INSTRUCTIONS: ARIZONA APPLICATION FOR A SEPARATION BENEFIT/DEFERRED BENEFIT (Form E6)

Arizona elected public officials who terminate their employment may either apply for a refund of money contributed to their state-administered retirement plan or apply to have benefits deferred until they are of age to collect. These requests are made using a form E6. This document can be obtained from the website of the Elected Officials' Retirement Plan of the State of Arizona.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 1: Enter your name on the first line.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 2: Enter your Social Security number on the second line.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 3: Enter your street address, as well as your apartment number (if applicable) on the third line.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 4: Enter your city, state and zip code on the fourth line.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 5: Enter your phone number on the fifth line.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 6: Enter your birth date on the sixth line.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 7: Enter the name of your office on the seventh line.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 8: Enter the beginning date of your employment in this office on the eighth line.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 9: Enter the termination date of your employment in this office on the ninth line.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 10: If you place your initials on the blank line in the section labeled "Refund Option," you are requesting a refund of contributions to the elected officials' retirement plan.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 11: If you place your initials on the blank line in the section labeled "Deferred Pension Office," you are leaving your credits on deposit in anticipation of collection when eligible.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 12: You must initial the next blank line.

Arizona Application For A Separation Benefit/Deferred Benefit E6 Step 13: Sign and date the bottom of the first page. Have your governing authority complete the certification of termination on the second page. 

INSTRUCTIONS: ALABAMA CHANGE OF BENEFICIARY FORM PRIOR TO RETIREMENT (Form RSA 100-C)

Prior to your retirement, if you wish to change the beneficiaries who will receive the accumulated credits from your contributions to your Alabama retirement fund as a state employee in the event of your death, you may do so by filing a form RSA 100-C. This document can be obtained from the website of the Retirement Systems of Alabama. Print or type your answers in black ink. Note that this form should not be used by those who are retired or participants in the DROP program.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 1: Enter your name and Social Security number.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 2: Enter your date of birth.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 3: Enter your home phone number.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 4: Indicate with a check mark if you are an active or inactive member.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 5: The section below is where you name your primary beneficiary. On the first line there, give their name.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 6: On the second line, state their relationship to you.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 7: On the third line, give their date of birth.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 8: On the fourth line, enter their Social Security number.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 9: On the fifth line, give their full address.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 10: You may name additional primary beneficiaries on the second page.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 11: The next section allows you to name a contingent beneficiary in the event that all of your primary beneficiaries are deceased. Provide their name, relationship to you, date of birth, Social Security number and address.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 12: You must sign and date the form in the presence of a notary public.

INSTRUCTIONS: ALABAMA STATEMENT OF WITHDRAWN SERVICE (Form RSA SWDS)

For previously withdrawn service to be credited to a retirement account administered by the Retirement Systems of Alabama, the form discussed in this article must be filed. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Statement Of Withdrawn Service RSA SWDS Step 1: Enter your first, middle and last name on the first blank line.

Alabama Statement Of Withdrawn Service RSA SWDS Step 2: Enter your address on the second blank line.

Alabama Statement Of Withdrawn Service RSA SWDS Step 3: Enter your Social Security number on the third blank line.

Alabama Statement Of Withdrawn Service RSA SWDS Step 4: Place a check mark next to the first statement if you have not established any other public retirement system credit for previously withdrawn service.

Alabama Statement Of Withdrawn Service RSA SWDS Step 5: Place a check mark next to the second statement if you have established another public retirement system credit for previously withdrawn service.

Alabama Statement Of Withdrawn Service RSA SWDS Step 6: Place a check mark next to the third statement if you have established credit with another public retirement system for part of your previously withdrawn service. Enter the total years and months of this service.

Alabama Statement Of Withdrawn Service RSA SWDS Step 7: Enter your signature on the next blank line.

Alabama Statement Of Withdrawn Service RSA SWDS Step 8: Enter your date on the next blank line.

Alabama Statement Of Withdrawn Service RSA SWDS Step 9: The form should then be certified by a notary public. On the first blank line, they will enter the state.

Alabama Statement Of Withdrawn Service RSA SWDS Step 10: On the second blank line, the notary public will enter the county.

Alabama Statement Of Withdrawn Service RSA SWDS Step 11: On the third blank line, the notary public will enter the number of the day.

Alabama Statement Of Withdrawn Service RSA SWDS Step 12: On the fourth blank line, the notary public will enter the month. On the fifth blank line, they will enter the month.

Alabama Statement Of Withdrawn Service RSA SWDS Step 13: On the sixth blank line, the notary public will enter your name. They will enter their signature and the date their commission expires on the last two blank lines.

INSTRUCTIONS: ALABAMA NOTICE OF FINAL DEPOSIT AND REQUEST FOR REFUND (Form RSA 7)

Alabama public employees enrolled in the state's Retirement Systems can use the form discussed in this article to give notice of their final deposit in these state retirement plans and request a refund of their benefits due. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 1: Part I concerns the member. Enter your name on the first blank line.

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 2: Enter your date of birth on the second blank line.

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 3: Enter your Social Security number on the third blank line.

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 4: Enter your home phone number on the fourth blank line.

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 5: Enter your street address or P.O. box number on the fifth blank line.

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 6: Enter your work phone number on the sixth blank line.

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 7: Enter your city, state and zip code on the seventh blank line.

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 8: Enter your RSA account number, if known, on the eighth blank line.

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 9: In Part II, check Part A if you wish to receive a lump sum payment of your full account minus the 20% which must be withheld for federal income tax payments.

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 10: Check Part B if you wish to have a direct rollover to a trustee named below. Enter the percentage of your account you wish to have transferred.

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 11: Provide all information requested about your trustee and the type of account your money will be transferred into. Sign and date the form. Have it certified by a notary public.

INSTRUCTIONS: ALABAMA RETIREMENT APPLICATION PACKET PART I

Members of the Teachers' Retirement System Of Alabama can use the packet discussed in this article to begin the retirement process. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Retirement Application Packet Part I Step 1: The first page of this packet is a cover sheet outlining its contents.

Alabama Retirement Application Packet Part I Step 2: The second page contains a checklist of documents to be filed and steps to be taken as part of the retirement process.

Alabama Retirement Application Packet Part I Step 3: The third page contains the application for retirement, which is TRS form 10. The first section requires the member to provide information about themselves.

Alabama Retirement Application Packet Part I Step 4: The second section concerns the designation of beneficiaries in the event of your death.

Alabama Retirement Application Packet Part I Step 5: The third section requires the member to sign and date the form. A notary public must also affix their seal.

Alabama Retirement Application Packet Part I Step 6: The fourth section must be completed by the employer.

Alabama Retirement Application Packet Part I Step 7: The fourth page contains an insurance authorization form, which is form PEEHIP IA. Part I concerns continuation or discontinuation of PEEHIP Hospital/Medical coverage.

Alabama Retirement Application Packet Part I Step 8: Part II concerns your street address.

Alabama Retirement Application Packet Part I Step 9: Part III must be completed by your payroll or insurance official.

Alabama Retirement Application Packet Part I Step 10: Part IV is only for members who have enrolled for optional coverage.

Alabama Retirement Application Packet Part I Step 11: Part V is for those whose employer does not participate in PEEHIP Medical/Hospital coverage.

Alabama Retirement Application Packet Part I Step 12: Part VI concerns vested members who are not currently enrolled.

Alabama Retirement Application Packet Part I Step 13: The fifth and sixth pages contain a Direct Deposit Authorization Form, which is form RSA DDR. This document is used to authorize the direct deposit of retirement benefits into the account of a retiree or the beneficiary of a deceased retiree. Provide all information requested about the recipient on the first page. The financial institution must complete the second page.

INSTRUCTIONS: ALABAMA APPLICATION OF SURVIVING SPOUSE FOR RETIREMENT BENEFITS (Form JRF SS)

In Alabama, surviving spouses of employees enrolled in the Judicial Retirement Fund of Alabama file a form JRF SS to request the decedent's retirement benefits. This form can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Application Of Surviving Spouse For Retirement Benefits JRF SS Step 1: On the first blank line, enter the first name, middle name and last name of the deceased member.

Alabama Application Of Surviving Spouse For Retirement Benefits JRF SS Step 2: On the second blank line, enter the date of death of the deceased member.

Alabama Application Of Surviving Spouse For Retirement Benefits JRF SS Step 3: On the third blank line, enter the policy held by the deceased member.

Alabama Application Of Surviving Spouse For Retirement Benefits JRF SS Step 4: On the fourth blank line, enter the date of birth of the surviving spouse.

Alabama Application Of Surviving Spouse For Retirement Benefits JRF SS Step 5: On the fifth blank line, enter the Social Security number of the surviving spouse.

Alabama Application Of Surviving Spouse For Retirement Benefits JRF SS Step 6: On the sixth blank line, enter the mailing street address of the surviving spouse.

Alabama Application Of Surviving Spouse For Retirement Benefits JRF SS Step 7: On the seventh blank line, enter the city, state and zip code of the surviving spouse.

Alabama Application Of Surviving Spouse For Retirement Benefits JRF SS Step 8: On the eighth blank line, the surviving spouse should enter his or her signature.

Alabama Application Of Surviving Spouse For Retirement Benefits JRF SS Step 9: On the ninth blank line, enter the date.

Alabama Application Of Surviving Spouse For Retirement Benefits JRF SS Step 10: The form should be certified by a notary public, who will affix their seal, provide all requested information, and enter their signature and the date on which their commission will expire.

Alabama Application Of Surviving Spouse For Retirement Benefits JRF SS Step 11: The form should be submitted to the Judicial Retirement Fund of Alabama by mailing it to the address given at the top of the form. Further assistance in completing this application can be obtained from the phone numbers also given at the top of the form.

INSTRUCTIONS: ARIZONA APPLICATION TO PURCHASE ACTIVE MILITARY SERVICE (Form 18)

A member of the Arizona Elected Officials' Retirement Plan who has at least ten years of service within the plan may receive credited service for active military service prior to the employee's current employment. This is done by filing a form 18. This document can be obtained from the website maintained by the Elected Officials' Retirement Plan of the State of Arizona.

Arizona Application To Purchase Active Military Service 18 Step 1: Enter your name on the first line.

Arizona Application To Purchase Active Military Service 18 Step 2: Enter your Social Security number on the second line.

Arizona Application To Purchase Active Military Service 18 Step 3: Enter your address on the third line.

Arizona Application To Purchase Active Military Service 18 Step 4: Enter your telephone number on the fourth line. 

Arizona Application To Purchase Active Military Service 18 Step 5: Enter your email address on the fifth line.

Arizona Application To Purchase Active Military Service 18 Step 6: Enter your birthdate on the sixth line.

Arizona Application To Purchase Active Military Service 18 Step 7: Enter your current employer on the seventh line.

Arizona Application To Purchase Active Military Service 18 Step 8: Enter your membership date on the eighth line.

Arizona Application To Purchase Active Military Service 18 Step 9: Enter your current position or classification on the ninth line.

Arizona Application To Purchase Active Military Service 18 Step 10: On the tenth line, enter the number of months you wish to purchase. Alternately, enter the dollar amount you wish to purchase on the eleventh line.

Arizona Application To Purchase Active Military Service 18 Step 11: Enter your branch of military service on the twelfth line.

Arizona Application To Purchase Active Military Service 18 Step 12: Check the first box to indicate that you have attached a copy of your military service record.

Arizona Application To Purchase Active Military Service 18 Step 13: Check the second box to indicate you have attached a copy of your military discharge certificate. If not, explain why.

Arizona Application To Purchase Active Military Service 18 Step 14: Initial the next three lines.

Arizona Application To Purchase Active Military Service 18 Step 15: Sign and date the bottom of the page.