Application for Pension Benefits

Application for Disability Pension Benefits


Use the Application for Disability Pension Benefits form if you are on disability and are ready to retire.

Please contact the Plan Administrator for a copy of your form.

Prior to completing this form, please obtain a Pension estimate from the Plan Administrator using the Request for Pension Estimate form.

Information Needed to Complete the Form

To complete this form, you must include your:

  • personal information,
  • disability information,
  • spousal information,
  • beneficiary information and
  • select a form of payment based on your spousal information


There are other forms that must be submitted before you will start receiving your Pension. To avoid delays in receiving your Pension contact the Administrator for the forms.  Depending on the type of Pension you choose, the Administrator will provide you with the appropriate forms.

Completed forms should be forwarded to the Plan Administrator.

Other questions on completing the form should be directed to the Plan Administrator.