NPERS0205
Rev. 08/2013
Page 1 of 1
BAR CODE
Contact Person
Phone
Plan Type
(Check One)
School/Agency/County
Agency/District Number
School
State
County
DCP
Address
State
Zip
NPERS Form & Publication Order Form
This form is to be used by employers to order forms and publications from NPERS. All forms may be photocopied.
The most current editions of all forms and publications on this list
are available on our website: npers.ne.gov.
Employers and plan members are encouraged to obtain forms and publications via the NPERS website whenever possible.
Be sure to periodically check the revision dates on forms and publications to be certain that all information is current.
QTY DOCUMENT NAME FORM NUMBER
Plan Member Handbook
Employer Contact NPERS6300
Adjustment Report NPERS6200
School Verification of Salary NPERS3800
Verification of Service Record NPERS2000
Application for Vesting Credit - School & Patrol NPERS2101
Non-Contributing School Member NPERS2400
Other
QTY DOCUMENT NAME FORM NUMBER
Plan Member Handbook
Annual Investment Report
Investment Election Form NPERS2500
Non-Contributing Member NPERS2430
Notification of Death NPERS4030
Other
QTY DOCUMENT NAME FORM NUMBER
Plan Member Handbook
Annual Investment Report
Investment Election NPERS2500
Non-Contributing Member NPERS2430
Notification of Death NPERS4030
Other
QTY DOCUMENT NAME FORM NUMBER
Plan Member Handbook
DCP Change Form NPERS8400
DCP Enrollment Form NPERS8000
Other
QTY DOCUMENT NAME FORM NUMBER
Beneficiary Designation NPERS1300
Application for Vesting Credit (for School Plan see above) NPERS2100
Order Form NPERS0205
ALL
PLANS
SCHOOL
STATE
COUNTY
DCP
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