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Active and InActive Member Forms

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Chapter 176 of the Acts of 2011 makes significant changes to the retirement laws for those who become members of a Retirement System on or after April 2, 2012. If an individual whose membership began prior to April 2, 2012 withdraws his or her funds from the Retirement System and later is employed in the public sector in the Commonwealth of Massachusetts and once again, becomes a member of a Retirement System, the rights and responsibilities in effect when the individual again becomes a member will be applicable.

Withdrawing your contributions has serious ramifications due to the number of changes affecting the retirement plan benefits and rights in the retirement system with the passage of Chapter 176 of the Acts of 2011. Some of the most prominent changes you should be aware of are:
* Increase to the minimum retirement age;
* New age factors for calculating a retirement
* Unavailability of G.L. c. 32 section 10
termination allowances;
* Five year average annual rate of regular
compensation for calculating allowances rather
than a three year average;
* Proration of benefits earned for service in
different Group classifications;

If you have any questions or concerns regarding these changes, we urge you to contact the Hampden County Regional Retirement Board at (413) 737-1344 so we can counsel you more thoroughly.

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