Membership Form &
Beneficiary Information Update
For FPPA Defined Benefit System Members
(Includes Statewide Defined Benefit Plan and
Statewide Hybrid Plan - Defined Benefit Component Plan)
FPPA has created a Membership Form which includes a section "Part C - Beneficiary Designation". This information will serve any active member who dies and leaves no surviving spouse or dependent children who are eligible for benefits under the Statewide Death & Disability Plan. It will also serve the inactive vested member who dies prior to distribution of benefits, and any active member who is eligible for a Normal Retirement and not participating in DROP.

Click here (PDF format) to download and print a copy of the Membership Form.
Please complete the entire form, and then send to:

5290 DTC Parkway, Suite 100
Greenwood Village, CO 80111

If you have any questions regarding this form, please contact FPPA's Administrative Accounting Clerk at (303) 770-3772 in the Denver Metro area or (800) 332-3772 toll free statewide.

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