337 N. Main, Sikeston, MO 63801
I authorize MoDOT & Patrol Employees' Retirement System to provide a verification of my benefits to the following Credit Union:
Division 10 Highway Employee's Credit Union
Intended Use of Information: Verification for Loan
This Authorization to Provide Benefit Verification will be effective for 90 days (one-time authorization).
By submitting the form below, I certify that I have read and agree to the Electronic Signature Terms.