member)	For Inactive Members only. If you have been employed within the last 90 days, use the Request for Refund and/or Rollover (Active Member) form.	PDF	DocuSign
Return To Work Application – November 2022 (Revised)		PDF	DocuSign
Service Purchase NM Private School Employment Application		PDF
Service Purchase Out of State Employment Application		PDF
Service Purchase Unused Sick Leave Application		PDF
Tax Withholding – Federal, 2023 IRS Form W-4P		PDF
Tax Withholding – New Mexico State Tax Withholding		PDF
Transfer or Direct Rollover to NMERB Request Form		PDF
Withdraw from Return To Work Application		PDF