Form Mm 0002 PDF Details

Navigating through personal and professional changes often requires updating official documents to reflect these transitions. The MM 0002 form serves this purpose for members and benefit recipients associated with specific programs in Maine. With provisions to update crucial personal information such as name and mailing address changes, this document ensures that records are current and accurate. Located at 46 State House Station in Augusta, ME, the administering office provides both a telephone line and a toll-free number to assist users, along with a TTY number for those requiring it. Completing and submitting this form is a straightforward process: it requires former and new information alongside the effective date of changes, followed by the necessary signatures to validate either by the member/benefit recipient or the employer, indicating a flexible submission policy. The form's structure underscores the importance of keeping one's details up to date to ensure seamless continuation of benefits and correspondence, making it an essential tool for individuals undergoing name changes, relocations, or other significant life alterations.

QuestionAnswer
Form NameForm Mm 0002
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesMm 0002 mainepers org forms pdfs 0002

Form Preview Example

46 State House Station

Augusta, ME 04333-0046

Telephone: (207) 512-3100

Toll-free: 1-800-451-9800

TTY: (207) 512-3102

MeMber/benefit recipient data update

 

Former

 

 

 

 

 

 

 

 

 

 

 

 

 

Member/Benefit

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Recipient Name:

 

 

 

 

 

 

 

 

 

 

 

(Prefix)

(First)

(MI)

 

 

(Last)

 

 

(Suffix)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Social Security Number:

 

 

 

 

 

Date of Birth:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(mm)

(dd)

(yyyy)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

name change/correction

 

 

 

 

 

 

 

 

 

 

 

 

 

New Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(Prefix)

(First)

 

 

(MI)

(Last)

 

 

 

(Suffix)

address change/correction

New Mailing

Address:

Effective Date of Change:

(Address Line 1)

(Address Line 2)

(City/Town)

(State)

(ZIP)

(mm) (dd) (yyyy)

(MainePERS Date Stamp Area)

To be signed by either the Member/Benefit Recipient or the Employer. Only ONE signature is required.

__________________________________________

________________

____________________________________________

(Signature of Member/Benefit Recipient)

(Date)

(Member/Benefit Recipient Name) (please print)

__________________________________________

__________________

________________________________________

(Signature of Employer)

(Date)

(Employer Certifying Official) (please print)

__________________________________________

_________________________________________

(Employer Location Code)

(Employer Phone Number)

 

Form #MM-0002

 

Rev. 9/11

How to Edit Form Mm 0002 Online for Free

You may prepare Form Mm 0002 easily with the help of our online tool for PDF editing. Our tool is continually evolving to deliver the best user experience possible, and that's because of our commitment to continuous enhancement and listening closely to customer comments. Should you be looking to start, here's what you will need to do:

Step 1: Open the PDF doc inside our editor by pressing the "Get Form Button" in the top area of this page.

Step 2: When you access the PDF editor, you'll see the document made ready to be completed. Aside from filling out various blank fields, you may as well do some other actions with the PDF, such as adding any textual content, editing the initial text, inserting images, placing your signature to the PDF, and much more.

This document requires particular details to be entered, thus make sure you take whatever time to fill in what is expected:

1. Complete your Form Mm 0002 with a group of major blank fields. Get all of the information you need and be sure not a single thing missed!

Step number 1 of filling in Form Mm 0002

2. Soon after filling out the last step, go to the subsequent stage and complete the essential particulars in all these fields - a e r A p m a t S e t a D S R E P, Effective Date of Change, yyyy, To be signed by either the, Signature of MemberBenefit, Date, Signature of Employer, Date, MemberBenefit Recipient Name, Employer Certifying Official, Employer Location Code, and Employer Phone Number.

Step number 2 of completing Form Mm 0002

Always be very careful while filling in yyyy and MemberBenefit Recipient Name, because this is the section where many people make some mistakes.

Step 3: Soon after looking through the fields and details, press "Done" and you're done and dusted! Create a free trial option at FormsPal and acquire direct access to Form Mm 0002 - which you can then work with as you want in your personal account page. FormsPal guarantees secure form tools devoid of personal data recording or sharing. Be assured that your information is safe with us!

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