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Application for Lump Sum (De minimis) Retirement Distribution

About this Form

Form number: 455-26

Audience:  MCPS Staff

Last revised: April 2014

INSTRUCTIONS: Complete this form 30 days prior to effective date of retirement, and return to the Employee and Retiree Service Center.

Adobe PDF Application for Lump Sum (De minimis) Retirement Distribution49 KEnglish

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