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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.

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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.

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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.
 

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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.

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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.
 

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Form RSA PUR TRAN Purchase Transfer Request

Form RSA PUR TRAN Purchase Transfer Request

 

INSTRUCTIONS: ALABAMA PURCHASE TRANSFER REQUEST (Form RSA PUR TRAN)

 

 

If electing to transfer funds from a qualified and tax-deferred fund for the purchase of service in the Alabama Employees' Retirement System or Teachers' Retirement System of Alabama, you should file the form discussed in this article. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 1: Part I concerns the member. Indicate with a check mark whether you are a member of the Employees' Retirement System or Teachers' Retirement System.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 2: Enter your Social Security number on the first blank line.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 3: Enter your account number on the second blank line.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 4: Enter your name on the third blank line.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 5: Enter your date of birth on the fourth blank line.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 6: Enter your address on the fifth blank line.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 7: Enter your home telephone number on the sixth blank line.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 8: Enter your work telephone number on the seventh blank line.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 9: Enter the amount of the transfer requested on the eighth blank line.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 10: Enter your signature on the ninth blank line.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 11: Enter the date on the tenth blank line.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 12: Have the form certified by a notary public.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 13: Part II concerns the retirement plan and should be completed by a representative of the plan. They should indicate the type of plan with a check mark.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 14: On the next two blank lines, the representative should enter the name of the company transferring the funds and your account number.

 

Alabama Purchase Transfer Request RSA PUR TRAN Step 15: The plan representative should provide all other requested information, then sign and date the form.

 

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Form RSA DROP BEN Applying for Beneficiary Payment DROP

Form RSA DROP BEN Applying for Beneficiary Payment DROP

 

INSTRUCTIONS: APPLICATION FOR BENEFICIARY PAYMENT DEFERRED RETIREMENT OPTION PLAN (Form RSA DROP BEN)

 

 

Spousal and non-spousal beneficiaries can apply for payments designated for them from an Alabama Deferred Retirement Option Plan (DROP) by filing the form discussed in this article. This document can be obtained from the website of the Retirement Systems of Alabama.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 1: Part I concerns the member and beneficiary. On the first blank line, enter the full name of the deceased member.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 2: On the second blank line, enter the Social Security number of the deceased member.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 3: On the third blank line, enter the date of birth of the deceased member.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 4: On the fourth blank line, enter the date of death of the deceased member.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 5: On the fifth blank line, enter the employing agency of the deceased member.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 6: On the sixth blank line, enter the full name of the beneficiary.


Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 7: On the seventh blank line, enter the beneficiary's date of birth.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 8: On the eighth blank line, enter the beneficiary's relationship to the deceased member.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 9: On the ninth blank line, enter the beneficiary's Social Security number.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 10: Enter the beneficiary's telephone number on the tenth blank line.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 11: Enter the beneficiary's address on the eleventh blank line.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 12: Part II concerns distribution options for spousal and non-spousal beneficiaries. Complete this section as directed.

 

Application For Beneficiary Payment Deferred Retirement Option Plan RSA DROP BEN Step 13: Sign and date Part III. Obtain the certification of a notary public. Your employer should complete Part IV.

 

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Form RSA-1 IOE DROP or TRANSFER Annual Investment Option Election for DROP Rollover or 457 Transfer RSA-1 Deferred Compensation Plan

Form RSA-1 IOE DROP or TRANSFER Annual Investment Option Election for DROP Rollover or 457 Transfer RSA-1 Deferred Compensation Plan

 

INSTRUCTIONS: ALABAMA ANNUAL INVESTMENT OPTION ELECTION DROP ROLLOVER OR 457 TRANSFER (Form RSA-1 IOE)

 

 

Alabama public employees enrolled in the state-administered RSA-1 delayed compensation retirement fund can use a form RSA-1 IOE to elect a DROP rollover or 457 transfer. This document can be obtained from the website of the Retirement Systems of Alabama.

 

Alabama Annual Investment Option Election Drop Rollover Or 457 Transfer RSA-1 IOE Step 1: Enter your first name, middle or maiden name and last name on the first blank line.

 

Alabama Annual Investment Option Election Drop Rollover Or 457 Transfer RSA-1 IOE Step 2: Enter your Social Security number on the second blank line.

 

Alabama Annual Investment Option Election Drop Rollover Or 457 Transfer RSA-1 IOE Step 3: Enter your date of birth on the third blank line.

 

Alabama Annual Investment Option Election Drop Rollover Or 457 Transfer RSA-1 IOE Step 4: If the member is deceased, enter the first name, middle name or maiden name and last name of the beneficiary on the fourth blank line, their Social Security number on the fifth blank line and their date of birth on the sixth blank line.

 

Alabama Annual Investment Option Election Drop Rollover Or 457 Transfer RSA-1 IOE Step 5: On the next blank line, enter your street address or P.O. box number.

 

Alabama Annual Investment Option Election Drop Rollover Or 457 Transfer RSA-1 IOE Step 6: On the next blank line, enter your city, state or zip code.

 

Alabama Annual Investment Option Election Drop Rollover Or 457 Transfer RSA-1 IOE Step 7: On the next blank line, enter your email address.

 

Alabama Annual Investment Option Election Drop Rollover Or 457 Transfer RSA-1 IOE Step 8: On the next blank line, enter your telephone number, including the area code.

 

Alabama Annual Investment Option Election Drop Rollover Or 457 Transfer RSA-1 IOE Step 9: Indicate the type of election you are requesting by placing a check mark next to the appropriate statement.

 

Alabama Annual Investment Option Election Drop Rollover Or 457 Transfer RSA-1 IOE Step 10: Enter the signature of the member or the beneficiary if the member is deceased on the next blank line and the date on the last blank line. 

 

Alabama Annual Investment Option Election Drop Rollover Or 457 Transfer RSA-1 IOE Step 11: Have the form certified and signed by a notary public.

 

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Retirement Application Packet Part I State

Retirement Application Packet Part I State

 

INSTRUCTIONS: ALABAMA RETIREMENT APPLICATION PACKET FOR STATE EMPLOYEES PART I

 

 

Alabama state employees who are approaching retirement must file state forms 10 and 12 to initiate the retirement process. This article discusses the packet provided by the state containing both of these documents, as well as the optional Direct Deposit Authorization Form. The packet can be found on the website of the Retirement Systems of Alabama.

 

Alabama Retirement Application Packet For State Employees Part I Step 1: The first page in this packet contains a checklist of the steps to be taken to complete these forms.

 

Alabama Retirement Application Packet For State Employees Part I Step 2: The second page contains Form 10, your Application For Retirement. The first section requires you to provide your name, Social Security number, complete home address and telephone number, date of birth, employer name and work phone number.

 

Alabama Retirement Application Packet For State Employees Part I Step 3: Indicate with a check mark whether your retirement is based on service or disability. If the latter, a report of disability form must be submitted.

 

Alabama Retirement Application Packet For State Employees Part I Step 4: Enter the date of your retirement. This must fall on the first of the month in question.

 

Alabama Retirement Application Packet For State Employees Part I Step 5: Enter your email address.

 

Alabama Retirement Application Packet For State Employees Part I Step 6: If you wish to receive retirement benefits via direct deposit, enter the name of your bank or financial institution.

 

Alabama Retirement Application Packet For State Employees Part I Step 7: The next section requires you to designate a primary beneficiary in the event of your death. Sign and date the form where indicated

 

Alabama Retirement Application Packet For State Employees Part I Step 8: Your employer must complete the bottom of this form.

 

Alabama Retirement Application Packet For State Employees Part I Step 9: The next page is Form 12, the Insurance Authorization Form. Here you document your wishes about continuing or discontinuing your health insurance.

 

Alabama Retirement Application Packet For State Employees Part I Step 10: The last page is only to be completed if you wish to authorize payments via direct deposit.

 

Alabama Retirement Application Packet For State Employees Part I Step 11: Once you have completed and filed these forms, you will be sent Part II to continue the retirement process.

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Form 9: Address and Name Change

Form 9: Address and Name Change

INSTRUCTIONS: ARIZONA ADDRESS AND NAME CHANGE FORM (Form 9)

 

 

To document an address or name change, Arizona public safety employees, elected officials and corrections officers who are active or retired should file a form 9 if they were enrolled in a state-administered retirement fund. This document can be obtained from the website maintained by the Elected Officials' Retirement Fund of the State of Arizona.

 

Arizona Address And Name Change Form 9 Step 1: On the first line of Section 1, enter your name and indicate the type of account with a check mark.

 

Arizona Address And Name Change Form 9 Step 2: On the second line, enter your SYSID (if known) and date of birth. If you are the ex-spouse of an enrolled member, enter their name.

 

Arizona Address And Name Change Form 9 Step 3: On the third line, enter your last name, first name and middle initial.

 

Arizona Address And Name Change Form 9 Step 4: On the fourth line, enter your email address.

 

Arizona Address And Name Change Form 9 Step 5: On the fifth line, enter your home phone number, cell phone number and work phone number.

 

Arizona Address And Name Change Form 9 Step 6: On the first line of Section 2, enter your primary mailing address. 

 

Arizona Address And Name Change Form 9 Step 7: On the second line, enter your city, state and zip code.

 

Arizona Address And Name Change Form 9 Step 8: If filing to document a change of address, enter the new street address on the third line and your new city, state and zip code on the fourth lien.

 

Arizona Address And Name Change Form 9 Step 9: If documenting a name change, enter your current and new full names in Section 3. You must attach a copy of a legal document showing your new name.

 

Arizona Address And Name Change Form 9 Step 10: Sign and date section 4. Those who are signing with a power of attorney or as a guardian who have not previously filed this certification must attach a complete copy of their legal appointment.

 

Arizona Address And Name Change Form 9 Step 11: If non-retired, mail or fax the form to the numbers specified at the top of the page. Otherwise, use the fax number provided for retired members.

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