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.

INSTRUCTIONS: ALABAMA APPLICATION FOR SURVIVOR BENEFIT

Survivors of deceased members of the Alabama Employees' Retirement System or Teachers' Retirement System can file the form discussed in this article to receive their benefits. The document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Application For Survivor Benefit Step 1: Indicate whether the deceased was a members of the Employees' Retirement System or Teachers' Retirement System by filling in the oval next to the applicable statement.

Alabama Application For Survivor Benefit Step 2: On the first blank line, enter the full name of the deceased.

Alabama Application For Survivor Benefit Step 3: On the second blank line, enter the Social Security number of the deceased.

Alabama Application For Survivor Benefit Step 4: On the third blank line, enter the date of birth of the deceased.

Alabama Application For Survivor Benefit Step 5: On the fourth blank line, enter the date of death of the deceased.

Alabama Application For Survivor Benefit Step 6: On the fifth blank line, enter the employing agency of the deceased.

Alabama Application For Survivor Benefit Step 7: On the sixth blank line, enter the full name of the surviving beneficiary.

Alabama Application For Survivor Benefit Step 8: On the seventh blank line, enter the date of birth of the beneficiary.

Alabama Application For Survivor Benefit Step 9: On the eighth blank line, enter the relationship to the deceased of the beneficiary.

Alabama Application For Survivor Benefit Step 10: On the ninth blank line, enter the Social Security number of the beneficiary.

Alabama Application For Survivor Benefit Step 11: On the tenth blank line, enter the telephone number of the beneficiary.

Alabama Application For Survivor Benefit Step 12: On the eleventh blank line, enter the complete address of the beneficiary.

Alabama Application For Survivor Benefit Step 13: In Part II, the beneficiary should sign and date the form. 

Alabama Application For Survivor Benefit Step 14: The beneficiary should have the remainder of Part II completed by a notary public.

Alabama Application For Survivor Benefit Step 15: Part III should be completed by the payroll official of the employer of the deceased.

Alabama Application For Survivor Benefit Step 16: File this return by mailing it to the address at the top of the page. A certified original death certificate must be attached.

INSTRUCTIONS: ALABAMA SERVICE CALCULATION (Form ERS F SC)

Those enrolled in the Employees' Retirement System of Alabama can use a form ERS F SC to request the establishment of a retirement credit for several different types of employment. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Service Calculation ERS F SC Step 1: On the first blank line, enter your full name.

Alabama Service Calculation ERS F SC Step 2: On the second blank line, enter your Social Security number.

Alabama Service Calculation ERS F SC Step 3: On the third blank line, enter your registration number.

Alabama Service Calculation ERS F SC Step 4: On the fourth blank line, enter your street address or P.O. box number, city, state and zip code.

Alabama Service Calculation ERS F SC Step 5: Do not complete the two tables, which are for agency use anyway. Below these, check the box next to the first statement if you are seeking a retirement credit for full time hourly rate employment.

Alabama Service Calculation ERS F SC Step 6: Check the box next to the second statement if you are seeking a retirement credit for part-time employment on a percentage basis. Enter the percent.

Alabama Service Calculation ERS F SC Step 7: Check the box next to the third statement if you are seeking a retirement credit for provisional (non-temporary) employment.

Alabama Service Calculation ERS F SC Step 8: Check the box next to the fourth statement if you are seeking a retirement credit for full-time employment during a period of non-enrollment due to administrative error. By checking this statement, you acknowledge that the agency is also required to make a payment for their error.

Alabama Service Calculation ERS F SC Step 9: Check the box next to the fifth statement if you are seeking a retirement credit for your work as an elected official. Enter the name of the office you served in.

Alabama Service Calculation ERS F SC Step 10: Check the box next to the sixth statement if you are seeking a retirement credit for another reason. Provide a written explanation.

Alabama Service Calculation ERS F SC Step 11: Submit this form to the appropriate agency official, who will complete the tables, then sign and date the bottom of the page.