Fire & Police Pension Association

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, have your signature witnessed and then send to:

FPPA
5290 DTC Parkway, Suite 100
Greenwood Village, CO 80111

Please remember! You must have a witness sign and date Page 2 of the form in order for the form to become effective. The witness must be someone other than yourself, your spouse or your beneficiary.

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.