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.

Form W-4P: Withholding Certificate For Pension Or Annuity Payments

INSTRUCTIONS: WITHHOLDING CERTIFICATE FOR PENSION OR ANNUITY PAYMENTS (Form W-4P)

All or a portion of your Arizona pension benefit may be considered federally taxable. You may complete a federal form W-4P to give the Arizona State Retirement System instructions on how to withhold federal taxes from your pension or annuity payments. This document can be obtained from the website maintained by the Internal Revenue Service.

Withholding Certificate For Pension Or Annuity Payments W-4P Step 1: The top section of the form is a personal allowances worksheet to be completed for your records. Enter "1" for yourself if you cannot be claimed as a dependent by anyone else on line 1 and meet at least one of the three other listed requirements. If you meet another one, enter another "1" on line 2. You may enter the same figure for your spouse on line C.

Withholding Certificate For Pension Or Annuity Payments W-4P Step 2: Enter the total number of dependents you will be claiming on line D, and enter "1" on line E if you will be filing as head of household.

Withholding Certificate For Pension Or Annuity Payments W-4P Step 3: Line F concerns the child tax credit. Total lines A through F and enter the sum on line G.

Withholding Certificate For Pension Or Annuity Payments W-4P Step 4: Detach the worksheet from the bottom half of the page along the line where indicated.

Withholding Certificate For Pension Or Annuity Payments W-4P Step 5: On the first line of the form, enter your first name and middle initial, last name and Social Security number.

Withholding Certificate For Pension Or Annuity Payments W-4P Step 6: On the next two lines, enter your full home address. On the right, enter your claim or identification number of your pension or annuity contract.

Withholding Certificate For Pension Or Annuity Payments W-4P Step 7: Check line 1 if you do not wish to have federal income tax withheld from your pension or annuity. If so, do not complete the remainder of the form.

Withholding Certificate For Pension Or Annuity Payments W-4P Step 8: Complete the Deductions and Adjustments Worksheet on the second page to complete line 2.

Withholding Certificate For Pension Or Annuity Payments W-4P Step 9: Complete the Multiple Pensions/More-Than-One-Income Worksheet on the second page to complete line 3.

TRS SMS 1109, State Military Service Purchase

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

Members of the Alabama Teachers' Retirement System (TRS) who have been honorably discharged from military service may purchase up to four years of active service using a form TRS SMS 1109. This document is submitted along with a DD Form 214 or other documentation of your service and discharge. The statement of military service can be obtained from the website of the Retirement Systems of Alabama. Note that this purchase of military service credit must be completed within the first year of your entry into the TRS.

Alabama Statement Of Military Service TRS SMS 1109 Step 1: On the first blank line, enter your name.

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

Alabama Statement Of Military Service TRS SMS 1109 Step 3: On the third blank line, enter your city, state and zip code.

Alabama Statement Of Military Service TRS SMS 1109 Step 4: Check the first box if you are receiving no benefits for military service.

Alabama Statement Of Military Service TRS SMS 1109 Step 5: Check the second box if you are receiving a service retirement benefit from a branch of the armed forces.

Alabama Statement Of Military Service TRS SMS 1109 Step 6: Check the third box if you are receiving a service retirement benefit based on your military service from another agency and enter its name.

Alabama Statement Of Military Service TRS SMS 1109 Step 7: Check the fourth box if you are receiving disability benefit payments from a branch of the armed forces.

Alabama Statement Of Military Service TRS SMS 1109 Step 8: Check the fifth box if you are receiving disability retirement benefits from an agency other than a branch of the armed forces and enter its name.

Alabama Statement Of Military Service TRS SMS 1109 Step 9: Indicate with a checkmark whether your discharge was honorable or other.

Alabama Statement Of Military Service TRS SMS 1109 Step 10: Sign and date the document before a notary public.

Alabama Statement Of Military Service TRS SMS 1109 Step 11: When submitting your document, attach copies of all available supporting armed forces documents giving the dates on which you began and ended active service.

Transfer of Membership from the ERS

INSTRUCTIONS: ALABAMA TRANSFER OF MEMBERSHIP FROM EMPLOYEES' RETIREMENT SYSTEM

Alabama government employees who transition into a state teaching job may use the form discussed in this article to transfer their service credits from the Employees' Retirement System to the Teachers' Retirement System. This form can be found on the website of the Retirement Systems of Alabama.

Alabama Transfer Of Membership From Employees' Retirement System Step 1: On the first line, enter your first, middle and last name, as well as your maiden name if applicable.

Alabama Transfer Of Membership From Employees' Retirement System Step 2: If the name under which you were employed was different, enter your employment name on the second line.

Alabama Transfer Of Membership From Employees' Retirement System Step 3: On the third line, provide your Social Security number.

Alabama Transfer Of Membership From Employees' Retirement System Step 4: On the fourth line, provide your street address or post office box number.

Alabama Transfer Of Membership From Employees' Retirement System Step 5: On the fifth line, enter your city, state and zip code.

Alabama Transfer Of Membership From Employees' Retirement System Step 6: On the sixth line, enter the name of the last Employees' Retirement System unit which employed you.

Alabama Transfer Of Membership From Employees' Retirement System Step 7: On the seventh line, enter the date of your last employment with that unit.

Alabama Transfer Of Membership From Employees' Retirement System Step 8: On the eighth line, enter the date on which you began your current employment with your Teachers' Retirement System unit.

Alabama Transfer Of Membership From Employees' Retirement System Step 9: On the ninth line, enter the date on which your present employment began.

Alabama Transfer Of Membership From Employees' Retirement System Step 10: Sign and date Part I.

Alabama Transfer Of Membership From Employees' Retirement System Step 11: Part II at the bottom of the page is to be completed by your last Employees' Retirement System employer. They should enter your total current year contributions during the date range provided and provide their signature.

Alabama Transfer Of Membership From Employees' Retirement System Step 12: The form should be filed by mailing it to the address given at the top of the form. Those requiring additional assistance with completing this form can call the support telephone number provided there.

Re-employed State Retiree Health Insurance Form

INSTRUCTIONS: ALABAMA RE-EMPLOYED STATE RETIREE HEALTH INSURANCE FORM (Form IB2)

Alabama retired public employees who become re-employed use the form discussed in this article to re-enroll in public employee health insurance or to decline coverage. This document can be obtained from the website maintained by the Alabama State Employees' Insurance Board.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 1: Indicate with a check mark whether you are seeking SEHIP coverage or declining coverage

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 2: Enter your first, middle and last name in the first blank box.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 3: Enter your sex in the second blank box.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 4: Enter your Social Security number in the third blank box.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 5: Enter your date of birth in the fourth blank box.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 6: Enter your Medicare number, if applicable, in the fifth blank box.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 7: Enter your street address in the sixth blank box.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 8: Enter your city in the seventh blank box.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 9: Enter your state in the eighth blank box.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 10: Enter your zip code in the ninth blank box.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 11: Enter your home telephone number, including the area code, in the tenth blank box.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 12: Enter your work telephone number, including the area code, in the eleventh blank box.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 13: If you have dependents, you must provide their full names, relationship to you, birth date and Social Security number in the table provided.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 14: Have your employer complete the bottom left section.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 15: Enter your signature and the date in the bottom right section.

Alabama Re-Employed State Retiree Health Insurance Form IB2 Step 16: Mail the form to the address given at the bottom of the page.

Retirement Application Packet for Non-State Employees Part I

Teacher Aide Service Information Teacher Corps Service Information Job Corps Service Information

INSTRUCTIONS: ALABAMA CERTIFICATION OF TEACHER AIDE SERVICE CERTIFICATION OF TEACHER CORPS SERVICE CERTIFICATION OF JOB CORPS SERVICE (Form TRS C TAS TCS JCS)

Active and contributing members of the Alabama Teachers' Retirement System with 10 years of contributing membership can purchase credit for up to 10 years of service as a teacher aide, participant in the Teacher Corps program or as a participant in the Job Corps program. This is done using the certification form discussed in this article, which can be obtained from the website of the Retirement Systems of Alabama.

Alabama Certification Of Teacher Aide Service Certification Of Teacher Corps Service Certification Of Job Corps Service TRS C TAS TCS JCS Step 1: Part I should be completed by the member. Enter your name on the first blank line.

Alabama Certification Of Teacher Aide Service Certification Of Teacher Corps Service Certification Of Job Corps Service TRS C TAS TCS JCS Step 2: Enter your mailing street address or P.O. box number on the second blank line.

Alabama Certification Of Teacher Aide Service Certification Of Teacher Corps Service Certification Of Job Corps Service TRS C TAS TCS JCS Step 3: Enter your city, state and zip code on the third blank line.

Alabama Certification Of Teacher Aide Service Certification Of Teacher Corps Service Certification Of Job Corps Service TRS C TAS TCS JCS Step 4: On the fourth blank line, enter the TRS system for which you were an employee.

Alabama Certification Of Teacher Aide Service Certification Of Teacher Corps Service Certification Of Job Corps Service TRS C TAS TCS JCS Step 5: Part II should be completed by your employer. On the first blank line, they should enter your job classification.

Alabama Certification Of Teacher Aide Service Certification Of Teacher Corps Service Certification Of Job Corps Service TRS C TAS TCS JCS Step 6: On the second blank line, your employer should enter your TRS member entry date.

Alabama Certification Of Teacher Aide Service Certification Of Teacher Corps Service Certification Of Job Corps Service TRS C TAS TCS JCS Step 7: In the table provided, information should be provided about your salary and work hours.

Alabama Certification Of Teacher Aide Service Certification Of Teacher Corps Service Certification Of Job Corps Service TRS C TAS TCS JCS Step 8: The authorized official should sign and date the form.

Form RSA-1 PEIRAF BEN Beneficiary Designation RSA-1 & PEIRAF

INSTRUCTIONS: ALABAMA BENEFICIARY DESIGNATION (Form RSA-1 PEIRAF)

Alabama public employees enrolled in the state-administered RSA-1 or PEIRAF retirement plans use the form discussed in this article to designate primary and contingent beneficiaries for their benefits in the event of their death. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Beneficiary Designation RSA-1 PEIRAF Step 1: Indicate whether you maintain a PEIRAF or RSA-1 account with a check mark.

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

Alabama Beneficiary Designation RSA-1 PEIRAF Step 3: On the second blank line, enter your street address or P.O. box number.

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

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

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

Alabama Beneficiary Designation RSA-1 PEIRAF Step 7: If documenting additional primary or contingent beneficiaries on the second page, check the box where indicated. This will be the case if designating more than three primary or contingent beneficiaries.

Alabama Beneficiary Designation RSA-1 PEIRAF Step 8: The first section concerns primary beneficiaries. For each, enter their name on the first blank line.

Alabama Beneficiary Designation RSA-1 PEIRAF Step 9: For each beneficiary, enter their relationship to you on the second blank line.

Alabama Beneficiary Designation RSA-1 PEIRAF Step 10: For each beneficiary, enter their date of birth on the third blank line.

Alabama Beneficiary Designation RSA-1 PEIRAF Step 11: For each beneficiary, enter their street address or P.O. box number, city, state and zip code on the fourth blank line.

Alabama Beneficiary Designation RSA-1 PEIRAF Step 12: The next section concerns contingent beneficiaries. For each one, provide their name, relationship to you, date of birth, Social Security number and complete address.

Alabama Beneficiary Designation RSA-1 PEIRAF Step 13: If you require space to document additional primary or contingent beneficiaries, enter your name and Social Security number at the top of the second page and provide all additional information.

Alabama Beneficiary Designation RSA-1 PEIRAF Step 14: Sign and date the first page, then obtain the certification of a notary public.

Retirement

Judicial Retirement System

Firefighter Certification