Retiree Pension Deduction Authorization

Automatically pay your annual retiree dues via pension deduction from the State Retirement and Pension System of Maryland

Membership ID# *

Your membership ID Number is on your invoice or your MSEA membership ID Card.

Name *

First

Last

Phone (Optional)

Email (Optional)

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Full Social Security Number (###-##-####) *

Your full social security number is required in order to process your pension deductions.

I hereby authorize the State Retirement and Pension System of Maryland to deduct annual membership dues from one of my pension checks each year. This authorization will remain in effect until I revoke it.

Signature *

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