These forms are used by retirement system staff to process requests to the Public Employee Retirement Administration Commission.
- This page, PERAC Administrator Forms, is offered by
- Public Employee Retirement Administration Commission
PERAC Administrator Forms
Table of Contents
Disability Forms for Administrators
Open PDF file, 85.8 KB,
Accidental Disability Retirement Checklist
(English, PDF 85.8 KB)
Open PDF file, 445.85 KB,
Disability Retirement Application
(English, PDF 445.85 KB)
Open PDF file, 242.79 KB,
Disability Transmittal to the Commission
(English, PDF 242.79 KB)
Open PDF file, 73.17 KB,
Notice of Retirement Board Action on Disability Application
(English, PDF 73.17 KB)
Open PDF file, 251.5 KB,
Notice to PERAC of Reinstatement of Duties
(English, PDF 251.5 KB)
General Membership Forms for Administrators
Open PDF file, 75.2 KB,
Notice to PERAC of the Granting of 12(2)(d) Benefits
(English, PDF 75.2 KB)
Open PDF file, 81.26 KB,
Termination Retirement Transmittal
(English, PDF 81.26 KB)
Compliance Forms for Administrators & Retirement Board Members
Open PDF file, 567.74 KB,
Board Change Form
(English, PDF 567.74 KB)
Open PDF file, 510.91 KB,
PROSPER Individual Account Approval Application
(English, PDF 510.91 KB)
Employer Forms
Open PDF file, 61.28 KB,
Employer's Request for Information
(English, PDF 61.28 KB)
Open PDF file, 250.28 KB,
Employer's Shift Substitution Certification
(English, PDF 250.28 KB)
Open PDF file, 59.48 KB,
Employer's Termination Retirement Certification
(English, PDF 59.48 KB)
Open PDF file, 368.29 KB,
Employer Statement for Disability Retirement Application
(English, PDF 368.29 KB)
Open PDF file, 421.97 KB,
Involuntary Retirement Application
(English, PDF 421.97 KB)
Buyback Worksheets
Open XLSX file, 17.21 MB,
Repayment Worksheets for Buybacks in 2026
(English, XLSX 17.21 MB)
Open PDF file, 1.13 MB,
Repayment Worksheets for Buybacks in 2025
(English, PDF 1.13 MB)
Open PDF file, 524.24 KB,
Repayment Worksheets for Buybacks in 2024
(English, PDF 524.24 KB)
Open PDF file, 159.01 KB,
Repayment Worksheets for Buybacks in 2023
(English, PDF 159.01 KB)
Open XLSX file, 17.17 MB,
Repayment Worksheets for Buybacks in 2022
(English, XLSX 17.17 MB)
RFP Notice Guidance
Open PDF file, 49.99 KB,
Initial RFP Evaluation
(English, PDF 49.99 KB)
Open PDF file, 64.82 KB,
PERAC Legal RFP Notice Sample
(English, PDF 64.82 KB)
Open PDF file, 152 KB,
PERAC RFP for Legal Services Sample
(English, PDF 152 KB)
PROSPER Forms
Open PDF file, 510.91 KB,
PROSPER Individual Account Approval Form
(English, PDF 510.91 KB)
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