Federal forms |
W-4P |
Withholding Certificate for Pension or Annuity Payments |
IRS form |
|
TRSL forms |
1 |
Authorized Contacts (04/18) |
1EDC |
Employer Directory Contacts (04/18) |
2 |
Enrollment Application/Employment Notification (02/21) |
2AC |
Change of Address Authorization (02/21) - For active members, retirees, beneficiaries, & alternate payees |
2C |
Certification of Membership in State System (02/21) |
2FRB |
Forfeiture of Retirement Benefits - Attestation of Understanding (02/21) |
2NC |
Active Member Name Change Request (02/21) |
2PT |
Enrollment Application for Secondary Part-Time Position with Same Employer (02/21) |
2R |
Election to Retain Membership (02/21) |
2SS |
Statement Concerning Your Employment in a Job Not Covered by Social Security (02/21) |
3 |
Beneficiary Designation for Non-Retired Members (12/20) - Return-to-work retirees use 3C |
3A |
Change of Beneficiary for Option 1 Retiree (12/20) |
3B |
Beneficiary Designation for DROP and ILSB Accounts (12/20) |
3C |
Beneficiary Designation for Retiree Return-to-Work Employee Contributions (12/20) |
4C |
Employment Terminations (04/05) |
4D |
Payment Distribution Voucher (01/20) |
4F |
Prior Year Correction of Earnings and Contributions (08/07) |
6A |
Certification of Supplemental Credit (02/04) |
7 |
Application for Refund (04/21) (See "Special Tax Notice Regarding TRSL Payments") |
7A |
Retiree Refund Application (04/21) (See "Special Tax Notice Regarding TRSL Payments") |
7D |
Direct Deposit for Refund of Contributions (04/21) (See "Special Tax Notice Regarding TRSL Payments") |
8 |
Application for Reciprocal Recognition of Service (08/07) |
8A |
Application for Transfer of Creditable Service (01/21) |
8BR |
Application for Purchase of Refunded Service to Reciprocate (08/07) |
8BT |
Application for Purchase of Refunded Service to Transfer (08/07) |
9 |
Application for Purchase of In-state Service (1/19) |
9A |
Application for Purchase of Out-of-State Public School Employment (1/19) |
9B |
Application for Purchase of Military Service (1/19) |
9C |
Application for Purchase of U.S. Dependent School Teaching Service (1/19) |
9D |
Application for Purchase of Refunded Service (08/02) |
9E |
Application for Purchase of In-state Private / Charter School Service (1/19) |
9R |
Rollover/Trustee-to-Trustee Transfer Acceptance (04/14) |
10 |
Benefit Estimate Request (05/19) |
11 |
Application for Service Retirement, ILSB, or DROP (01/21) - Replaces old forms 11A and 11F |
11B |
Agency Certification (12/20) |
11G |
DROP or ILSB Account Spousal Consent (11/20) |
11G-1 |
DROP or ILSB Retiree Spousal Consent to Withdrawal Method (11/20) |
11H |
Termination of Employment at End of DROP Participation/Employment (11/20) |
11J |
DROP or ILSB Retiree Withdrawal Method Selection (11/20) |
11K |
DROP or ILSB Retiree Nonspousal Beneficiary Request for Withdrawal Selection (11/20) |
11K-P |
DROP or ILSB Retiree Alternate Payee Receiving Split Benefit as a Result of Divorce (11/20) |
11K-S |
DROP or ILSB Retiree Spousal Beneficiary Request for Withdrawal Selection (11/20) |
11M-S |
DROP or ILSB Retiree Spousal Beneficiary Request for Withdrawal (03/21) |
11N |
DROP or ILSB Retiree Withdrawal Method Selection for Ages 72 and Over (11/20) |
11PS |
DROP or ILSB Retiree Partial Single-Sum Withdrawal (11/20) |
11R |
Direct Deposit of DROP or ILSB Account Withdrawals (11/20) - Use 15D for regular benefits |
11RTW |
Application for Return-to-Work (RTW) Supplement (11/20) |
11S |
Sick Leave Certification (11/20) |
12 |
Application for Disability Retirement (01/21) - now combined with Form 12B |
12A |
Disability Report by Supervisor (01/21) |
12B |
Member Statement of Disabling Condition - now combined with Form 12 |
12C |
Physician Report of Disabling Condition (01/21) - now combined with Form 12C-P |
12C-P |
Physician Report of Disabling Condition - now combined with Form 12C |
12D |
Physician Annual Report of Disabling Condition (01/21) - For retirees only |
12PDMC |
Statement of Child's Permanent Disabling Condition (01/21) |
13 |
Application for Survivor Benefits (04/21) |
13A |
Application for Refund of Deceased Member's Contributions (04/21) |
13C |
Student Attendance Certification (04/21) |
13E |
Application for Payment to Surviving Spouse/Children (04/21) |
13M |
Statement of Dependent's Marital Status (04/21) |
14A |
Company Application Retiree Payroll Deduction Program (04/18) |
15 |
Retiree Return-to-Work Notification (obsolete) refer to Procedures Manual for enrollment instructions, Index 15.0 |
15C |
Retiree Change of Address Authorization - OBSOLETE (Use Form 2AC) |
15CS |
Retiree Return-to-Work Critical Shortage Certification (12/20) |
15D |
Direct Deposit of Benefits (12/20) - Use 11R for DROP or ILSB account withdrawals |
15ELEC |
Return-to-Work (RTW) of TRSL Retiree - La. R.S. 11:710.1 (12/20) |
15JS |
Addendum to Direct Deposit of Benefits - Nonspousal Joint Signer(s) (12/20) |
15PA |
Affidavit for Power of Attorney (12/20) |
16 |
Application for ORP or Change of Carrier (06/19) |
16AC |
ORP Member Change of Address Authorization (09/10) |
16NC |
ORP Member Name Change Request (09/10) |
18 |
Electronic Reporting Registration (07/10) |
FBR |
Option to Continue Contributions during Time of Furlough without Pay (10/09) |
PARC |
Petition for TRSL Administrative Rule Adoption, Amendment, or Repeal (07/19) |