Media Tax Form

							PERA Tax Deduction Form

  Important Information You Should
  Know About Filling Out a PERA
  Tax Deduction Form



         Public Employees Retirement Association of New Mexico
Frequently Asked Questions
    The tax deduction information may be changed at
     anytime after retirement. To change your tax
     deduction information you must:
        Complete a new PERA Tax Deduction form and;
        Send the completed original PERA Tax Deduction form to
         PERA.
    The original PERA Tax Deduction form must be
     received by PERA by the 8th of the month to take
     effect in that month. If PERA doesn’t receive the
     original form until after the 8th, then the change in tax
     deduction information will take effect the following
     month.


                    Public Employees Retirement Association of New Mexico
Member Information Section




                               Mary Smith
                                           999-99-9999
                               P. O. Box 0000, Albuquerque, NM 87000

                                    505-222-1234




         Public Employees Retirement Association of New Mexico
Tax Information Section



    X

                                                                   X




                  0
    X
                      $100.00                             $50.00

    X
                      $321.00                            $21.00
          Public Employees Retirement Association of New Mexico
Member Authorization Section




                                                          06/10/2010




         Public Employees Retirement Association of New Mexico
Completing the Form
    Once you have completed this 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