Home Retirement Page 15

Retirement

Report of Disability Packet

Report of Disability Packet

 

INSTRUCTIONS: ALABAMA REPORT OF DISABILITY PACKET 

 

 

Alabama public employees enrolled in the state's Retirement Systems can use the packet discussed in this article to file for a disability benefit. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

 

Alabama Report Of Disability Packet Step 1: The first page is a cover page.

 

Alabama Report Of Disability Packet Step 2: The second page contains general instructions for completion of this packet and explains who is eligible to file for a disability benefit. In order to qualify for this benefit, you must have at least 10 years of creditable service, be in-service and be determined to be permanently incapacitated for the further performance of duty by the RSA medical board.

 

Alabama Report Of Disability Packet Step 3: The third page contains Part I of form RSA PRD, a statement from an examining physician. At the top of this page, they will enter your name, Social Security number, address, sex, date of birth, email address, blood pressure, height, job classification, urinalysis and weight.

 

Alabama Report Of Disability Packet Step 4: The doctor will enter the date on which you came into their professional care and the date of their last examination.

 

Alabama Report Of Disability Packet Step 5: The physician will answer all questions about your health on the third and fourth pages. 

 

Alabama Report Of Disability Packet Step 6: At the bottom of the fourth page, the physician should print and sign their name, enter their address and phone number, their specialty, and the date of submission.

 

Alabama Report Of Disability Packet Step 7: The fifth page contains Part II, which is the applicant's authorization. Enter your name on the first blank line.

 

Alabama Report Of Disability Packet Step 8: Enter your Social Security number on the second blank line.

 

Alabama Report Of Disability Packet Step 9: Enter the date on the third blank line.

 

Alabama Report Of Disability Packet Step 10: Enter your physician's name on the fourth blank line.

 

Alabama Report Of Disability Packet Step 11: Enter your street address or P.O. box number on the fifth blank line.

 

Alabama Report Of Disability Packet Step 12: Enter your city, state and zip code on the sixth blank line.

 

Alabama Report Of Disability Packet Step 13: Indicate what you are applying for with a check mark. Sign the form and provide your address.

 

Download the PDF file .

Form TRS SMS 1109 State Military Service Purchase

Form TRS SMS 1109 State Military Service Purchase

 

INSTRUCTIONS: ALABAMA STATEMENT OF MILITARY SERVICE (Form TRS SMS 1109)

 

 

New employees who become members of the Retirement Systems of Alabama may purchase up to four years of active duty military service credit based upon an honorable discharge. This is done using the form discussed in this article, which is available on the website maintained by the Retirement Systems of Alabama.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 1: Enter your name on the first blank line.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 2: Enter your Social Security number on the second blank line.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 3: Enter your street address or P.O. box number on the third blank line.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 4: Enter your city, state and zip code on the fourth blank line.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 5: Check the box next to the first statement if you are receiving no benefits for your military service.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 6: Check the box next to the second statement if you are receiving a service retirement benefit from a branch of the Armed Forces.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 7: Check the box next to the third statement if you are receiving a service retirement benefit based partially on your military service from a source other than a branch of the Armed Forces. Specify the source.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 8: Check the box next to the fourth statement if you are receiving a disability retirement benefit from a branch of the Armed Forces.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 9: Check the box next to the fifth statement if you are receiving a disability retirement benefit based partially on your military service from a source other than a branch of the Armed Forces. Specify the sources.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 10: Check the box next to the sixth statement if you received an honorable discharge.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 11: Check the box next to the seventh statement if you did not receive an honorable discharge.

 

Alabama Statement Of Military Service TRS SMS 1109 Step 12: Sign and date the form.

 

Download the PDF file .

Form RSA-1 457 IN TRANS Incoming Transfer from Other Section 457 Plans to RSA-1

Form RSA-1 457 IN TRANS Incoming Transfer from Other Section 457 Plans to RSA-1

 

INSTRUCTIONS: ALABAMA INCOMING TRANSFER FROM OTHER SECTION 457 PLANS TO RSA-1 (Form RSA-1 457)

 

 

To apply for a transfer from other section 457 plans to an RSA-1 fund managed by the Retirement Systems of Alabama as a state employee, file the document discussed in this article. This form can be obtained from the website of the Retirement Systems of Alabama.

 

Alabama Incoming Transfer From Other Section 457 Plans To RSA-1 RSA-1 457 Step 1: Part I concerns the member. On the first two blank lines, enter your name and Social Security number.

 

Alabama Incoming Transfer From Other Section 457 Plans To RSA-1 RSA-1 457 Step 2: On the next two blank lines, enter your home street address or P.O. box number, city, state and zip code.

 

Alabama Incoming Transfer From Other Section 457 Plans To RSA-1 RSA-1 457 Step 3: On the next two blank lines, enter your phone number and email address.

 

Alabama Incoming Transfer From Other Section 457 Plans To RSA-1 RSA-1 457 Step 4: On the next blank line, enter the name of your employer.

 

Alabama Incoming Transfer From Other Section 457 Plans To RSA-1 RSA-1 457 Step 5: On the next blank line, enter your date of birth.

 

Alabama Incoming Transfer From Other Section 457 Plans To RSA-1 RSA-1 457 Step 6: Indicate with a check mark whether you are a member of ERS/JRF, TRS or other.

 

Alabama Incoming Transfer From Other Section 457 Plans To RSA-1 RSA-1 457 Step 7: Part II concerns your previous 457 plan. Provide its name, the name of a contact person and their phone number, the plan's address, the account number with a trustee or record keeper, the qualified transfer amount and deferrals prior to 1997 not previously deferred for state of Alabama purposes. A trustee official or record keeper must sign and date this section.

 

Alabama Incoming Transfer From Other Section 457 Plans To RSA-1 RSA-1 457 Step 8: Part III contains payment transfers.

 

Alabama Incoming Transfer From Other Section 457 Plans To RSA-1 RSA-1 457 Step 9: In Part IV, enter the amount whose transfer you are authorizing on the blank line.

 

Alabama Incoming Transfer From Other Section 457 Plans To RSA-1 RSA-1 457 Step 10: Sign and date the page where indicated, then obtain the certification of a notary public.

 

Download the PDF file .

RSA 7 Notice of Final Deposit and Request for Refund

RSA 7 Notice of Final Deposit and Request for Refund

 

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

 

 

Alabama state employees who are terminating their employment and are not seeking employment with another agency can file a form RSA 7 to make their final deposit and request a refund. This document can be obtained from the website of the Retirement Systems of Alabama.

 

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 1: Part I requests information about you. 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 on the eighth blank line if known.

 

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 9: In Part II, indicate with a check mark whether you wish to receive your refund as a lump-sum payment or as a direct rollover giving a percentage of the taxable benefit of your specification to a trustee. If the latter, provide all identifying information requested about them and obtain the signature of a trustee official.

 

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 10: Sign and date the bottom of the first page. The bottom portion of the page should be completed by a notary public.

 

Alabama Notice Of Final Deposit And Request For Refund RSA 7 Step 11: Part III should be completed by the payroll official of your employer. 

Download the PDF file .