Forms → Staff → Benefits → Designation of Beneficiary/Beneficiaries
Form number: 455-5
Audience: MCPS Staff
Last revised: August 2015
This form is to be used by MCPS staff ONLY to update their MCPS Core and/or Supplemental Pension Plan beneficiary/beneficiaries.
Please return completed form to the Employee and Retiree Service Center, Montgomery County Public Schools, 45 West Gude Drive, Suite 1200, Rockville, Maryland 20850. Print clearly. Retain a copy for your records.
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