Benefits Estimate Request Form


* Is this a Buy Back only request?


* Are you within 3 years of Early or Normal Retirement ?



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Employee Class



Current Status



Marital Status




Estimate(s) Requested: (Check All that apply):








Buyback Estimates(s) Requested:




Has this service been purchased?


Prior City Service


Has this service been purchased?


Out-of-City Public Service
Out of City Public Verification Form


Has this service been purchased?


(Verification form must be completed and submitted by previous employer.)

Submitted by:
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Acknowledgement:
I understand that estimates are completed in the order they are received and it may take up to six weeks for me to receive an estimate.
I also acknowledge there is a maximum of two calculations per retirement type in a calendar year I can receive from an analyst.
Additional calculations within a calendar year can be provided by utilizing the pension calculator on the Retirement Website.