Forms

A-E

Affidavit of Attorney in Fact

This completed form must accompany your Power of Attorney document.

All Deferred Compensation Program Forms

Forms are available at the DCP Web site.

Authorization for Direct Deposit

Complete this form to sign up for direct deposit of your retirement benefit.

Beneficiary Designation

Use this form to designate or change the person, estate, trust or organization to receive any money due from your retirement account at the time of your death.

Beneficiary Designation for Persons Receiving Survivor Benefits

Use this form if you are receiving retirement benefits from another person’s account. You can designate or change the person, estate, trust or organization to receive your final survivor payment at the time of your death.

Contractor Status Form

Use this form to verify whether or not a contractor who is directly compensated has retired using the 2008 Early Retirement Factors (ERF)

DCP Distribution Request

DCP Participation Agreement

Enrollment

For new and current employees of participating employers including all state agencies/higher education and over 800 political subdivision employers like school districts, counties, cities, fire districts and more.

F-O

IRS form W-4P

Withholding certificate for pension or annuity payments. Use this form to tell payers the correct amount of federal income tax to withhold from your payment(s).

IRS form W-8BEN

Note: This form is on the IRS Web site. It does not belong to DRS.

IRS form W-9

Note: This form is on the IRS Web site. It does not belong to DRS.

Information Release Authorization

Release your account information to a third party, such as your financial planner.

LEOFF Plan 2 Retiree Re-employment Form

This form must be completed by a LEOFF Plan 2 retiree returning to work in a PERS, PSERS, SERS, or TRS eligible position. Retirees must choose between two options: to become a member of PERS, PSERS, SERS or TRS and temporarily suspend their LEOFF benefit; or not become a member and continue to receive their LEOFF benefit.

Legal Order Payee Beneficiary Designation

Use this form if you have a separate account set up as a result of a legal order splitting a member’s account. You can designate or change the person, estate, trust or organization to receive any money due from your Legal Order Payee account at the time of your death.

Member Information Form

Enrollment form new PERS, SERS or TRS members; for Plan 2 members who choose to transfer to Plan 3; or for Plan 3 members returning to eligible employment.

Name/Address Change

For retirees, beneficiaries and former members. Active members: please update your name and/or address through your employer.

P-R

Plan 3 Change of Investment Program

Plan 3 members use this form to select a new investment program for future contributions; this form should be turned in to the employer.

Plan 3 forms

S-Z

SERS Plan 2 and Plan 3 Substitute's Guide

For classified substitutes who belong to SERS Plan 2 or Plan 3.

TRS Plan 1 Substitute Teacher's Guide to Obtaining Service Credit

Substitute Teachers who belong to TRS Plan 1.

TRS Plan 2 and Plan 3 Substitute's Guide

For substitute teachers who belong to TRS Plan 2 or Plan 3.

TRS Plan 3 January Contribution Rate Change Form

For TRS Plan 3 members wishing to change their contribution rate during the month of January.

Withdrawal of Retirement Contributions (For Plan 1 and Plan 2 - Includes Form)

For Plan 1 and Plan 2 members who have terminated retirement covered-employment and who are eligible for withdrawal of contributions and interest earned. When completing the request to withdraw contributions, members need to also complete an IRS form W-9 to verify Social Security number prior to payment.

Withdrawal of Retirement Contributions (For Plan 3 - Includes Form)

See Plan 3 Request for Payment of Defined Contribution Funds.