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Department of Management Services

Forms

This page provides a complete list of the forms available to members. For your convenience, we have grouped forms together in the following retirement packets.

Retirement Packets
DROP Retirement Forms Packet (Adobe PDF Document) Packet containing all the forms needed to apply for DROP Retirement including the DP-11, the DP-ELE, the FRS-11o and the SA-1
Service Retirement Forms Packet (Adobe PDF Document) Packet containing all the forms needed to apply for Service Retirement including the FR-11, the FRS-11o and the SA-1
Disability Retirement Forms Packet-Pension Plan (Adobe PDF Document) Packet containing all the forms needed for Pension Plan members to apply for Disability Retirement including the FR-13, FR-13a, FR-13b, FRS-11o and SA-1
Disability Retirement Forms Packet-Investment Plan (Adobe PDF Document) Packet containing all the forms needed for Investment Plan members to apply for Disability Retirement including the PR-13, FR-13a, FR-13b, PR-11o and SA-2

For your convenience, we have grouped forms together in the following employee contribution refund packet.

Employee Contribution Refund Packet
Refund Packet (Adobe PDF Document) Packet containing the form needed for Pension Plan members to apply for a refund of employee contributions (Form FRS-M81) and a Special Tax Notice on pre-tax refunds

All forms are listed individually in alphabetical order in the following table.

Form ID Form Description
ADDCH-1 (Adobe PDF Document) Mailing Address Change Request Form - FRS Pension Payment Recipients Only
BEN-001 (Adobe PDF Document) Beneficiary Designation Form - Active Members Only
BVR-1 (Adobe PDF Document) Birth Verification Form (Request for Proof of Age)
DFS-A1-26R (Adobe PDF Document) Direct Deposit Authorization
DP-11 (Adobe PDF Document) Application for Service Retirement and the DROP
DP-ELE (Adobe PDF Document) Notice of Election to Participate in the DROP and Resignation of Employment
DP-EXT (Adobe PDF Document) Extension of DROP for Specified K-12 Instructional Personnel
DP-PAYT DROP Selected Payout Method. This form is automatically sent to the DROP participant by the Division three months in advance of the member’s DROP termination date to select his or her DROP payout method (direct payment, rollover, or a combination thereof) upon termination from DROP. Contact the DROP Termination and Refund Payment Section if you have not received this form within the time frame specified or if you are terminating DROP early. This form is not available electronically.
DT-11 (Adobe PDF Document) Teachers' Retirement System Application for Service Retirement and the DROP
ELE-1 (Adobe PDF Document) General Retirement Plan Choice Form for Regular, Special Risk and Special Risk Administrative Support Class Employees
ELE-1-EZ (Adobe PDF Document) "EZ" Retirement Plan Choice Form for Regular, Special Risk and Special Risk Administrative Support Class Employees
ELE-2 (Adobe PDF Document) 2nd Election Retirement Plan Choice Form
ELE-2-EZ (Adobe PDF Document) "EZ" 2nd Election Retirement Plan Choice Form
EOC-1 (Adobe PDF Document) Ballot Form for Employees of Elected Officers' Class
FR-9 (Adobe PDF Document) Information Request
FR-11 (Adobe PDF Document) Application for Service Retirement
FR-13 (Adobe PDF Document) Application for Disability Retirement - Pension Plan Members Only
FR-13b (Adobe PDF Document) Physician's Report
FR-23 (Adobe PDF Document) Notification of Reemployment for Suspension of Retirement Benefits
FR-23a (Adobe PDF Document) Application to Reactivate Retirement Benefits
FR-28 (Adobe PDF Document) Application to Purchase Retirement Credit for a Leave of Absence
FR-30 (Adobe PDF Document) Verification for In-State or Out-Of-State Service Credit
FR-DS-ORP (Adobe PDF Document) State University System/State Community College Optional Retirement Program Distribution Statement
FRS-11o (Adobe PDF Document) FRS Pension Plan Option Selection for Members
FRS-400 (Adobe PDF Document) Application for Special Risk Membership - Law Enforcement/Correctional Officers
FRS-401 (Adobe PDF Document) Special Risk Credit for Past Service
FRS-402 (Adobe PDF Document) Application for Special Risk Equivalent Credit
FRS-404 (Adobe PDF Document) Application for Special Risk Administrative Support Class
FRS-405 (Adobe PDF Document) Application for Special Risk Membership - Firefighters/Paramedics/EMTs
FRS-415 (Adobe PDF Document) Application for Special Risk Class Membership - Forensic Discipline, Effective July 1, 2008
FRS-M81 (Adobe PDF Document) Request for Refund of Employee Contributions
FST-11o (Adobe PDF Document) Option Selection for TRS and SCOERS Members
FST-12 (Adobe PDF Document) Beneficiary Designation Form - Retired Members and DROP Participants
HIS-1 (Adobe PDF Document) FRS Health Insurance Subsidy Certification for Pension Plan Members
HIS-IP (Adobe PDF Document) FRS Application for Health Insurance Subsidy for Investment Plan Members
HIS-IP-2 (Adobe PDF Document) FRS Health Insurance Subsidy Certification for Investment Plan Members
IPDROP-AD-1 (Adobe PDF Document) DROP to Investment Plan Direct Rollover Form for Current Members
IPDROP-RO-1 (Adobe PDF Document) DROP to Investment Plan Direct Rollover Form for Former Members
JAD (Adobe PDF Document) Information about Determining if a Beneficiary Qualifies as a Joint Annuitant
MF-1 (Adobe PDF Document) Statement of Military Eligibility
MF-2 (Adobe PDF Document) Statement of Military Eligibility to Purchase Military Service Under the Out-Of-State Provisions
OAP-ETF (Adobe PDF Document) Supplemental Statement for Distributions for SMSOAP
OCC-1 (Adobe PDF Document) Ballot/Enrollment Form for CCORP Employees
OCC-2 (Adobe PDF Document) Retirement Plan Conversion Form for CCORP Employees
OPT-FRS (Adobe PDF Document) Information about Selecting Benefit Options for FRS Pension Plan Members
ORP-2A (Adobe PDF Document) SUSORP Retirement Conversion Form
ORP-CHANGE (Adobe PDF Document) SUSORP Change Form
ORP-ENROLL (Adobe PDF Document) SUSORP Retirement Plan Choice Form
ORP-ETF (Adobe PDF Document) Supplemental Statement for Distributions for SUSORP
ORP-MAND (Adobe PDF Document) SUSORP Mandatory Participation Form
PR-11o (Adobe PDF Document) Option Selection for Disability Retirement - Investment Plan Members Only
PR-13 (Adobe PDF Document) Application for Disability Retirement - Investment Plan Members Only
PRO-1 (Adobe PDF Document) Pretax Direct Rollover Form
REF-PAYT FRS Pension Plan Refund Payout Selection. This form is automatically sent to the member by the Division to select his or her refund payout method (direct payment, rollover, or a combination thereof) after the member has submitted his or her request for a refund to the Division on Form FRS-M81, and it has been acknowledged by the Division. Contact the DROP Termination and Refund Payment Section if you do not receive this form. This form is not available electronically.
SA-1 (Adobe PDF Document) Spousal Acknowledgement Form
SA-2 (Adobe PDF Document) Spousal Acknowledgement Form for Investment Plan Disability Retirement
SMS-1 (Adobe PDF Document) State Senior Management Service Employees Retirement Plan Enrollment Form
SMS-3 (Adobe PDF Document) Local Senior Management Service Employees Retirement Plan Enrollment Form
W-4P (Adobe PDF Document) Withholding Certificate for Pension Payments