N.H. Admin. Code § Ret 502.02

Current through Register No. 50, December 12, 2024

Section Ret 502.02 - Filing NHRS Form 4, Application for Group I Service Retirement

(a) To apply for service retirement, Group I members shall submit the following documents:

(1) The application for Service Retirement, NHRS Form 4;

(2) A tax withholding certificate;

(3) A copy of the Social Security card or IRS Form W-9;

(4) A copy of the member's birth certificate; and

(5) A copy of any beneficiary's birth certificate if the member selects a survivorship option.

(b) Every Group I member shall complete Section I of NHRS Form 4 by providing the following information:

(1) The member's name;

(2) The member's Social Security number;

(3) The member's mailing address;

(4) The employer's name;

(5) The member's position title;

(6) The member's home telephone number;

(7) The member's date of birth; and

(8) The member's effective date of retirement.

(c) Every Group I member shall select and sign only one benefit payment choice.

(d) Every Group I member shall designate primary beneficiaries on NHRS Form 4 by providing the following information:

(1) The name(s) of the beneficiary(ies);

(2) The mailing address(es) of the beneficiary(ies);

(3) The Social Security number(s) of the beneficiary(ies);

(4) The date(s) of birth of the beneficiary(ies);

(5) The beneficiary(ies)'s relationship to the member; and

(6) The distribution percentage in the case of multiple beneficiaries.

(e) Every Group I member shall designate contingent beneficiaries on NHRS Form 4 by providing the same information as required in (d) above.

(f) Every Group I member shall sign and date NHRS Form 4 and shall have it acknowledged by a Notary Public or a Justice of the Peace.

(g) The member shall retain the yellow copy of NHRS Form 4, and shall return the white copy to the system.

N.H. Admin. Code § Ret 502.02

#7574, eff 10-10-01, EXPIRED: 10-10-09

New. #9563, eff 10-14-09