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Form E20: Election not to Participate in the Elected Official’s Retirement Plan

Form E20: Election not to Participate in the Elected Official's Retirement Plan

 

INSTRUCTIONS: ARIZONA ELECTION NOT TO PARTICIPATE IN THE ELECTED OFFICIALS' RETIREMENT PLAN (Form E20)

 

 

Arizona state elected officials with term limits can file a form E20 if they wish to elect not to participate in the states' elected officials' retirement plan. This document can be obtained from the website maintained by the Elected Officials' Retirement Plan of the State of Arizona.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 1: On the first line, enter your name.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 2: On the second line, enter your Social Security number.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 3: On the third line, enter the title of your elected office.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 4: On the fourth line, enter your date of birth.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 5: On the fifth line, enter the beginning date of your current date of office.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 6: On the sixth line, enter your address.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 7: On the seventh line, enter today's date.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 8: The first two paragraphs provide a general statement that you are making this election.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 9: Six numbered benefits you are waiving are listed below. By signing and dating the form, you are acknowledging this waiver.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 10: Enter the date on the first blank line on the bottom of the page.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 11: Sign the second blank line.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 12: A witness should print and sign their name in the third blank line.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 13: If the applicant has a spouse, their signature should be provided in the fourth blank line.

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Domestics Relation Order

Domestics Relation Order

 

INSTRUCTIONS: ARIZONA DOMESTIC RELATIONS ORDER

 

 

To assign an alternate payee a portion of the benefits payable to an Arizona public safety personnel, corrections officer or elected official's retirement plan, a domestic relations order should be completed. This document can be obtained from the website maintained by those retirement plans.

 

Arizona Domestic Relations Order Step 1: Enter your name and address at the top of the form.

 

Arizona Domestic Relations Order Step 2: Enter the name of both spouses where indicated and your county.

 

Arizona Domestic Relations Order Step 3: In section 1, indicate your type of retirement plan with a check mark.

 

Arizona Domestic Relations Order Step 4: In section 2, indicate whether the participant in the plan is the plaintiff or respondent with a check mark. Give their address and date of birth.

 

Arizona Domestic Relations Order Step 5: In section 3, indicate whether the alternate payee is the plaintiff or respondent with a check mark. Give their address and date of birth.

 

Arizona Domestic Relations Order Step 6: In section 4, enter the date of marriage and the date on which community property interest ended.

 

Arizona Domestic Relations Order Step 7: Section 5 should only be completed if the participant has not yet retired or is not participating in the deferred retirement option plan.

 

Arizona Domestic Relations Order Step 8: Section 6 concerns division of monthly pension payments.

 

Arizona Domestic Relations Order Step 9: Section 7 concerns post-retirement benefit increases.

 

Arizona Domestic Relations Order Step 10: Section 8 should only be completed if the participant has not yet retired and/or is not a participation in the deferred retirement option plan.

 

Arizona Domestic Relations Order Step 11: Section 9 concerns employee contributions during participation in the deferred retirement option plan, if applicable.

 

Arizona Domestic Relations Order Step 12: Section 10 is optional and concerns disposition of the alternate payee's share in the event the alternate payee's death precedes that of the participant.

 

Arizona Domestic Relations Order Step 11: Sections 11 through 14 contain information about how this domestic relations order will take effect.

 

Arizona Domestic Relations Order Step 12: The judge of your superior court will sign and date the last page.

 

Arizona Domestic Relations Order Step 13: Both the participant and alternate payee should sign the last page.

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RSA-1 Enrollment

RSA-1 Enrollment

 

INSTRUCTIONS: ALABAMA RSA-1 ENROLLMENT (Form RSA-1 EN)
 
Alabama public employees who wish to enroll in the RSA-1 retirement fund do so using a form RSA-! EN. This document can be obtained from the website maintained by the Retirement Systems of Alabama.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 1: On the first blank line, enter your first, middle and last name.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 2: On the second blank line, enter your P.O. box number or street address.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 3: On the third blank line, enter your city, state and zip code.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 4: On the fourth blank line, enter your Social Security nubmer.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 5: Indicate with a check mark whether you are male or female.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 6: On the fifth blank line, enter your date of birth.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 7: On the sixth blank line, enter your phone number.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 8: On the seventh blank line, enter your email address.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 9: On the eighth blank line, enter the agency name of your employer.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 10: On the ninth blank line, enter your employer phone number.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 11: On the tenth blank line, enter your employer address.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 12: Below this, four options are given to describe your current status. Check the first box if you are a member of the Employees' Retirement System (ERS). 
 
Alabama RSA-1 Enrollment RSA-1 EN Step 13: Check the second box if you are a member of the Teachers' Retirement System (TRS).
 
Alabama RSA-1 Enrollment RSA-1 EN Step 14: Check the third box if you are a member of the Judicial Retirement Fund (JRF).
 
Alabama RSA-1 Enrollment RSA-1 EN Step 15: Check the fourth box if you are not a member of the ERS, TRS or JRF.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 16: Provide your signature and date at the bottom of the page.
 
Alabama RSA-1 Enrollment RSA-1 EN Step 17: Submit the form to the address provided at the top of the page, along with separately completed Beneficiary Designation and Investment Option Election forms. 
 

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Application to Obtain Service Credit for Maternity Leave Without Pay

Application to Obtain Service Credit for Maternity Leave Without Pay

 

INSTRUCTIONS: ALABAMA APPLICATION TO OBTAIN SERVICE CREDIT FOR MATERNITY LEAVE WITHOUT PAY

 

 

Members of the Alabama Employees' Retirement System can use the form discussed in this article to obtain service credit for maternity leave without pay. In order to be eligible to file this form, they must be an active member and contributing to the Employees' Retirement System at the time of purchase and must not have already received credit for this time with the program or any retirement plan other than Social Security. This document can be obtained from the website of the Employees' Retirement System of Alabama.

 

Alabama Application To Obtain Service Credit For Maternity Leave Without Pay Step 1: On the first blank line, enter your first name, middle or maiden name, and last name.

 

Alabama Application To Obtain Service Credit For Maternity Leave Without Pay Step 2: On the second blank line, enter your date of birth.

 

Alabama Application To Obtain Service Credit For Maternity Leave Without Pay Step 3: On the third blank line, enter your Social Security number.

 

Alabama Application To Obtain Service Credit For Maternity Leave Without Pay Step 4: On the fourth blank line, enter your street address or post office box number.

 

Alabama Application To Obtain Service Credit For Maternity Leave Without Pay Step 5: On the fifth blank line, enter your city, state and zip code.

 

Alabama Application To Obtain Service Credit For Maternity Leave Without Pay Step 6: On the sixth blank line, enter the name of your current employer.

 

Alabama Application To Obtain Service Credit For Maternity Leave Without Pay Step 7: The bottom half of the form is to be completed by your employer. On the first and second blank lines of this section, they should enter the beginning and ending dates of your maternity leave without pay.

 

Alabama Application To Obtain Service Credit For Maternity Leave Without Pay Step 8: On the third blank line, they should enter your employee job classification.

 

Alabama Application To Obtain Service Credit For Maternity Leave Without Pay Step 9: On the fourth blank line, they should enter the name of the employing institution.

 

Alabama Application To Obtain Service Credit For Maternity Leave Without Pay Step 10: The certifying official should sign and date the form, as well as providing their official title.

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Form ERS SMS Statement of Military Service Act 66

Form ERS SMS Statement of Military Service Act 66

 

INSTRUCTIONS: ALABAMA STATEMENT OF MILITARY SERVICE ACT 66 (Form ERS SMS)

 

 

Alabama public employees enrolled in a state-administered retirement plan can obtain credit for active military service by filing the form discussed in this article. This document can be obtained from the website of the Retirement Systems of Alabama.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 1: Enter your first, middle and last name on the first blank line.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 2: Enter your address on the second blank line.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 3: Enter your Social Security number on the third blank line.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 4: Check the first box if you are currently receiving no retirement benefits.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 5: Check the second box if you are currently receiving service retirement benefits from a branch of the Armed Forces.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 6: Check the third box if you are currently receiving service retirement benefits based partially on military service from a source other than a branch of the Armed Forces. Specify the source on the blank line provided.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 7: Check the fourth box if you are currently receiving disability retirement benefits from a branch of the Armed Forces.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 8: Check the fifth box if you are currently receiving disability retirement benefits based partially on military service from a source other than a branch of the Armed Forces. Specify the source on the blank line provided.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 9: Enter your signature on the next blank line.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 10: Enter the date on the next blank line.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 11: The firm should be certified by a notary public.

 

Alabama Statement Of Military Service Act 66 ERS SMS Step 12: Mail the completed form to the address given at the top of the page. Further assistance in completion can be obtained by calling the numbers given here.

 

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Form ERS 7IR Ineligible Member Refund Request

Form ERS 7IR Ineligible Member Refund Request

 

INSTRUCTIONS: ALABAMA INELIGIBLE MEMBER REFUND REQUEST (Form ERS 7IR)

 

 

When an Alabama public agency discovers that it has withheld retirement deductions from an employee who is not eligible for enrollment in the Employees' Retirement System of Alabama, they may request a refund using the document discussed in this article. This form should only be filed after you have ceased withholding retirement deductions from the employee's compensation and you have remitted the final contribution to the Employees' Retirement System of Alabama. This document can be found on the website of the Retirement Systems of Alabama.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 1: Enter the employee's first, middle and last name on the first blank line.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 2: Enter the employee's Social Security number on the second blank line.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 3: Enter the employee's register number on the third blank line.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 4: State the reason for the employee's ineligibility on the fourth blank line.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 5: Enter the total retirement deductions made from the employee's salary on the fifth blank line.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 6: Enter the total matching employer contributions remitted on the sixth blank line.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 7: Enter the total refund amount owed to the employee and employer on the seventh blank line. This amount should be calculated by the Employees' Retirement System of Alabama.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 8: Enter the date the last deduction from the employee's salary was made on the eighth blank line.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 9: Enter the name of the employing agency on the ninth blank line.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 10: Enter the agency's mailing address on the next three blank lines.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 11: On the next blank line, the employing official should enter their signature.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 12: On the next blank line, enter the date.

 

Alabama Ineligible Member Refund Request ERS 7IR Step 13: On the last blank line, enter the title of the employing official.

 

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Form JRF MMCR – Salary Monthly Member Contribution Remittance Probate Judges on Salary

Form JRF MMCR - Salary Monthly Member Contribution Remittance Probate Judges on Salary

INSTRUCTIONS: ALABAMA MONTHLY MEMBER CONTRIBUTION REMITTANCE PROBATE JUDGES ON SALARY (Form JRF MMCR – Salary)

 

 

Alabama probate judges who are members of the Judicial Retirement Fund and compensated by salary are required to contribute 6% of their annual compensation. These payments must be made in equal monthly installments and are documented using a form JRF MMCR – Salary. This form can be obtained from the website maintained by the Retirement Systems of Alabama.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Salary JRF MMCR – Salary Step 1: On the first blank line, enter the end date of the month you are filing for.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Salary JRF MMCR – Salary Step 2: On the second blank line, enter your county.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Salary JRF MMCR – Salary Step 3: On the third blank line, enter the member name. 

 

Alabama Monthly Member Contribution Remittance Probate Judges On Salary JRF MMCR – Salary Step 4: On the fourth blank line, enter your Social Security number.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Salary JRF MMCR – Salary Step 5: On the first blank line of line 1, enter your annual salary.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Salary JRF MMCR – Salary Step 6: On the second blank line of line 1, enter the annual rate of 6%.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Salary JRF MMCR – Salary Step 7: Multiply your annual salary by the annual rate and enter the resulting product on the third blank line of line 1. This is your annual contribution.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Salary JRF MMCR – Salary Step 8: On the first blank line of line 2, enter your annual contribution.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Salary JRF MMCR – Salary Step 9: Divide your annual contribution by 12 and enter the resulting figure on the second blank line of line 2. This is your monthly contribution.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Salary JRF MMCR – Salary Step 10: The next section should only be completed if salary changes occurred during the monthly reporting period. 

 

Alabama Monthly Member Contribution Remittance Probate Judges On Salary JRF MMCR – Salary Step 11: Have the form certified by a notary public.

 

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Form EOSS: Out of State/Federal Service Affidavit

Form EOSS: Out of State/Federal Service Affidavit

 

INSTRUCTIONS: ARIZONA OUT OF STATE/FEDERAL SERVICE AFFIDAVIT (Form EOSS)

 

 

Arizona elected officials with at least five years of credited service within the state Elected Officials' Retirement Plan may redeem up to five years of prior elected service out of state or in a federal capacity. This is done by filing a form EOSS. This document can be obtained from the website maintained by the Elected Officials' Retirement Plan of the State of Arizona. 

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 1: Enter your name on the first line, your Social Security number on the second line, and your date of birth on the third line.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 2: Enter your complete street address on the fourth line and your telephone number on the fifth line.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 3: Enter the name of your former employer or retirement system on the sixth line.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 4: Enter your position formerly held on the seventh line.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 5: Enter the name of a contact person on the eighth line.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 6: Enter the address of your former employer or retirement system on the ninth line and its telephone number on the tenth line.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 7: Enter your prior service beginning and ending dates on the eleventh and twelfth lines.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 8: On the next line, indicate with a check mark whether you received compensation for your employment during this service period.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 9: Enter the number of months you wish to have calculated.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 10: On the next four lines, give all information requested about your current employment.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 11: Initial all applicable statements on the next five lines.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 12: Sign and date the bottom of the page.

 

Arizona Out Of State/Federal Service Affidavit EOSS Step 13: The form must be presented to a notary public for their seal.

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Authorization to Defer Compensation

Authorization to Defer Compensation

 

INSTRUCTIONS: ALABAMA AUTHORIZATION TO DEFER COMPENSATION (Form RSA-1 ADC)
 
Alabama public employees use a form RSA-1 ADC to authorize deferring compensation as part of new enrollment in the state RSA-1 retirement fund program or to modify the amount of compensation deferred. This document can be obtained from the website of the Retirement Systems of Alabama.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 1: On the line labeled "From," enter your first, middle or maiden and last name.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 2: On the next blank line, enter your Social Security number.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 3: Check "New Enrollment" if you are enrolling in the RSA-1 program.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 4: Check "Restart" if you are restarting your involvement in RSA-1.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 5: Check "Increase Deferrals" if you wish to increase the amount of compensation to be deferred to your RSA-1 retirement fund.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 6: Check "Decrease Deferrals" if you wish to decrease the amount of compensation to be deferred to your RSA-1 retirement fund.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 7: Check "Sick/Annual Leave" if you wish to temporarily halt deferrals of compensation to your RSA-1 retirement fund for either of those reasons.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 8: Check "Stop Deferrals" if you wish to cease deferrals of compensation to your retirement fund.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 9: On the next blank line, enter the dollar amount you wish to have deferred per pay period to your RSA-1 retirement fund.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 10: On the next blank line, enter the date on which you wish for these deferrals to take effect. Note that this date cannot be any earlier than the first of the month following the date on which this form is submitted.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 11: Sign and date the bottom of the page.
 
Alabama Authorization To Defer Compensation RSA-1 ADC Step 12: If you are requesting cessation of deferrals of compensation on grounds of financial compensation, a payroll officer must also sign and date the form.
 

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