Forms By Subject - TRSL - Teachers' Retirement System of Louisiana

Forms by Subject

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Document drop off – You can drop off documents at the TRSL office. But...don’t forget! Documents can be submitted to us through normal delivery methods, including mail, email, or fax. Please note that TRSL requires originals (not copies or scans) of some TRSL forms. If an original is required, it will be noted at the top of the form.

Address or name changes

Change of Address Authorization (Form 2AC) - For active members, retirees, survivors, beneficiaries, & alternate payees

Active Member Name Change Request (Form 2NC)

ORP Member Change of Address Authorization (Form 16AC)

ORP Member Name Change Request (Form 16NC)

Beneficiary (Designations by member)

Beneficiary Designation for Non-Retired Members (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)

Physician Report of Disabling Condition (Form 12C)

Physician Annual Report of Disabling Condition (Form 12D) - For retirees only

Statement of Child's Permanent Disabling Condition (Form 12PDMC)

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 or Beneficiary's Estate or Successor's Request for Withdrawal (Form 11K-E)

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 73 and Over (Form 11N)

DROP or ILSB Retiree Partial Single-Sum Withdrawal (Form 11PS)

Direct Deposit of DROP or ILSB Account Withdrawals (Form 11R)

Withholding Certificate for Periodic Pension or Annuity Payments (Form 5-W4P) IRS form

Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions (Form 5-W4R) IRS form

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)

Agency Certification (Form 11B)

Sick Leave Certification (Form 11S)

Retiree Return-to-Work Critical Shortage Certification (Form 15CS)

Return-to-Work (RTW) of TRSL Retiree - La. R.S. 11:710.1 (Form 15ELEC)

RTW of TRSL Retiree - Special Transfer Group Election of 2010 Group Coverage (Form 15TR)

Electronic Reporting Registration (Form 18)

Enrollment

Enrollment Application/Employment Notification (Form 2)

Certification of Membership in State System (Form 2C)

Enrollment Application for Secondary Part-Time Position with Same Employer (Form 2PT)

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)

Federal forms

10-W4	Withholding Certificate for Periodic Pension or Annuity Payments (for retirement benefits)	IRS form
05-W4P	Withholding Certificate for Periodic Pension or Annuity Payments (for DROP/ILSB withdrawals)	IRS form
05-W4R	Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions (for DROP/ILSB withdrawals)	IRS form
10-W4R	Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions (for refund payments)	IRS form