Below you will find all the forms available at the Pension Fund office.  In order to expedite your requests quicker, you are welcome to download the forms here, fill them out and mail them to:

Park Employees' Annuity & Benefit Fund

55 E Monroe

Suite 2720

Chicago, IL  60603

By doing this you will eliminate the time required to phone our office and request the forms via mail.  However, as always, you are more than welcome to phone our office, and our office is always happy to assist you.  You can reach us by phone at (312) 553-9265.

PLEASE NOTE: ALL PAGES OF A DOWNLOADED FORM MUST

  ACCOMPANY YOUR MAILING! 

  If a page is left blank please send it.

Forms & Downloads

Park Employees' Annuity & Benefit Fund of Chicago

Pension Forms

APPLICATION FOR RETIREMENT

The form below must be filled out if your spouse was a Chicago Park District Employee and has passed away.  You may be eligible for a survivors pension and should fill out the form below.

APPLICATION FOR SURVIVOR'S ANNUITY

DIRECT DEPOSIT AGREEMENT

The form below must be filled out if you wish to have your pension checks Directly Deposited to your bank checking account.

The form below must be filled out if you wish to retire.

Active Member Forms

The form below must be filled out if you were injured on the job and are looking to collect Duty Disability.  If this is the case we are sorry to learn about your misfortune.

APPLICATION FOR DUTY DISABILITY

The form below is a Membership Record.  You most likely have filled this form out already, but if you need to fill one out feel free to use the form below. 

NOTE: this for is formatted to print on 11" x 17" paper.  We hope to have the standard 8.5" x 11" version soon.

MEMBERSHIP RECORD

General Forms

The form below must be filled out if you wish to select or change your.  PLEASE NOTE:  This form must be notarized prior to submission.

DESIGNATION OF BENEFICIARYS

Refund Forms

The form below must be filled out if and only if a) you are no longer employed by the Chicago Park District and b) you wish to receive a refund of all your contributions to date.  Please allow at least 2 weeks prior to requesting your refund.  This 2 week period will insure that all of your payroll postings have been posted and that you will receive the full refund amount owed you.

REFUND REQUEST

The form below must be used if you are taking a refund and wish all or part of that refund be rolled over into a qualifying retirement plan.

ROLLOVER CERTIFICATION