Pensions

e-Signature Forms

It’s quick, convenient, and safe—and completely paperless!

Find these electronic forms in the Resources section of MyCPG Accounts: 

  • – Direct Deposit Authorization Form     
  • – Working While Pensioned Exception Application
  • – Extension of Ministry Application

Certain Transactions Require MAP

Starting Q4 2026, certain transactions must be completed in My Admin Portal (MAP) by an Institution Administrator. Organizations without an Institution Administrator should contact their Diocesan Administrator as soon as possible to have one assigned.

Clergy Pension Forms
Title
What is this for?
Pages
Mail It
Personal Information Change Form
To update personal information for clergy and lay employees.
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016
Preretirement Survivor Benefit Designation Form
To designate beneficiaries for the preretirement survivor benefit under the Clergy Pension Plan
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016
New Assignment Notice - 2017
To update your pension information when you take a new job effective on or before December 31, 2017
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016 or fax to 877-432-9274
Report of Change in a Cleric's Compensation - 2017
To report a change in your compensation effective on or before December 31, 2017
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016 or fax to 877-432-9274
Working While Pensioned Exception Application
To request an exception to the rules for Working While Pensioned
The Church Pension Fund c/o Benefits Policy COEO Committee 19 East 34th Street New York, New York 10016
Payment Method Authorization Form
To receive your monthly pension benefit by direct deposit
The Church Pension Fund Attn: Client Services 19 East 34th Street NY, NY 10016
Extension of Ministry Application
To continue participating in the Clergy Pension Plan while serving at a non-The Episcopal Church organization
The Church Pension Fund 19 East 34th Street New York, NY 10016
Employer Adoption Agreement-Clergy Pension Plan or International Clergy Pension Plan
Agreement form to join The Church Pension Fund Clergy Pension Plan or International Clergy Pension Plan for an employer who is associated with The Episcopal Church (but not subject to the authority of the Church)
2
N/A
Defined Benefit Plan (Lay)
Title
What is this for?
Contact Information
Personal Information Change Form
To update personal information for clergy and lay employees.
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016
Lay Lump Sum Death Benefit Beneficiary Designation Form
To name a beneficiary for the Lay Lump Sum Death Benefit (payable if an eligible Lay DB participant dies prior to retirement)
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016
Lay Defined Benefit Retirement Plan Employer Adoption Agreement
For an employer to join the Lay DB pension plan
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016
Defined Contribution Plan (Lay)
Title
What is this for?
Contact Information
Personal Information Change Form
To update personal information for clergy and lay employees.
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016
Sample Annual Notice Letter
Sample annual letter for non-qualified organizations to send employees with RSVP and DC pension
Employee Enrollment Form Defined Contribution (RSVP and Lay DC) Plans
Employer record-keeping for an employee to join the Lay DC plan or RSVP
admin-assist@cpg.org
Adoption Agreement for the Lay DC 403(b) Plan
For employers to adopt The Episcopal Church Lay Employees’ Defined Contribution Retirement Plan (403(b)) or amend an existing adoption of that plan.
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016
Adoption Agreement for the Lay DC 401(a) and 403(b) Plans
For employers to amend an existing adoption of The Episcopal Church Lay Employees’ Defined Contribution Retirement Plans (401(a) & 403(b)). No new adoptions of the Lay DC 401(a) plan are permitted.
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016
Fidelity PSW New User Request Form
For access to PSW contribution remittance platform for Lay DC and RSVP remittances
Divorce & Marriage Forms
Title
What is this for?
Contact Information
Splitting Your Pension Upon Divorce - Clergy DB
Information about how a QDRO can be used to split DB pension benefits due to a divorce.
Splitting Your Pension Upon Divorce - Lay DB
Information about how a QDRO can be used to split pension benefits due to a divorce.
QDRO Procedures - DB Plan (Clergy and Lay)
Determination process for approval of a qualified domestic relations order (QDRO).
Model QDRO - Shared Payment - Clergy Pension Plan
Model order for shared payment QDRO
Model QDRO - Shared Payment - Lay DB Plan
Model order for shared payment QDRO
Model QDRO - Separate Interest - Clergy Pension Plan
Model order for separate interest QDRO
Model QDRO - Separate Interest - Lay DB Plan
Model order for separate interest QDRO
DRO Procedures & Models – RSVP & Lay DC Plan
How a domestic relations order (DRO) can be used to split a defined contribution plan account due to a divorce, including the determination process and model DROs
Fidelity Workplace Services, LLC, QDRO Administration Group, P.O. Box 770001, Cincinnati, OH 45277-0066 ATTN: The Church Pension Fund
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
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
Tax Withholding Forms
Title
What is this for?
Pages
Mail It
IRS Withholding Forms At-A-Glance
Overview of revised Form W-4P and new Form W-4R
1
N/A
Form W-4P – Withholding Certificate for Periodic Pension or Annuity Payments (Federal Income Tax)
To withhold federal taxes from your periodic pension payments
3
N/A
Instructions for Form W-4P – Withholding Certificate for Periodic Pension or Annuity Payments (Federal Income Tax)
Instructions for completing the Form W-4P
2
N/A
State Equivalent – Withholding Certificate for Periodic Pension Distributions (State Income Tax)
To withhold state taxes from your monthly pension benefit
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016
Form W-4R – Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions (Federal Income Tax)
To withhold federal taxes on your nonperiodic pension distributions
3
N/A
Instructions for Form W-4R – Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions (Federal Income Tax)
Instructions for completing the Form W-4R
2
N/A
State Equivalent – Withholding Certificate for Nonperiodic Pension Distributions (State Income Tax)
To withhold state taxes from your non-periodic pension payments
The Church Pension Fund Attn: Client Services 19 East 34th Street New York, NY 10016
2026 Federal Income Tax Status Of CPF (Form B)
To calculate housing exclusion for retirees
2
2025 Federal Income Tax Status Of The Church Pension Fund Benefits (CPF Form B)
To calculate housing exclusion for retirees
2
2024 Federal Income Tax Status Of The Church Pension Fund Benefits (CPF Form B)
To calculate housing exclusion for retirees
1
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