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Non-Represented Pension Calculation Request Form
Name: _____________________________________________
Address: _____________________________________________
_____________________________________________
_____________________________________________
MARTA e-mail address __________________________________
Employee ID #: ____________________________
Date for Calculation: ______________________ (Please provide a date within 5 years of today) If a date is not provided, your calculation will be based on current benefit options.
Today’s Date: _____________________________
Do you have Union Service after January 1, 2005? Y/N Transfer date: _____________
I have purchased ______ yrs. ________ mos. of buyback/portability service.
(If you are a former employee that paid back pension contributions or purchased service from a local Municipality).
A life annuity calculation for the employee will be provided.
Please choose one method of delivery:
FORMCHECKBOX The address indicated above
FORMCHECKBOX Will pick up when completed Phone/Ext: __________________
FORMCHECKBOX MARTA e-mail address
Please limit calculation requests to 2 per year.
Rev. 03/17/2017
Metropolitan Atlanta Rapid Transit Authority
2424 Piedmont Road, N.E.
Atlanta, Georgia 30324-3330
Fax - (404) 848-5519
e-mail - HYPERLINK "mailto:[email protected]" [email protected]
Ph.: (404) 848-5393- Office
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