Home Retirement Page 14

Retirement

Form RSA-1 PURSVC In-Service Transfer to Purchase Permissive Service Credit RSA-1 Deferred Compensation Plan

Form RSA-1 PURSVC In-Service Transfer to Purchase Permissive Service Credit RSA-1 Deferred Compensation Plan

 

INSTRUCTIONS: ALABAMA IN-SERVICE TRANSFER TO PURCHASE PERMISSIVE SERVICE CREDIT (Form RSA-1 PURSVC)

 

 

Alabama public employees enrolled in the RSA-1 deferred compensation plan use the form discussed in this article to file an in-service transfer to purchase permissive service credit. This document can be obtained from the website of the Retirement Systems of Alabama.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 1: Indicate with a check mark whether you are enrolled in ERS or TRS.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 2: Part I concerns the member. On the first two blank lines, enter your full name and Social Security number.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 3: On the next two blank lines, enter your home street address or P.O. box number, city, state and zip code.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 4: On the next blank line, enter your phone number, including the area code.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 5: On the next blank line, enter the name of your employer.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 6: On the next blank line, enter your date of birth.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 7: Part II concerns your retirement system. On the first blank line, enter its name.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 8: On the second blank line, enter the street address of the retirement system.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 9: On the third blank line, enter the city, state and zip code of the retirement system.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 10: On the fourth blank line, enter your retirement system account number.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 11: Part III concerns the payment method and authorization. On the first blank line, enter the amount you are authorizing the transfer of from your RSA-1 plan to the retirement system listed above. Indicate with a check mark from which account you wish for these funds to be withdrawn.

 

Alabama In-Service Transfer To Purchase Permissive Service Credit RSA-1 PURSVC Step 12: Sign and date Part IV, then obtain certification from a notary public.

 

Download the PDF file .

Form RSA LEOCFERS Law Enforcement Officer Certification

Form RSA LEOCFERS Law Enforcement Officer Certification

 

INSTRUCTIONS: ALABAMA LAW ENFORCEMENT OFFICER CERTIFICATION (Form RSA LEOCFERS)

 

 

To certify Alabama law enforcement service, use the form discussed in this article. This document may be obtained from the website maintained by the Retirement Systems of Alabama.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 1: Part I should be completed by your current employer. On the first blank line, they will enter your name.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 2: On the second blank line, your current employer should enter your Social Security number.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 3: On the third blank line, your current employer should enter your current address.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 4: On the fourth blank line, your current employer should enter your work phone number.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 5: On the fifth blank line, your current employer should enter your home phone number.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 6: The employer should check the box indicate you work in law enforcement as applicable, then enter your position title on the next blank line.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 7: Your current employer should indicate whether your employment status is full-time or part-time.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 8: Your current employer should enter the name of the employing agency on the next blank line.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 9: The certifying official should enter their signature on the next blank line.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 10: The certifying official should enter the date on the next blank line.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 11: The certifying official should enter their title on the next blank line.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 12: Part II should be completed by the employer to whom the eligible periods of service were rendered. They should document your position title, beginning and ending dates of service, and total service in the table provided, then enter their agency name, the date, their signature and their title where indicated.

 

Alabama Law Enforcement Officer Certification RSA LEOCFERS Step 13: Mail the form to the address given in the instructions contained on the second page.

 

Download the PDF file .

Form RSA 10 D-D Request for DROP Distribution and Rollover Election

Form RSA 10 D-D Request for DROP Distribution and Rollover Election

 

INSTRUCTIONS: ALABAMA REQUEST FOR DROP DISTRIBUTION AND ROLLOVER ELECTION (Form RSA 10 D-D)

 

 

To request distribution from a Deferred Retirement Option Plan (DROP) or a rollover election in Alabama, file the form discussed in this article. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

 

Alabama Request for Drop Distribution And Rollover Election RSA 10 D-D Step 1: Part I concerns the member. Enter your first, middle and last name on the first blank line.

 

Alabama Request for Drop Distribution And Rollover Election RSA 10 D-D Step 2: Enter your Social Security number on the second blank line.

 

Alabama Request for Drop Distribution And Rollover Election RSA 10 D-D Step 3: Enter your street address or P.O. box number on the third blank line.

 

Alabama Request for Drop Distribution And Rollover Election RSA 10 D-D Step 4: Enter your home phone number, including the area code, on the fourth blank line.

 

Alabama Request for Drop Distribution And Rollover Election RSA 10 D-D Step 5: Enter your city, state, country and zip code on the fifth blank line.

 

Alabama Request for Drop Distribution And Rollover Election RSA 10 D-D Step 6: Part II concerns your distribution options. Check the first statement if you wish to receive a lump sum payment containing all funds from your DROP account, minus the 20% which must be withheld for federal income tax. If this is the case, do not complete Part III.

 

Alabama Request for Drop Distribution And Rollover Election RSA 10 D-D Step 7: Check the second statement if you wish to have the entire DROP account balance rolled over into an eligible retirement account listed in Part III.

 

Alabama Request for Drop Distribution And Rollover Election RSA 10 D-D Step 8: Check the third statement if you wish to have a certain percentage of the DROP funds rolled over into an eligible retirement account listed in Part III. Enter the percentage.

 

Alabama Request for Drop Distribution And Rollover Election RSA 10 D-D Step 9: Indicate with a check mark whether you are transferring funds into an RSA-1 account or another type of retirement account. If the latter, specify.

 

Alabama Request for Drop Distribution And Rollover Election RSA 10 D-D Step 10: Sign and date the first page. If applicable, have the trustee receiving the rollover complete Part III.

 

Download the PDF file .

Form RSA-1 IOE Annual Investment Option Election RSA-1 Deferred Compensation Plan

Form RSA-1 IOE Annual Investment Option Election RSA-1 Deferred Compensation Plan

 

INSTRUCTIONS: ALABAMA INVESTMENT OPTION ELECTION (Form RSA-1 IOE)

 

 

Alabama public employees enrolled in the state-administered RSA-1 deferred compensation program can use the form discussed in this article to elect to use their investment option. This document can be obtained from the website of the Retirement Systems of Alabama.

 

Alabama Investment Option Election RSA-1 IOE Step 1: Enter your first name, middle or maiden name and last name on the first blank line.

 

Alabama Investment Option Election RSA-1 IOE Step 2: Enter your Social Security number on the second blank line.

 

Alabama Investment Option Election RSA-1 IOE Step 3: Enter your date of birth on the third blank line.

 

Alabama Investment Option Election RSA-1 IOE Step 4: If the member is deceased, enter the full name of the beneficiary on the fourth blank line.

 

Alabama Investment Option Election RSA-1 IOE Step 5: If applicable, enter the beneficiary's date of birth on the fifth blank line.

 

Alabama Investment Option Election RSA-1 IOE Step 6: On the seventh blank line, enter your street address or P.O. box number.

 

Alabama Investment Option Election RSA-1 IOE Step 7: On the eighth blank line, enter your city, state and zip code.

 

Alabama Investment Option Election RSA-1 IOE Step 8: On the ninth blank line, enter your email address.

 

Alabama Investment Option Election RSA-1 IOE Step 9: On the tenth blank line, enter your phone number, including the area code.

 

Alabama Investment Option Election RSA-1 IOE Step 10: In the next section, you must indicate what action you wish to be taken with your account balance. Check the first statement if you wish to transfer a percentage of the month-end balance in your RSA-1 fixed investment option to the stock investment option, the second statement if you wish to transfer a fixed dollar amount, the third statement if you wish to transfer a percentage from your stock investment option to the RSA-1 fixed investment option, or the fourth statement if you wish to transfer a dollar amount from your stock investment option to the RSA-1 fixed investment option.

 

Alabama Investment Option Election RSA-1 IOE Step 11: Indicate your wishes regarding future deferrals where indicated.

 

Alabama Investment Option Election RSA-1 IOE Step 12: Enter the signature of the member or the beneficiary if the member is deceased and the date.

 

Download the PDF file .

Law Enforcement Officer Certification

Law Enforcement Officer Certification

 

INSTRUCTIONS: ALABAMA LAW ENFORCEMENT OFFICER CERTIFICATION ACT 2004-637

 

 

Full-time law enforcement and corrections officers in Alabama who have not had a previous period of eligibility to purchase a hazardous duty service credit can do so by filing the form discussed in this article. It can be obtained from the website maintained by the Retirement Systems of Alabama.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 1: Part I is to be completed by your current employer. Your name is entered on the first line.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 2: Your Social Security number is entered on the second line.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 3: Your complete address is entered on the third line.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 4: Your work telephone number is entered on the fourth line, while your home telephone number is entered on the fifth line.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 5: The title of your current position is entered on the sixth line.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 6: Your employer should indicate with a check mark whether you are employed on a full-time or part-time basis.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 7: The title of your position is entered on the seventh line.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 8: The certifying official should enter their title and the date, as well as providing their signature.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 9: Part II is for the documentation of previous periods of eligible service completed as a full-time employee. This should be completed by the applicable employer. Your position title for each such position will be entered in the first column.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 10: The beginning date of each previous period of service will be entered in the second column.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 11: The ending date of each previous period of service will be entered in the third column.

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 12: Your total length of service should be entered in the fourth column. 

 

Alabama Law Enforcement Officer Certification Act 2004-637 Step 13: The certifying official should sign and date the form, as well as entering their title and the agency name. You may then file the form.

Download the PDF file .

Form 8: Beneficiary Designation

Form 8: Beneficiary Designation

 

INSTRUCTIONS: ARIZONA BENEFICIARY DESIGNATION FORM (Form 8)

 

 

Arizona public safety personnel, corrections officers, and elected officials enrolled in the state's retirement plan for each type of employee can all use a form 8 to designate primary and secondary beneficiaries in the event of their death. This document can be obtained from the website maintained by the Elected Officials' Retirement Fund of the State of Arizona.

 

Arizona Beneficiary Designation Form 8 Step 1: Section 1 requires information about the member filing. On the first line, enter your Social Security number, SYSID (if known), and indicate with a check mark whether this request applies to a retired or non-retired account.

 

Arizona Beneficiary Designation Form 8 Step 2: On the next line, enter your date of birth and email address.

 

Arizona Beneficiary Designation Form 8 Step 3: On the next line, enter your last name, first name and middle initial.

 

Arizona Beneficiary Designation Form 8 Step 4: On the next line, enter your street address, city, state and zip code.

 

Arizona Beneficiary Designation Form 8 Step 5: On the next line, enter your home phone number, cell phone number and work phone number.

 

Arizona Beneficiary Designation Form 8 Step 6: Section 2 is for designation and documentation of beneficiaries. The first section should only be used to name a primary beneficiary. Enter their Social Security number in the first box.

 

Arizona Beneficiary Designation Form 8 Step 7: Enter their full name in the second box.

 

Arizona Beneficiary Designation Form 8 Step 8: Indicate their relationship to you with a check mark in the third box.

 

Arizona Beneficiary Designation Form 8 Step 9: Enter their birth date in the fourth box.

 

Arizona Beneficiary Designation Form 8 Step 10: Enter their address in the fifth box.

 

Arizona Beneficiary Designation Form 8 Step 11: Enter their telephone number in the sixth box.

 

Arizona Beneficiary Designation Form 8 Step 12: In the next two sections, you may designate up to two more primary or secondary beneficiaries. In each section, indicate with a check mark which of teh two types you are designating, then provide all information requested.

 

Arizona Beneficiary Designation Form 8 Step 13: A witness who is not a beneficiary should print and sign their name in Section 3, as well as entering the date.

 

Arizona Beneficiary Designation Form 8 Step 14: Sign and date the last line.

Download the PDF file .

DROP Participation Period Completed – Will Continue Employment

DROP Participation Period Completed - Will Continue Employment

 

INSTRUCTIONS: ALABAMA DEFERRED RETIREMENT OPTION PLAN (DROP) PARTICIPATION PERIOD COMPLETED/CONTINUED SERVICE (Form ERS 10 D-CCE)
 
Alabama state employees transferring to another job use a form ERA 10 D-CCE to terminate their enrollment in the state Deferred Retirement Option Plan (DROP). This document can be obtained from the website of the Employees' Retirement System of Alabama.
 
Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERA 10 D-CCE Step 1: On the first line, enter your first, middle and last name.
 
Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERA 10 D-CCE Step 2: On the second line, enter your Social Security number.
 
Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERA 10 D-CCE Step 3: On the third line, enter your employing agency.
 
Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERA 10 D-CCE Step 4: On the fourth line, enter your requested DROP termination date. This must be the last day of any given month.
 
Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERA 10 D-CCE Step 5: On the fifth line, enter your phone number.
 
Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERA 10 D-CCE Step 6: Check the box on line I.
 
Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERA 10 D-CCE Step 7: Sign line II in the presence of a notary public.
 
Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERA 10 D-CCE Step 8: Part III should be completed by your employer. On the first line, they will enter your last date of service prior to DROP termination.
 
Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERA 10 D-CCE Step 9: On the second line, your employer will enter the closing date of the last payroll for salary earned prior to DROP termination.
 
Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERA 10 D-CCE Step 10: On the third line, your employer will enter your total accrued unused sick leave days at the end of the DROP participation period.
 
Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERA 10 D-CCE Step 11: An authorized official should sign and date the fourth line, as well as entering the employing institution's name and telephone number.
 

Download the PDF file .

Applying for DROP Distribution – Early Termination

Applying for DROP Distribution - Early Termination

 

INSTRUCTIONS: ALABAMA DEFERRED RETIREMENT OPTION PLAN (DROP) REQUEST FOR EARLY TERMINATION OF DROP

 

 

Alabama state employees and retirees who are eligible to transfer part of their state retirement plans to an IRA or an employer plan can do so by using the document discussed in this article. This form can be found on the website of the Retirement Systems of Alabama.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 1: Enter your name and Social Security number.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 2: Enter your address.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 3: Enter your work and home telephone numbers.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 4: Enter your employing agency.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 5: Enter the requested effective date of your DROP termination.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 6: Enter your date of birth.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 7: In response to part I, indicate with a check mark why you are requesting an early termination of your DROP.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 8: In part II, indicate your wishes regarding withholding from pension or annuity payments.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 9: Only complete part III if your employing agency permits the conversion of sick leave days to retirement credits.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 10: Sign the form in Part IV.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 11: A notary public should sign the form and affix their seal.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 12: The employer should complete Part V.

 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP Step 13: This packet also provides a form authorizing the continuation of state health insurance, as well as one allowing you to elect to take rollover distribution and one authorizing direct deposits of your refund.

Download the PDF file .

RSA 100-C Change of Beneficiary Prior to Retirement Form

RSA 100-C Change of Beneficiary Prior to Retirement Form

 

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.
 

Download the PDF file .