Fire & Police Pension Association

FPPA Retired Member Forms

Affidavit For Check Replacement
Click on this link to download a form if you are requesting a replacement check.

Direct Deposit Forms

Signing up for direct deposit for the FIRST time. Click here

If you are ALREADY RECEIVING direct deposit advices.

Members will NOW have a choice for if or when deposit advices are mailed to them.
Click here to learn more.

FPPA Records Release Form
Click on this link to download a form to authorize FPPA to release information contained in you FPPA file.

W-4P Monthly Pension Distribution Form
Click on this link to download a form to change the amount of Federal and/or State taxes

Application for Change in Disability Status

This packet is for disability retirees who are applying for a change in disability status.

Forms for post-retirement distributions of:
SRA, Money Purchase Plan or the FPPA 457 Plan.
Click on the links below for applications to take distributions from your SRA, Money Purchase Plan or FPPA 457 Plan.

SRA Distributions

	This packet is for former Statewide Defined Benefit Plan MEMBERS ONLY wishing to take an SRA distribution.

	This packet is for members who have received FPPA Board approval for their disability retirement application or survivor benefits, and now wish to take an SRA distribution.

Money Purchase Plan Distribution

This packet is for former Money Purchase Plan MEMBERS ONLY and wishing to take a distribution.

FPPA 457 Plan Distribution

This packet is for FPPA 457 Plan MEMBERS ONLY and wishing to take a distribution.