Forms

There are a number of forms used by the MEBA Benefit Plans for notifying the Plan Office of changes to your status, and for applying for various benefits. These forms can be viewed by downloading them in Adobe® Acrobat® Reader format. If you don't have Acrobat Reader and would like to download it, click here.

All participants must complete and sign a Permanent Data Form which can be obtained from the Plan Office, any MEBA Branch Office, or by downloading and printing the form under the Member Services Forms Tab.  You must use this form to: (a) designate your beneficiary for the Life Benefit, and (b) advise the Plan of your eligible dependents. A new form must be completed if there is any change in your or your dependents' status (e.g., changes due to births, marital status, deaths, student status, address change, etc.).

All completed forms should be returned directly to the Plan Office in Baltimore. Your form is valid only when you, the participant, have completed and signed it personally.

Emails and faxes are accepted, however please call the Plan Office to verify receipt of any completed forms.

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