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Active Member Forms

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Request for Withdrawal Form
Download: 1003applicationforwithdrawal.pdf

Beneficiary Nomination Form
For Actively Employed Members

Download: beneficiary_selection_1001.pdf



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Hampden County Regional Board of Retirement
67 Hunt Street, #116, Agawam, Ma 01001
Tel. (413) 737-1344 • Fax (413) 732-7999