members
Members

Forms

Subject List

Beneficiary/Survivor
Deferred Compensation Program
Finance Management
IRS Forms
Judicial Benefit Multiplier Program
Legal
Nearing Retirement
New Members
Plan 3
Retiree or Withdrawn/Inactive Member
Substitute Teacher/School Employee
Withdrawals

Beneficiary/Survivor

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.


Deferred Compensation Program

All Deferred Compensation Program Forms
Forms are available at the DCP Web site.
DCP Distribution Request
DCP Participation Agreement


Finance Management

Information Release Authorization
Release your account information to a third party, such as your financial planner.


IRS Forms

IRS form W-4P
Withholding certificate for pension or annuity payments. Use this form to tell payers the correct amount of federal income tax to withhold from your payment(s).
IRS form W-8BEN
Note: This form is on the IRS Web site. It does not belong to DRS.
IRS form W-9
Note: This form is on the IRS Web site. It does not belong to DRS.


Judicial Benefit Multiplier Program

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.


Legal

Affidavit of Attorney in Fact
This completed form must accompany your Power of Attorney document.


Nearing Retirement

Authorization for Direct Deposit
Complete this form to sign up for direct deposit of your retirement benefit.
PERS Plan 1 Request for Post 30-Year Program Benefit Estimate
TRS Plan 1 Request for Post 30-Year Program Benefit Estimate


New Member

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.
Member Information Form
Enrollment form 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

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.
Plan 3 forms
TRS Plan 3 January Contribution Rate Change Form
For TRS Plan 3 members wishing to change their contribution rate during the month of January.


Retiree or Withdrawn/Inactive Member

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.


Substitute Teacher/School Employee

SERS Plan 2 and Plan 3 Substitute's Guide (Includes Form)
Substitute teachers who belong to SERS Plan 2 or Plan 3.
TRS Plan 2 and Plan 3 Substitute's Guide (Includes Form)
Substitute teachers who belong to TRS Plan 2 or Plan 3.


Withdrawals

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 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.