FPPA Statewide Death & Disability Plan Forms
General FPPA Forms
Affidavit of Common Law Marriage
Change of Address Form
Email Address Form
FPPA Records Release Form
For Members During Their Career
Step by Step Through the Disability Process
Apply for a Disability Benefit
For Member Survivors
Apply for a Survivor Benefit
For Members Currently Receiving Benefits
Change in Disability Status Application
Request SRA Distribution from FPPA - For the disability or survivor benefits applicable to your situation.
- Instructions
- Special Tax Notice
- Application
Currently receiving Disability Benefits and are now divorcing.
Disability Retiree Change of Designated Beneficiary
FPPA Forms for the Management of Deposits
Electronic Funds Transfer (EFT) Form
Deposit Advice Selection Form - Control the frequency of your Deposit Advices with this form. Learn more about Deposit Advices options.
Affidavit For Check Replacement
W-4P Monthly Pension Distribution Form
W-9 Request for Taxpayer Identification Number and Certification
Governing Board
Governing Documents
FPPA
- About FPPA
- Address & Directions
- Contact Us
- Employment Opportunities
- FPPA Overview
- Glossary of FPPA Terms
- News and Video
- Organizational Chart
- Our Vision & Mission Statement
- Participating Employers (This link will direct you to the Annual Report | Statistical Section.)
- Public Records
- RFP
National Suicide Prevention Lifeline
Are you in a crisis? Struggling emotionally and need to talk to someone?
Call the National Suicide Prevention Lifeline or chat online.
It's free and confidential.
(800) 273-TALK (8255) • suicidepreventionlifeline.org
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