Locating and Paying Participants

September 2012

Draft of Modernized My PBA Screens

The screen mockups are intended to show the expected placement of the data elements for the modernized MyPBA. Please disregard

• any data reflected on the screens, e.g., 2012

• inconsistent data

• review tags shown in brackets (e.g., [*F*], [*R*], etc.).

Contents

Form 700 Apply for Pension Benefits 2

Form 701 Payee Information Form 9

Form 705 Beneficiary Application for Pension Benefits 10

Form 706 Beneficiary Application For Pension Benefits – OF 18

Form 707 Designation of Beneficiary for Benefits Owed at Death 26

Form 708 Designation of Beneficiary 27

Form 711 Change of Beneficiary for Certain & Continuous (C&C) Benefits Only 28

Form 716 Continuous Eligibility Certification 29

Form 716A Continuous Eligibility Certification 30

Form 720 Application for Lump-Sum Payment 31

Update Electronic Direct Deposit Screen 33

Election to Withhold Federal Income Tax from Periodic Payments Screen 34

Form 700 Apply for Pension Benefits

Step 4 Tax Withholding: if option B is selected, fields for that option are displayed.

Step 4 Tax Withholding: if option C is selected, fields for that option are displayed.

Form 701 Payee Information Form

Form 705 Beneficiary Application for Pension Benefits

Step 4 Tax Withholding: if option B is selected, fields for that option are displayed.

Step 4 Tax Withholding: if option C is selected, fields for that option are displayed.

Form 706 Beneficiary Application For Pension Benefits – OF

Step 4 Tax Withholding: if option B is selected, fields for that option are displayed.

Step 4 Tax Withholding: if option C is selected, fields for that option are displayed.

Form 707 Designation of Beneficiary for Benefits Owed at Death

Form 708 Designation of Beneficiary

Form 711 Change of Beneficiary for Certain & Continuous (C&C) Benefits Only

Form 716 Continuous Eligibility Certification

Form 716A Continuous Eligibility Certification

Form 720 Application for Lump-Sum Payment

Lump sum Payment Election: if option A is selected, fields for that option are displayed.

Lump sum Payment Election: if option C is selected, fields for that option are displayed.

Update Electronic Direct Deposit Screen

Election to Withhold Federal Income Tax from Periodic Payments Screen

Tax Withholding: if option B is selected, fields for that option are displayed.

Tax Withholding: if option C is selected, fields for that option are displayed.

Rev. 9/28/2012 - Page 6