Withholding Certificate for Pension or Annuity Payments

INSTRUCTIONS: ALABAMA WITHHOLDING INSTRUCTIONS FOR PENSION OR ANNUITY PAYMENTS

Alabama public employees who are enrolled in a state-administered monthly pension or annuity are required to file instructions documenting their wishes concerning federal withholding tax. Failure to file this form will result in taxes being withheld on rates commensurate with married individuals with three exemptions. This document can be found on the website of the Retirement Systems of Alabama.

Alabama Withholding Instructions For Pension Or Annuity Payments Step 1: On the first blank line, enter your name.

Alabama Withholding Instructions For Pension Or Annuity Payments Step 2: On the second blank line, enter your Social Security number.

Alabama Withholding Instructions For Pension Or Annuity Payments Step 3: Check the box next to the first statement if you do not want to have federal withholding tax deducted from your monthly pension or annuity. Note that this will make you liable for all tax payments, including potential penalties if your payments are not sufficient. If you check this box, you do not need to complete the remainder of the form.

Alabama Withholding Instructions For Pension Or Annuity Payments Step 4: Check the box next to the second statement if you wish to have your withholding tax calculated on the basis of your marital status and number of exemptions claimed. If so, indicate your marital status with a checkmark on line A and enter the total number of exemptions claimed on line B.

Alabama Withholding Instructions For Pension Or Annuity Payments Step 5: Check the box next to the third statement if you wish to have an amount greater than required by the tax tables withheld from your monthly pension or annuity. If so, enter the dollar amount. Indicate your marital status with a checkmark on line A and enter the total number of exemptions claimed on line B.

Alabama Withholding Instructions For Pension Or Annuity Payments Step 6: If you wish to have an additional amount withheld, check the box next to the fourth statement and enter the dollar amount. Indicate your marital status using a checkmark on line A and enter the total number of exemptions you will claim on line B.

Alabama Withholding Instructions For Pension Or Annuity Payments Step 7: Sign and date the bottom of the page where indicated.

Beneficiary Designation

INSTRUCTIONS: ALABAMA BENEFICIARY DESIGNATION RSA-1 AND PEIRAF

Alabama public employees enrolled in either the RSA-1 or PEIRAF retirement funds should file a beneficiary designation to appoint beneficiaries to whom funds will be disbursed in the event of their death. This beneficiary designation form can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 1: At the top left-hand corner, indicate with a check mark whether you are enrolled in the RSA-1 or PEIRAF program.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 2: On the first blank line, enter your first name, middle or maiden name and last name.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 3; On the second blank line, enter your street address or PO box number.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 4: On the third blank line, enter your city, state and zip code.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 5: On the fourth blank line, enter your Social Security number.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 6: On the fifth blank line, enter your phone number.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 7; If you are including beneficiary information on both sides of the page, check the line stating so.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 8: The first section allows you to name up to three primary beneficiaries who will receive your benefits providing they survive you. The format for naming each beneficiary. In the first blank line for each primary beneficiary, enter their name.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 9: In the second blank line for each primary beneficiary, enter their relationship to you.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 10: In the third blank line for each primary beneficiary, enter their date of birth.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 11: In the fourth blank line for each primary beneficiary, enter their Social Security number.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 12: In the fifth blank line for each primary beneficiary, enter their address.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 13: Follow the same format to name all contingent beneficiaries who will inherit in case your primary beneficiaries do not survive you.

Alabama Beneficiary Designation RSA-1 And PEIRAF Step 14: Sign and date the form before a notary public.

Special Catch-Up Election and Worksheet

INSTRUCTIONS: ALABAMA SPECIAL CATCH-UP ELECTION AND WORKSHEET (Form RSA-1 CATCH UP)

Alabama public employees who are enrolled in the RSA-1 retirement fund plan can use an RSA-1 Catch Up worksheet to make catch-up deferrals for years in which they failed to contribute the maximum possible to the retirement fund. This can be done in the three years prior to Normal Retirement Age. This form can be found on the website of the Retirement Systems of Alabama.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 1: At the top of the first page, enter your name, address, Social Security number, phone number, date of birth and email address.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 2: In the next section labeled "Special Catch-Up Election," enter the age you are designating your Normal Retirement Age and the year in which you will be this age.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 3: In the section labeled "Employee Certification," enter the name of your current employer and their address. Sign and date the bottom of this page.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 4: Complete the worksheet on the second and third pages. The first column lists every calendar year from 1986 to 2011. For each year for which you did not pay the maximum deferrable amount, enter your gross income as documented on your W-2 for that year in column B.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 5: Enter the amount contributed to your RSA-1 fund that year in column C.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 6: Subtract column C from column B. Enter the difference in column D.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 7: Consult the instructions for "Step 5" on the page to determine what figure should be entered in column E.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 8: In column F, enter the amount deferred to retirement funds in that year.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 9: Subtract column F from column E. Enter the difference in column G. This determines how much you can make in catch-up payments for that year. Transfer this information to the chart at the bottom of the page.

Special Tax Notice Regarding Plan Payments

INSTRUCTIONS: ARIZONA SPECIAL TAX NOTICE REGARDING PLAN PAYMENTS

The Arizona Public Safety Personnel Retirement System sent out the letter discussed in this article to inform those enrolled in its system, as well as corrections officers and elected officials enrolled in the equivalent state-run pension plans, how to defer federal income tax on their retirement savings. This document can be obtained from the website maintained by the Arizona Public Safety Personnel Retirement System.

Arizona Special Tax Notice Regarding Plan Payments Step 1: The first paragraph is an introductory paragraph explaining the purpose of this document.

Arizona Special Tax Notice Regarding Plan Payments Step 2: The second paragraph concerns your right to waive the 30-Day Notice Period.

Arizona Special Tax Notice Regarding Plan Payments Step 3: The next two paragraphs outline your rollover options.

Arizona Special Tax Notice Regarding Plan Payments Step 4: The next section provides general information about rollovers. The first paragraph discusses how a rollover can affect tax payments.

Arizona Special Tax Notice Regarding Plan Payments Step 5: The next paragraph discusses to where a rollover can be made.

Arizona Special Tax Notice Regarding Plan Payments Step 6: The next three paragraphs discuss how to do a rollover.

Arizona Special Tax Notice Regarding Plan Payments Step 7: The next section discusses how much you may roll over.

Arizona Special Tax Notice Regarding Plan Payments Step 8: The next section discusses consequences of not performing a rollover, including paying 10% additional tax on early distributions.

Arizona Special Tax Notice Regarding Plan Payments Step 9: The remainder of this part of the document discusses rollovers to IRAs and potential attendant 10% additional tax payments and state income taxes.

Arizona Special Tax Notice Regarding Plan Payments Step 10: The next section discusses special rules and options. The first topic discussed is payments including after-tax contributions.

Arizona Special Tax Notice Regarding Plan Payments Step 11: The next topic discussed is what to do if you miss the 60-day rollover deadline.

Arizona Special Tax Notice Regarding Plan Payments Step 12: The next topic discussed is what to do if you were born on or before January 1, 1936.

Arizona Special Tax Notice Regarding Plan Payments Step 13: The remainder of the topics discussed concern retired public safety officers whose pension payments pay for health coverage or qualified long-term care insurance, those who are not plan participants, and how to obtain more information.

Certification of Service

INSTRUCTIONS: ALABAMA CERTIFICATION OF SERVICE

To determine whether an enrolled member of Alabama's Teacher Retirement System is eligible for additional retirement service credit for a given period and to document their retirement service credit, a certification of service form should be completed by the state agency in question. This document can be found on the website maintained by the Retirement Systems of Alabama.

Alabama Certification Of Service Step 1: The official completing the form should enter their name on the first blank line and the name of the certifying agency on the blank line below.

Alabama Certification Of Service Step 2: On the right, the name of the employee should be entered on the first blank line.

Alabama Certification Of Service Step 3: On the second blank line on the right, the Social Security number of the employee should be entered.

Alabama Certification Of Service Step 4: On the third blank line on the right, the TRS number of the employee should be entered.

Alabama Certification Of Service Step 5: On the blank line just above the chart below, the job classificaiton of the employee for the time being certified should be entered.

Alabama Certification Of Service Step 6: In the first column of the table, the school year in question should be entered.

Alabama Certification Of Service Step 7: In the second column of the table, the contract salary of the employee should be entered.

Alabama Certification Of Service Step 8: In the third column of the table, the actual salary paid should be entered.

Alabama Certification Of Service Step 9: In the fourth column of the table, the number of months worked in that school year should be entered.

Alabama Certification Of Service Step 10: In the fifth column of the table, the number of months contracted in the school year should be entered.

Alabama Certification Of Service Step 11: In the sixth column of the table, the time base of that school year should be entered.

Alabama Certification Of Service Step 12: The authorized official should sign and date the bottom of the page, as well as providing a contact telephone number, including their area code.

Alabama Certification Of Service Step 13: The form should be submitted to the Retirement Systems of Alabama via the address given at the top of the page.

Statement of Withdrawn Service

INSTRUCTIONS: ALABAMA STATEMENT OF WITHDRAWN SERVICE

Alabama state employees enrolled in either the Employees' Retirement System or the Teachers' Retirement System who have previously withdrawn their contributions can restore previously canceled credits by filing the form discussed in this article. This withdrawn service cannot be service credit which has been established with any other public retirement system.

Alabama Statement Of Withdrawn Service Step 1: On the first blank line, enter your first, middle and last names.

Alabama Statement Of Withdrawn Service Step 2: On the second blank line, enter your complete address.

Alabama Statement Of Withdrawn Service Step 3: On the third blank line, enter your Social Security number.

Alabama Statement Of Withdrawn Service Step 4: Three statements are printed below. Place a check in the first set of blank parentheses if you have not established any other public retirement system credit utilizing previously withdrawn service.

Alabama Statement Of Withdrawn Service Step 5: Place a check in the second set of blank parentheses if you have established any other public retirement system credit utilizing previously withdrawn service.

Alabama Statement Of Withdrawn Service Step 6: Place a check in the third set of blank parentheses if you have established another public retirement system credit for part of your previously withdrawn service. Enter the number of years and months which have been transferred to this credit.

Alabama Statement Of Withdrawn Service Step 7: Enter your signature and the date.

Alabama Statement Of Withdrawn Service Step 8: Once you have completed the form, it must be certified by a notary public. In the space below the solid line, they will enter the state and county, the date on which you appeared before them and your name. They will then sign the bottom of the form, provide the date on which their commission expires, and affix their seal.

Alabama Statement Of Withdrawn Service Step 9: File the form at the address given at the top of the form.

Alabama Statement Of Withdrawn Service Step 10: Once your application has been processed, you will need to pay the cost of purchasing your previously withdrawn service. You will be assessed a fee of the amount previously withdrawn, along with eight percent interest compounded from the date of withdrawal to the date of payment. The total withdrawn payment must be made before your employment ceases.

Form IB18 Retiree Years of Service Verification Form

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.

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.

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.

Retirement

Judicial Retirement System

Firefighter Certification