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Forms by Subject

Address or name changes
Active Member Change of Address Authorization (Form 2AC)
Active Member Name Change Request (Form 2NC)
Retiree Change of Address Authorization (Form 15C) - Survivors, beneficiaries, and alternate payees can also use
ORP Member Change of Address Authorization (Form 16AC)
ORP Member Name Change Request (Form 16NC)
 
Beneficiary (Designations by member)
Beneficiary Designation (Form 3)
Change of Beneficiary for Option 1 Retiree (Form 3A)
Beneficiary Designation for DROP and ILSB Accounts (Form 3B)
Beneficiary Designation for Retiree Return-to-Work Employee Contributions (Form 3C)
 
Direct deposit
Direct Deposit for Refund of Contributions (Form 7D)
Direct Deposit of DROP or ILSB Account Withdrawals (Form 11R) - Use 15D for regular benefits
Direct Deposit of Benefits (Form 15D) - Use 11R for DROP or ILSB account withdrawals
Addendum to Direct Deposit of Benefits - Nonspousal Joint Signer(s) (Form 15JS)
 
Disability retirement
Application for Disability Retirement (Form 12)
Disability Report by Supervisor (Form 12A)
Member Statement of Disabling Condition (Form 12B)
Physician Report of Disabling Condition (Form 12C)
Physician Report of Disabling Condition (Form 12C-P) - For use by psychiatrist
Physician Annual Report of Disabling Condition (Form 12D) - For retirees only
 
DROP and ILSB accounts
Beneficiary Designation for DROP and ILSB Accounts (Form 3B)
DROP or ILSB Account Spousal Consent (Form 11G)
DROP or ILSB Retiree Spousal Consent to Withdrawal Method (Form 11G-1)
DROP or ILSB Retiree Withdrawal Method Selection (Form 11J)
DROP or ILSB Retiree Nonspousal Beneficiary Request for Withdrawal Selection (Form 11K)
DROP or ILSB Retiree Alternate Payee Receiving Split Benefit as a Result of Divorce (Form 11K-P)
DROP or ILSB Retiree Spousal Beneficiary Request for Withdrawal Selection (Form 11K-S)
DROP or ILSB Retiree Spousal Beneficiary Request for Withdrawal (Form 11M-S)
DROP or ILSB Retiree Withdrawal Method Selection for Ages 70-1/2 and Over (Form 11N)
DROP or ILSB Retiree Partial Single-Sum Withdrawal (Form 11PS)
Direct Deposit of DROP or ILSB Account Withdrawals (Form 11R)
 
Employers
Authorized Contacts (Form 1)
Employer Directory Contacts (Form 1EDC)
Forfeiture of Retirement Benefits - Attestation of Understanding (Form 2FRB)
Employment Terminations (Form 4C)
Payment Distribution Voucher (Form 4D)
Prior Year Correction of Earnings and Contributions (Form 4F)
Certification of Supplemental Credit (Form 6A)
Agency Certification (Form 11B)
Sick Leave Certification (Form 11S)
Retiree Return-to-Work Notification (Form 15)
Electronic Reporting Registration (Form 18)
 
Enrollment
Enrollment Application/Employment Notification (Form 2)
Certification of Membership in State System (Form 2C)
Election to Retain Membership (Form 2R)
Statement Concerning Your Employment in a Job Not Covered by Social Security (Form 2SS)
Application for ORP or Change of Carrier (Form 16)
 
Miscellaneous
Forfeiture of Retirement Benefits - Attestation of Understanding (Form 2FRB)
DROP or ILSB Qualified Katrina Emergency Tax Relief Act of 2005 (KETRA) or Gulf Opportunity Zone Act of 2005 (GO Zone) Withdrawals Repayment (Form 11RD)
Company Application Retiree Payroll Deduction Program (Form 14A)
Retiree Return-to-Work Notification (Form 15)
Affidavit for Power of Attorney (Form 15PA)
Option to Continue Contributions during Time of Furlough without Pay (Form FBR)
 
Purchases and transfers of service credit
Application for Reciprocal Recognition of Service (Form 8)
Application for Transfer of Creditable Service (Form 8A)
Application for Purchase of Refunded Service to Reciprocate (Form 8BR)
Application for Purchase of Refunded Service to Transfer (Form 8BT)
Application for Purchase of In-state Service (Form 9)
Application for Purchase of Out-of-State Public School Employment (Form 9A)
Application for Purchase of Military Service (Form 9B)
Application for Purchase of U.S. Dependent School Teaching Service (Form 9C)
Application for Purchase of Refunded Service (Form 9D)
Rollover/Trustee-to-Trustee Transfer Acceptance (Form 9R)
 
Refunds (Please see "Special Tax Notice Regarding TRSL Payments")
Application for Refund (Form 7)
Retiree Refund Application (Form 7A)
Direct Deposit for Refund of Contributions (Form 7D)
Taxable Lump-Sum Distribution Election (Form 7L)
 
Retirees
Withholding Certificate for Pension or Annuity Payments (Form W-4P) - IRS form
Retiree Refund Application (Form 7A)
Retiree Return-to-Work Notification (Form 15)
Affidavit for Power of Attorney (Form 15PA)
Retiree Return-to-Work Critical Shortage Certification (Form 15CS)
Retiree Return-to-Work Position Certification (Form 15POSC)
 
Retirement
Benefit Estimate Request (Form 10)
Application for Service Retirement, ILSB, or DROP (Form 11) - Replaces old forms 11A and 11F
Termination of Employment at End of DROP Participation/Employment (Form 11H)
 
Survivor benefits
Application for Survivor Benefits (Form 13)
Application by Nonspousal Beneficiary for Refund of Deceased Member's Contributions/Benefits (Form 13A)
Application by Spouse for Refund of Deceased Member's Contributions/Benefits (Form 13A-S)
Student Attendance Certification (Form 13C)
Application for Payment to Surviving Spouse/Children (Form 13E)
Statement of Dependent's Marital Status (Form 13M)
Renunciation of Beneficiary (Form 13R)

Helpful checklists

  Beneficiary/Survivor Checklist
  Disability Retirement Application Checklist
  Retirement Application Checklist
  Checklist for Retiring after DROP




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