Member Forms - Subject List

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Forms


Beneficiary Designation: In addition to designating the beneficiary of retirement monies, the form includes a section for a $150,000 death benefit for PERS, PSERS, SERS, TRS, LEOFF and WSPRS members who die as a result of an injury sustained in the course of employment, or an occupational disease or infection that arises naturally and proximately out of covered employment.
Legal Order Payee Beneficiary Designation: Designate beneficiary information in case of death prior to complete distribution of benefits. For those receiving a retirement benefit as a result of a legal order.
Name/Address Change: For retirees, beneficiaries and former members. Active members: please update your name and/or address through your employer.


Affidavit of Attorney in Fact: This completed form must accompany your Power of Attorney document.
Deferred Compensation Program Forms: Forms are available at the DCP Web site.


Information Release Authorization: Release your account information to a third party, such as your financial planner.
Member Information Form: Enroll new PERS, SERS or TRS members; for Plan 2 members who choose to transfer to Plan 3; or for Plan 3 members returning to eligible employment.
Plan 3 Change of Investment Program: Plan 3 members use this form to select a new investment program for future contributions; this form should be turned in to the employer.


Judicial Benefit Multiplier Election Form (PERS): This form is for judicial members of the Public Employees' Retirement System who choose to participate in the Judicial Benefit Multiplier Program.
Judicial Benefit Multiplier Election Form (TRS Plan 1): This form is for judicial members of the Teachers' Retirement System Plan 1 who choose to participate in the Judicial Benefit Multiplier Program.


Enrollment: For new members of LEOFF or WSPRS; members returning to a LEOFF or WSPRS eligible position; or PERS elected or Governor-appointed officials; a city managers; or chief administrative officers of a court, port district, or public utility district.


Authorization for Direct Deposit: Have your retirement benefit deposited directly into your personal bank account. You should also complete an IRS form W-4P to advise the correct tax amount to be withheld.
LEOFF Plan 2 Retiree Re-employment Form: This form must be completed by a LEOFF Plan 2 retiree returning to work in a PERS, PSERS, SERS, or TRS eligible position. Retirees must choose between two options: to become a member of PERS, PSERS, SERS or TRS and temporarily suspend their LEOFF benefit; or not become a member and continue to receive their LEOFF benefit.


SERS Plan 2 and Plan 3 Substitute's Guide (Includes Form): Information and forms packet for substitute teachers who belong to SERS Plan 2 or Plan 3.
TRS Plan 2 and Plan 3 Substitute's Guide (Includes Form): Information and forms packet for substitute teachers who belong to TRS Plan 2 or Plan 3.


Withdrawal of Retirement Contributions (For Plan 1 and Plan 2 - Includes Form): For Plan 1 and Plan 2 members who have terminated retirement covered-employment and who are eligible for withdrawal of contributions and interest earned. When completing the request to withdraw your contributions, members need to also complete an IRS form W-9 to verify Social Security Number prior to payment.
Withdrawal of Retirement Contributions (For Plan 3 - Includes Form): See Plan 3 Request for Payment of Defined Contribution Funds.