Pension Administration


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Treasurer Contact

Office of the Treasurer
550 Main Street
Hartford, CT 06103
Telephone: (860) 757-9110
Fax: (860) 722-6071
Office Hours: 8:00am - 5:00pm

Retiree Forms and Instructions

Dear Retiree,
See below for links to five commonly used forms. All forms can be returned to us at the following address, sent back via fax at 860-722-6068, or scanned and emailed to the Plan Administrator, Donna Parker, at This email address is being protected from spambots. You need JavaScript enabled to view it..">This email address is being protected from spambots. You need JavaScript enabled to view it.. If you have any questions about completing the forms, please call us at 860-757-9128.

City of Hartford – Pension Unit
550 Main Street
Hartford, CT 06103


2012 Fed W4P Fed W4P

Federal Taxes (W-4P)

If you do not want any income taxes withheld, check the box at the end of line 1. Leave the other lines blank.
If you want additional taxes withheld in addition to the standard percentage:

  • Leave line 1 blank on the Withholding Certificate at the bottom of the first page of the Form W-4P.
  • Complete line 2 with your marital status and the number of exemptions you want.
  • Put the total additional dollar amount to be withheld, including any amount currently being withheld, in the blank at the end of line 3. Underneath that amount write "TOTAL ADDITIONAL".

2012 CT W4P CT W4P

Connecticut Taxes (CT-W4P)

If you are living out of state and do not wish to have Connecticut income tax withheld, please complete the Form CT-W4P with $0.00 withholding. If you move out of state, your Connecticut tax withholding will not be stopped automatically.

Please note that the Connecticut form requires you to state the amount you want withheld as a flat dollar amount. There is no option for you to enter a percentage or to ask that taxes be automatically calculated.


COH Direct DepositDirect Deposit

Direct Deposit Form: Note that the direct deposit will not occur until the second month after the direct deposit information is received. Your first pension payment after we receive your direct deposit request will be paid in the form of a paper check. If you are changing your direct deposit from one bank to another, you will receive a paper check for the month in between the switch. DO NOT THROW AWAY YOUR CHECK.


COH Address Change Address Change

Change of Address Form: You need to change your address in writing. If you need to change your address for the current month, please call us at 860-757-9128 to make arrangements to hold your next check or direct deposit advice.



COH Beneficiary Form Address Change


Beneficiary Form: If you die after you retire, and you do not have an eligible spouse, Civil Union partner, or children according to the terms of the Plan, your named beneficiaries will receive the balance of any contributions in your account.

HARTFORD CITY HALL ADDRESS: 550 Main Street, Hartford, CT 06103 PHONE: (860)757-9311 HOURS: 8AM - 5PM