PERA Direct Deposit Form

1. PERA Direct Deposit Form Important Information You Should Know About Filling Out a PERA Direct Deposit Form Public Employees Retirement Association of New Mexico

2. Frequently Asked Questions • The direct deposit information may be changed at anytime after retirement. To change your direct deposit information you must: • Complete a new Direct Deposit form and have your financial institution complete the bottom portion of the form and; • Send the completed original Direct Deposit form to PERA. • The original direct deposit form must be received by PERA by the 8th of the month to take effect in that month. If PERA does not receive the original until after the 8th, then the change in direct deposit information will take effect the following month. Public Employees Retirement Association of New Mexico

3. Member and Bank Information Section Mary Smith 9 9 9 9 9 9 9 9 9 P. O. Box 111 Albuquerque NM 87000 505-222-1234 Bank Name X 987654 Mary Smith 10/01/2009 Public Employees Retirement Association of New Mexico

4. Financial Institution Certification Section Financial Institution Name P. O. Box 111 Albuquerque, NM 87000 123456789 505-123-1234 John Wilson Public Employees Retirement Association of New Mexico

5. Member Authorization Section Public Employees Retirement Association of New Mexico

6. Completing the Form • Once you have completed the form: • Make a copy for yourself, and • Send the original form to PERA. • If you have any questions concerning this form or any other issue, please contact PERA at 1-800-342-3422. Public Employees Retirement Association of New Mexico