Employee Forms
Most of the forms below are now fillable. We strongly recommend that you fill the forms out on your computer where available before printing them. Adobe Acrobat Reader is required to view and fill out these forms. Get a free download at adobe.com.
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Retirement Application & Forms
Direct Deposit of your monthly benefit payment is now required for all applications received after January 1, 2010. The required form is included with the retirement application below. If you are currently on direct deposit as an active employee, we can use the same account you are currently using. Please complete your retirement application on your computer before printing it out and mailing to us.
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Application for Voluntary Superannuation Retirement with Instructions
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Option Selection Form
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Direct Deposit Form
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Judicial Retirement Application
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Notice of Injury
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Section 10 Employer Certification Form
This form is now required for all Section 10 retirements -
Change of Beneficiary Form
(not valid for Option C retirees)
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Group Classification Form
Employees in Groups 2 and 4 must fill out this form
Disability Retirement Forms
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Application Cover Sheet
(pdf) - print out and use as a checklist to ensure your application is complete.
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Medical Records Certification
(pdf) - to be filled out and signed by the member. Must accompany the disability application.
- Disability Application (pdf) - Download from the Public Employee Retirement Administration Commission (PERAC) website.
Buyback Forms
Refund/Rollover Request
Beneficiary Forms
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Change of Beneficiary Form
(not valid for Option C retirees)
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Option D
Retiree Forms
Survivor Forms
Employer Forms
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New Enrollment Form
All applicable sections must be filled out. -
Section 10 Employer Certification Form
This form is now required for all Section 10 retirements -
Service Transfer Form
Use if employee has other qualifying service to transfer into the State System -
Notice of Injury Form
If the employee was injured while on the job, please document the incident with this form.