FormsStaffBenefits → Request for Estimate of Retirement Benefits

Request for Estimate of Retirement Benefits

About this Form

Form number: 455-2A

Audience:  MCPS Staff

Last revised: November 2011

Complete this form and return to the Employee and Retiree Service Center. Employees must be eligible for retirement as of the projected date of retirement stated below.

Adobe PDF Request for Estimate of Retirement Benefits63 KEnglish

Forms require Adobe Acrobat Reader 8 or higher. Get Acrobat