Full Menu
Forms → Staff → Personnel → Addendum to Application for Retirement/Notice of Separation
Form number: 455-2B
Audience: MCPS Staff, MCPS Retirees
Last revised: September 2020
INSTRUCTIONS: Complete, sign electronically or manually, and return to the Employee and Retiree Service Center (ERSC). You may fax the signed form to 301-279-3651 or 301-279-3642, or email a PDF of the signed form to ERSC@mcpsmd.org.
Forms require Adobe Acrobat Reader 8 or higher. Get Acrobat