401(k) Contribution Authorization Form

Purpose

 This application allows for contributions from an employee's salary towards a PERA 401(k) tax-deferred annuity. 

Fax this form to Employee Services at 303-860-4299. Enrollment and changes received by the 10th of the month will be effective that month.

Last updated: 3/26/2019

Download this form below. Then, fax this form to Employee Services.