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Forms & Security Applications

Forms

AFSCME - Benefit Program, Dues, or Income Protection - Contact AFSCME at 622-6191
Employee Direct Deposit
Duplicate W-2
Lost Check
State Reimbursement

MSEA Application
MSEA Income Protection Plan Application-Contact MSEA at 622-3151
MSRS Application - Regular State Employees
MSRS Cancellation/Reduction in Coverage
MSRS Change in Beneficiary Group Life Insurance
MSRS Dependent Insurance
MSRS Group Life
MSRS Plan & Option Form - Per 116 or 117
MSRS Request for Basic and/or Additional Insurance Coverage Requiring Evidence of Insurability
MSRS Purchase Service Credit Agreement - Contact Maine State Retirement
Maine State Troopers Association - Contact MSTA at 622-2277
Payment Reversal
Replacement Check Request
Savings Bond Request
W-4 Employees Withholding Certificate
W-4ME State Form
W-4 ME State W-5 Earned Income Credit Advance Payment Certificate

Security Applications

Millenium Security Application

MS-TAMS Security Application

Warehouse Security Application (Updated: 01/26/2012)

 

 

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