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  1. Home
  2. Employer Forms

Employer Forms

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General forms

  • Notice of Appointment of Authorized Agent or Contact (SFN 17029)
  • Meeting Request & Registration Form (SFN 53176)
  • Employer Payment Election (SFN 52799)
  • Organization Authorization for Electronic Payment (SFN 59511)

Employer Based Wellness forms

  • Employer Based Wellness Program - Commitment Agreement (SFN 58643)
  • Employer Based Wellness Program Year - End Program/ Activity Confirmation (SFN 58437)
  • Employer Based Wellness Program Discount Application (SFN 58436)
  • Wellness Funding Program Application (SFN 58361)

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Copyright © 2021
ND Public Employees Retirement System
1600 East Century Avenue, Suite 2 | PO Box 1657 | Bismarck, ND 58502-1657
P: 701.328.3900 | TF: 800.803.7377 | F: 701.328.3920
https://www.ndpers.nd.gov/contact/

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