Flex Retirees Organization

FRO Signup Page

In order to pursue additional actions on behalf of FRO members, we need the following demographic information. Please be assured that all your information is being treated as personal & confidential. It has and will only be shared with those who “need to know”. Demographic information will be used without including personal information such as name, address.

Please fill this form out only once for each retiree. If both your and your spouse worked for John Deere, both of you should fill out this form.

DO NOT hit the enter key until all the data has been entered. It's best to use the tab key to move to the next field.

PLEASE TYPE CAREFULLY AND CHECK YOUR ENTRY BEFORE SUBMITTING!

    Retiree's First Name: *
   Retiree's Middle Name: *
     Retiree's Last Name: *
     Retiree's Birthdate: (MM-DD-YYYY) *
        Retiree's Gender: *
     Spouse's First Name:
   Spouse's Middle Name:
    Spouse's Last Name:
      Spouse's Birthdate: (MM-DD-YYYY)
         Spouse's Gender:
Retiree's Street Address: *
          Retiree's City: *
      Retiree's State: (2 character state only) *
      Retiree's ZIP Code: *
Retiree's Home Phone #: (123-456-7890)
Retiree's Cell Phone #: (123-456-7890)
Retiree's E-mail Address:

Secondary or Winter Address (Optional)
          Street Address:
                    City:
                   State: (2 character state only)
              Zip Code:
                 Phone #: (123-456-7890)
For the Retiree only
               Hire Date: (MM-DD-YYYY) *
Deere Unit where hired: *
         Retirement Date: (MM-DD-YYYY) *
Deere Unit at retirement: *
      Type of Retirement: *
     IF SERP what year?
Were you eligible to retire on 1 July 1993? *

Comments: