Spousal Waiver Form

Spousal Declaration Form


At retirement, members should use the Spousal Declaration Form to declare whether they have or do not have a spouse.

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

Information Needed to Complete the Form

To complete this form, the Member will need:

  • Spouse’s name and address (if spouse exists)
  • Name, address and signature of a witness
  • Photo-ID of witness, if no spouse exists


Questions on completing the form should be directed to the Plan Administrator.

Completed forms should be sent to the Plan Administrator.