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Clergy Pension Forms

Title What is This For? Contact Information
Application for an Exception to the Rules for Work After Retirement [For bishops to submit with a letter of request] To request an exception to pension rules for work after retirement

The Committee on Ecclesiastical Offices Held by Beneficiaries of
The Church Pension Fund
19 East 34th Street
New York, New York 10016

Application for Retirement (Replacement form only) Replacement application to receive retirement benefits under The Church Pension Fund Clergy Pension Plan. Call (866) 802-6333 M-F ET for a complete retirement packet.

One of several forms in your retirement packet. By itself, this application will not initiate your retirement.

Change of Address Form Update your personal address and contact information on all your CPG accounts.

Complete, sign and return by faxing to (212) 592-9408 or
Mail to the Customer Engagement Team
Church Pension Group
19 East 34th Street
New York, NY 10016
Call toll-free (866) 802-6333

Payment Method Authorization Form To receive your monthly pension benefit by direct deposit

The Church Pension Fund
C/o Pension Services
19 East 34th Street
NY, NY 10016

New Assignment Notice To update your pension information when you take a new job

Pension Services
The Church Pension Fund
19 East 34th Street
New York, NY 10016
or fax to (212) 592-9487

Personal Status/Changes Form To update your contact information and report marriage, births, etc.

Pension Services
The Church Pension Fund
19 East 34th Street
New York, NY 10016
or fax to (212) 592-9487

Report of Change in Your Compensation To report a change in your compensation

Pension Services
The Church Pension Fund
19 East 34th Street
New York, NY 10016
or fax to (212) 592-9487

Retirement Return Checklist To help make sure you know to send all the documents necessary to process your retirement.

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Clergy Pension Publications

  Title What is This For? Pgs
2015 Clergy Tax Guide (for 2014 Tax Returns) Guide for filing personal taxes.

63

N/A Checklist for Clergy To help you prepare for retirement

1

Guide to Benefits Under the Clergy Pension Plan Clergy: Overview of clergy pension benefits and rules

47

Retirement Benefits & Savings Options for Clergy - International For U.S. citizens and U.S. resident aliens who have service inside and outside the U.S.

2

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Divorce & Marriage Forms

Title What is This For? Contact Information
Divorce and Your Pension General information concerning divorce and your pension.

Legal Department
The Church Pension Fund
19 East 34th Street
New York, NY 10016
QDRO@cpg.org
Fax: (212) 592-9428

Consent Form Authorizes CPF to give your pension information to your attorney or to someone else.

Legal Department
The Church Pension Fund
19 East 34th Street
New York, NY 10016
QDRO@cpg.org
Fax: (212) 592-9428

Former Spouse Option Election Form To provide a survivor's benefit to a former spouse

Client Services Operations
The Church Pension Fund
19 East 34th Street
New York, NY 10016
benefits@cpg.org
Fax: (877) 432-9274

Model QDRO Form for Clergy To divide your retirement benefit with a former spouse

Legal Department
The Church Pension Fund
19 East 34th Street
New York, NY 10016
QDRO@cpg.org
Fax: (212) 592-9428

QDRO Procedures for Clergy Steps for determining spousal benefits in the event of divorce

Legal Department
The Church Pension Fund
19 East 34th Street
New York, NY 10016
QDRO@cpg.org
Fax: (212) 592-9428

Revocation of Former Spouse Option Form To revoke benefit from former spouse

Client Services Operations
The Church Pension Fund
19 East 34th Street
New York, NY 10016
benefits@cpg.org
Fax: (877) 432-9274

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Withdrawal Forms

Title What is This For? Contact Information
Deferred Annuity Contract Withdrawal Form Deferred Annuity Contract Withdrawal Form

Church Life Insurance Corporation
19 East 34th Street
New York, NY 10016

Direct Deposit of Church Life Annuity Benefit Direct Deposit of Church Life Annuity Benefit Form

Church Life Insurance Corporation
19 East 34th Street
New York, NY 10016

Federal Income Tax Withholding Certificate Form W-4P Federal Tax Withholding Form for Pension or Annuity Payments

Interest Accumulation Fund Account Withdrawal Form Interest Accumulation Fund Account Withdrawal Form

Church Life Insurance Corporation
19 East 34th Street
New York, NY 10016

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