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This page has not been translated. Please go to PBGC.gov's Spanish home page for more information available in Spanish.

Esta página no ha sido traducida. Por favor vaya a la página principal del sitio de español de PBGC para ver información disponible en español.

Forms for Workers and Retirees

PBGC may ask workers and retirees to provide additional required information, as appropriate. Some of these forms may be submitted electronically via My Pension Benefits Access (MyPBA), an online service for participants to complete transactions with PBGC. For more information, see Online Transactions: My MyPBA FAQs.

Form Number

Form Name

How to Obtain Form or What Information to File

How to Submit Information

700

Participant Application for Pension Benefits

MyPBA or Customer Contact Center

By mail, MyPBA

700RN

Election of Retroactive Annuity Starting Date (Spousal Consent Not Required

Limited circulation*

By mail, MyPBA

700RSC

Election of Retroactive Annuity Starting Date (Spousal Consent Required)

Limited circulation*

By mail, MyPBA

701

Payee Information Form (PIF)

MyPBA, PDF, or Customer Contact Center

By mail, MyPBA

702

General Information Form (GIF)

Limited circulation

By mail

703

Application for Elective Lump-Sum Payment

Limited circulation*

By mail

703MP

Application for Elective Lump-Sum Payment (For Missing Participants)

Limited circulation*

By mail

703RBD

Application for Elective Lump-Sum Payment, post RBD

Limited circulation*

By mail

703RBD-MP

Application for Elective Lump-Sum Payment, post RBD (For Missing Participants)

Limited circulation*

By mail

704

Report of Earnings and Social Security Disability Information

Limited circulation*

By mail

705

Beneficiary Application for Pension Benefits

Customer Contact Center

By mail

706

Beneficiary Application for Pension Benefits – OF (For benefits in optional form)

Customer Contact Center

By mail

707

Designation of Beneficiary for Benefits Owed at Death (Currently Receiving Pension Benefits)

MyPBA, PDF, or Customer Contact Center

By mail, MyPBA

708

Designation of Beneficiary (Not Currently Receiving Pension Benefits)

MyPBA, PDF, or Customer Contact Center

By mail

710

Application for Electronic Direct Deposit

MyPBA, PDF, or Customer Contact Center

By mail, MyPBA

711

Change of Beneficiary for Certain & Continuous (C&C) Benefits Only

PDF, or Customer Contact Center

By mail

712

Uniformed Services Information Form

Limited circulation*

By mail

713

Election to Withdraw Employee Contributions

Limited circulation*

By mail

714

Withdrawal of Employee Contributions - Non Spouse Beneficiary

Limited circulation*

By mail

715

Power of Attorney Form

PDF or Customer Contact Center

By mail

716

Certification of Social Security Disability Status

Customer Contact Center

By mail

716A

Certification of Pension Plan Disability Status

Customer Contact Center

By mail

717

Benefit Inquiry Questionnaire

Limited circulation*

By mail

718

Installment Payment Agreement

Limited circulation*

By mail

719

Election to Withhold Federal Income Tax (FIT) from Periodic Payments

MyPBA, PDF, or Customer Contact Center

By mail, MyPBA

720

Application for Lump-Sum Payment

Customer Contact Center

By mail

720CD

Application for Lump-Sum Payment (Child or Other Dependant QDRO)

Limited circulation*

By mail

720MP

Application for Lump-Sum Payment (Missing Participants)

Limited circulation*

By mail

721

Application for Eligible Rollover Payment – Non-Spouse Beneficiary

Limited circulation*

By mail

721T

Tax Election for Payment Not Eligible for Rollover

Limited circulation*

By mail

722

Financial Statement of Debtor

Limited circulation*

By mail

723

Request for Additional time to file an Appeal of a PBGC Benefit Determination

PDF or Customer Contact Center

Follow Form 723 instructions (page 2 of PDF)

724

Appeal of a PBGC Benefit Determination

PDF or Customer Contact Center

Follow Form 724 instructions (page 2 of PDF)

N/A

PBGC Form COA (Change of Address)

PDF or Customer Contact Center

By mail, fax

 

* Some PBGC forms are appropriate for certain situations and are listed as ‘limited circulation’. These forms are not accessible on PBGC’s website. If you think that you may need such a form, please call PBGC’s Customer Contact Center so that a PBGC specialist may determine if the form is appropriate for you.

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Last Updated: April 12, 2022

MyPBA

Participants in PBGC-trusteed plans can use PBGC's fast, free, and secure online service tool to apply for pension benefits, update contact information, adjust federal income tax withholding, and more.

Learn how!

Log In to MyPBA

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