Below you will find all the forms available at the Pension Fund office.  In order to expedite your requests, you are welcome to download the forms, complete and return to:

Park Employees' Annuity & Benefit Fund

55 East Monroe Street, Suite 2720

Chicago, IL  60603

By doing this, you will eliminate the time required to contact the Fund and request the forms via mail.  You can reach the Fund at (312) 553-9265.

Please Note:

All pages of a downloaded form must accompany your mailing.  If a page is left blank, please send it.

Forms & Downloads

Park Employees' Annuity and Benefit Fund

of Chicago

Pension Forms

The form below must be completed if your spouse was a Chicago Park District Employee and has passed away.  You may be eligible for a survivor's pension and should complete the form below.

APPLICATION FOR SURVIVOR'S ANNUITY

DIRECT DEPOSIT AGREEMENT

The form below must be completed if you want to take advantage of Direct Deposit. By doing so, your benefit check will be automatically credited to your bank account at 12:01 AM on the first (1st) of every month.

The form below must be completed if you wish to retire.

Active Member

Forms

The form below must be completed if you were injured on the job and you want to apply for Duty Disability. 

APPLICATION FOR DUTY DISABILITY BENEFIT

The permanent record of your membership in the Fund is referred to as your "Membership Record". This form must be completed and filed at the Fund office. 

General Forms

The form below must be completed and filled out at the Fund office if you wish to update or change your beneficiary. You must complete a new form.  NOTE:  This form must be notarized prior to submission.

DESIGNATION OF BENEFICIARY

Refund Forms

The form below must be completed if you are no longer employed by the Chicago Park District and you wish to receive a refund of all your contributions to date.  Please allow at least 2 weeks prior to requesting your refund.  This 2 week period will insure that all of your payroll postings have been posted and that you will receive the entire amount of your refund.

REQUEST FOR REFUND

The form below must be completed if you have an illness or injury not related to your employment and you are seeking to collect Ordinary Disability Benefit.

APPLICATION FOR ORDINARY DISABILITY BENEFIT NON-JOB RELATED

APPLICATION FOR RETIREMENT

MEMBERSHIP RECORD