Form 5C: Rollover Distribution Election - Mississippi
Public Employees’ Retirement System of Mississippi 429 Mississippi Street, Jackson, MS 39201-1005 800.444.7377 601.359.3589 601.359.5261, fax www.pers.ms.gov Rollover Distribution Election Form 5C – Revised 03/18/2020 Please print or type in black ink.
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