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APPLICATION FORM

Call us at 1-877-822-4209 if you require assistance filling in the application form.

STEPS TO COMPLETE APPLICATION

You require Adobe Acrobat Reader to fill out the form.

You can download Acrobat Reader for free here if it’s not installed on your computer.

You require Adobe Acrobat Reader to fill out the form.

You can download Acrobat Reader for free here if it’s not installed on your computer.
  1. Download the fillable PDF application form.
  2. Save the PDF file to your computer.
  3. Locate saved file on your computer.
  4. Saved Files are typically found in your download folder.

  5. Right Click on the file, select Open With and choose Adobe Acrobat Reader DC
  1. Download the fillable PDF application form.
  2. Save the PDF file to your computer.
  3. Locate saved file on your computer.
  4. Saved Files are typically found in your download folder.

  5. Right Click on the file, select Open With and choose Adobe Acrobat Reader DC
  1. Fill in the application form.

    Save your progress anytime by selecting FILE from the top menu and choosing SAVE AS or by clicking SAVE FORM on the last page. Rename the file to your company name so it’s easy to find

  2. Add additional employee information by clicking Add Another Employee
  3. Click Save Form at the bottom of the PDF once completed.
  4. Choose where you want to save your file on your computer

    We recommend saving it on your Desktop so it’s easy to find.

  5. Rename the PDF file to your company name
  1. Fill in the application form.

    Save your progress anytime by selecting FILE from the top menu and choosing SAVE AS or by clicking SAVE FORM on the last page. Rename the file to your company name so it’s easy to find

  2. Add additional employee information by clicking Add Another Employee
  3. Click Save Form at the bottom of the PDF once completed.
  4. Choose where you want to save your file on your computer

    We recommend saving it on your Desktop so it’s easy to find.

  5. Rename the PDF file to your company name
Email the saved application form to service@pebplans.com or print and fax it to 1 888 787 0727
Email the saved application form to service@pebplans.com or print and fax it to 1 888 787 0727
explaining tips
Email the saved application form to service@pebplans.com or print and fax it to 1 888 787 0727

Tips and tricks

Added too many pages? Click the Delete Page button on the right top corner to remove extra pages.
Add up to 50 employees by clicking on the Add Another Employee button at the bottom left corner
Click the Save Form Button and save the document to your computer. We recommend saving it to your desktop so it’s easy to find.
Rename the PDF to your company name and press the save button.
Email the saved application form to service@pebplans.com or print and fax it to 1 888 787 0727