SC RETIREMENT SYSTEMS | Access the forms listed below on the PEBA website forms page
- Retirement Plan Enrollment Form 1100
- Active Member Beneficiary Form 1102
- State ORP Beneficiary Designation Form 1106
- Request for Service Purchase Request 2101
EMPLOYEE INSURANCE PROGRAM | Access the forms listed below on the PEBA website forms page
- Active Notice of Election Form
- Certification Regarding Tobacco Use
- COBRA Notice of Election Form
- Dependent Social Security Number Form
- MoneyPlu$ Enrollment Form
- MoneyPlu$ Health and Dependent Day Care Reimbursement Claim Form
- MoneyPlu$ Spending Accounts Change in Status Form
- Incapacitated Child Certification Form
- Life Insurance Statement of Health (MetLife)
MISCELLANEOUS
- Federal W4 Withholdings 2024
- South Carolina W4 Withholdings 2024
- Universal Name/Address Change Form
- Emergency Notification Form