Ohio Patrolmen's Benevolent Association
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OPBA Retirement Information Sheet

RETIREMENT ITEMS SHOULD BE MAILED TO YOU WITHIN 3 MONTHS FROM OUR RECEIPT OF THIS FORM.

First Name:
Middle Initial:
Last Name:
Position:
Department:
Badge Number (if applicable):
Mailing Address:
Phone Number:
Email: 
Retirement Date:
Years of Service (including bought military and other dept.)
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