Employer Forms

Contact Change Request

These forms are quick and easy to complete online. You can fill them out on any computer, tablet, or smartphone, and sign them electronically. The completed form will automatically be sent to the Office of Pensions—no PDF reader or special software needed!

Online Forms

Healthcare Application: Aetna/Highmark

Healthcare Application Special Medicfill

Dental Application

Vision Application

Spousal Coordination of Benefits Information

To complete these forms, just print them out and fill them in. If you prefer to complete a form online, simply visit the online forms section above and select the form you need.

Printable Forms

Tax Forms

Pensioners may request that Federal and Delaware state taxes be withheld from their retirement monthly pension benefit. The Office of Pensions does not withhold state taxes for any state other than Delaware.
You can update your tax withholding by completing and submitting a new form(s), they will replace your current withholdings:

IRS W-4P Form

State of Delaware Tax Withholding In Lieu of DE-W4

The Office of Pensions staff cannot provide tax advice. If you have specific questions regarding taxes, you may wish to consult with a qualified tax adviser.

Social Security Forms

Bundled Forms

Health Care Forms Zipped Bundle

Payroll Forms Zipped Bundle

Employee Retirement Zipped Bundle

Pension Application Forms (2nd Retirements and Diamond State Port Only)

You may send the printed form or forms to the Office of Pensions in any of these ways: