Form PSRS-151 "Request for Retirement Estimate" - Pennsylvania

What Is Form PSRS-151?

This is a legal form that was released by the Pennsylvania Public School Employees' Retirement System - a government authority operating within Pennsylvania. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on July 1, 2019;
  • The latest edition provided by the Pennsylvania Public School Employees' Retirement System;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form PSRS-151 by clicking the link below or browse more documents and templates provided by the Pennsylvania Public School Employees' Retirement System.

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Download Form PSRS-151 "Request for Retirement Estimate" - Pennsylvania

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Commonwealth of Pennsylvania - Public School Employees' Retirement System
0151
Mail Center
5 N 5th Street
Harrisburg PA 17101-1905
Request for Retirement
Toll-free: 1.888.773.7748
www.psers.pa.gov
Estimate
Fax: 717.772.3860
PSRS- 151 (07/2019)
Complete this form only if your anticipated retirement date is within the next 12 months. See instructions on the reverse si de of this form.
Social Security Number
Daytime Phone
Member Name
(
)
Address (Street, City, State, Zip)
Evening Phone
Email Address
(
)
Provide your current school year’s (July 1 – June 30) salary.
PSERS will project your final average salary based on the
Tentative Date of Retirement: _______________
information provided by you and your employer.
Current School Year’s Salary: _______________
Current Employment Status:
Survivor Annuitant:
Type of Estimate Request:
(See definitions on reverse.)
(Check all that apply.)
Date of Birth _______________
Active/Paid Leave
Gender _______________
Regular
Unpaid Leave
 Spouse / Non-spouse
Terminated
Disability
(please check one)
Part-time members and members who are not retiring in June must complete the following:
Previous PSERS Retiree:
Number of days or hours from July 1 through June 30 that you expect to work in your final
school year of employment:
Yes _____
No _____
Days: _________
- OR -
Hours: __________
Your Signature:
Date Signed:
Upon completion, forward or fax this form to:
PSERS
5 N 5th Street
Harrisburg PA 17101-1905
FAX: 717.772.3860
REMINDERS:
Class T-G, Class T-H, and Class DC members cannot request an estimate at this time.
Purchase of Service: If applicable, your completed application to purchase credit for service must be received by PSERS prior to your last day
of paid service. Please visit the PSERS website for more details.
An Application for Retirement must be received by PSERS within 90 days of your termination date in order to receive retroactive retirement
benefits. Even in those situations where there is a pending divorce action or purchase of service, in order to preserve retroactive benefits, the
Application for Retirement must still be submitted within the 90 day time frame.
THIS FORM IS NOT AN APPLICATION FOR RETIREMENT.
FOR PSERS USE ONLY
Retirement Date:
Frozen Annuity: Yes / No
Years of Service:
Contributions:
Final Average Salary:
T-C _____
T-D _____
Taxable ___________
Pre-87 ___________
Post-86 ___________
T-E _____
T-F _____
Total ________
Debt: Purchase of Service/Overpayment/
CNW ___________
Interest ___________
Frozen Annuity
____________
Comments (divorce, MDIB, etc.):
Request for Retirement Estimate
Page 1 of 2
Commonwealth of Pennsylvania - Public School Employees' Retirement System
0151
Mail Center
5 N 5th Street
Harrisburg PA 17101-1905
Request for Retirement
Toll-free: 1.888.773.7748
www.psers.pa.gov
Estimate
Fax: 717.772.3860
PSRS- 151 (07/2019)
Complete this form only if your anticipated retirement date is within the next 12 months. See instructions on the reverse si de of this form.
Social Security Number
Daytime Phone
Member Name
(
)
Address (Street, City, State, Zip)
Evening Phone
Email Address
(
)
Provide your current school year’s (July 1 – June 30) salary.
PSERS will project your final average salary based on the
Tentative Date of Retirement: _______________
information provided by you and your employer.
Current School Year’s Salary: _______________
Current Employment Status:
Survivor Annuitant:
Type of Estimate Request:
(See definitions on reverse.)
(Check all that apply.)
Date of Birth _______________
Active/Paid Leave
Gender _______________
Regular
Unpaid Leave
 Spouse / Non-spouse
Terminated
Disability
(please check one)
Part-time members and members who are not retiring in June must complete the following:
Previous PSERS Retiree:
Number of days or hours from July 1 through June 30 that you expect to work in your final
school year of employment:
Yes _____
No _____
Days: _________
- OR -
Hours: __________
Your Signature:
Date Signed:
Upon completion, forward or fax this form to:
PSERS
5 N 5th Street
Harrisburg PA 17101-1905
FAX: 717.772.3860
REMINDERS:
Class T-G, Class T-H, and Class DC members cannot request an estimate at this time.
Purchase of Service: If applicable, your completed application to purchase credit for service must be received by PSERS prior to your last day
of paid service. Please visit the PSERS website for more details.
An Application for Retirement must be received by PSERS within 90 days of your termination date in order to receive retroactive retirement
benefits. Even in those situations where there is a pending divorce action or purchase of service, in order to preserve retroactive benefits, the
Application for Retirement must still be submitted within the 90 day time frame.
THIS FORM IS NOT AN APPLICATION FOR RETIREMENT.
FOR PSERS USE ONLY
Retirement Date:
Frozen Annuity: Yes / No
Years of Service:
Contributions:
Final Average Salary:
T-C _____
T-D _____
Taxable ___________
Pre-87 ___________
Post-86 ___________
T-E _____
T-F _____
Total ________
Debt: Purchase of Service/Overpayment/
CNW ___________
Interest ___________
Frozen Annuity
____________
Comments (divorce, MDIB, etc.):
Request for Retirement Estimate
Page 1 of 2
Understanding the Request for Retirement Estimate (PSRS-151)
Complete this form only if your retirement date is within the next 12 months or if you qualify for one of the exceptions
listed below. Otherwise, you are able to produce your own estimates.
 Work only part-time
 Have a frozen annuity (you previously received a monthly benefit from PSERS)
 Are vested (eligible for a monthly benefit) but not presently working for a PA public school
 Considering disability benefits within the next 12 months
 Are a multiple service member and considering retirement within the next 24 months
(Multiple service is the credited service of a member who has elected to combine his credited service
in both the Public School Employees’ Retirement System and the State Employees’ Retirement
System (SERS).)
If none of the above situations applies to you, please use the estimate calculators available through PSERS Member
Self-Service (MSS) Portal and on our website at www.psers.pa.gov. The PSERS retirement estimate calculators allow
you to produce an unlimited number of estimates of your potential PSERS retirement benefits.
Please carefully read the following information to assist you with the proper completion of the Request for Retirement
Estimate (PSRS-151). This information is used to calculate your benefit estimate. If PSERS does not receive accurate
information, your benefit estimate will not reflect an amount close to the actual retirement benefit you should receive.
Please be sure to verify the information you supply on this form before sending it to PSERS. This will help avoid
any errors in your estimate request. Members are limited to two PSERS staff -produced estimates in the year in which
they intend to retire.
Survivor Birth Date
Current School Year Salary
A school year salary can be defined as the retirement
The Survivor Birth Date is the date of birth of your
proposed survivor annuitant. The survivor's date of
covered compensation earned between July 1 and
birth is used in the estimated benefit calculation under
June 30 of each fiscal year. It is a key element in
Options 2 & 3.
determining the retirement benefit; therefore, it is very
important that all information provided is as close to
If the date provided is incorrect, it will alter the
the true amount as possible.
estimated benefit amount under those options for your
Please note that it does not include non-retirement
projected monthly benefit as well as the survivor's
projected benefit.
covered compensation (e.g. incentives, severance
pay, lump-sum payouts for sick, vacation, or personal
If you choose a non-spouse, there may be a
leave, etc.)
percentage cap on the amount that he or she may
receive.
If An Error Occurs
After you receive the retirement estimate from PSERS, you should review the figures used for the calculation. If
you receive the retirement estimate from PSERS and you detect an error, contact the PSERS Member Service
Center toll-free at: 1.888.773.7748. You may also contact PSERS via email at ContactPSERS@pa.gov.
Request for Retirement Estimate
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