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REVENUE TRANSMITTAL FORM PMRB-20

PLEASE RETURN THIS COPY TO PMRS$ _____ Fund Money (Municipal, General, or Special)$ _____ State Aid - Act 205$ _____ Employee Deductions for _____$ _____ Other (Please Explain) REVENUE TRANSMITTAL FORMPMRB-20 Commonwealth of Pennsylvania07/09 INSTRUCTIONS: This form should be completed when sending any remittances to PMRS for deposit with your pension plan. Please identify the source and purpose of the mail this form and any related documents, including a check made payable to Pennsylvania Municipal Retirement System, BOX 1165 HARRISBURG, PA 17108-1165 PLEASE TYPE OR PRINT ALL ENTRIES IN INK AND SIGN WHERE A: To be completed by MUNICIPAL PLAN NAME 2. MUNICIPAL CODE 3. CHECK AMOUNT4. SOURCE OF THIS PAYMENT 5.

PLEASE RETURN THIS COPY TO PMRS $ _____ Fund Money (Municipal, General, or Special) $ _____ State Aid - Act 205 $ _____ Employee Deductions for

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  Form, Revenue, Transmittal, Revenue transmittal form pmrb 20, Pmrb

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