INSTRUCTIONS: ALABAMA GENERAL STATEMENT OF SERVICE

When Alabama state employees are preparing to retire, one of the forms which must be filed in order to purchase services to be credited to their retirement account is a general statement of service. This document can be found on the website maintained by the Employees' Retirement System of Alabama.

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

Alabama General Statement Of Service Step 2: On the second blank line, enter your post office box number or your street address.

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

Alabama General Statement Of Service Step 4: On the fourth blank line, enter your Social Security number.

Alabama General Statement Of Service Step 5: Two statements are provided below. You should only check the box next to the statement applicable to you. The first statement should be checked if you have not established credit with any other public retirement service based on the service being claimed as a credit with the Employees' Retirement System of Alabama. By checking this statement, you also agree to notify the Employees' Retirement System of Alabama if you become entitled to credits or benefits for these services with any other public retirement plan when your entire, and that if you take these credits or benefits, your purchased service credit will be withdrawn and refunded to you.

Alabama General Statement Of Service Step 6: Check the box next to the second statement if you have established another public retirement system credit based on the service for which you are claiming credit with the Employees' Retirement System of Alabama.

Alabama General Statement Of Service Step 7: Provide your signature and the date in the blank lines where indicated.

Alabama General Statement Of Service Step 8: The form must then be certified by a licensed notary public. They will enter your state and county, the date on which you appear before them and your name. They will then sign the form, enter the date on which their commission expires, and affix their seal.

Alabama General Statement Of Service Step 9: File the form by mailing it to the address provided at the top of the form.

INSTRUCTIONS: ALABAMA ERS ENROLLMENT MEMBER INFORMATION RECORD (Form ERS 100)

When enrolling in the Alabama Employees' Retirement System, form ERS 100 is used to provide a record of your information. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama ERS Enrollment Member Information Record ERS 100 Step 1: Indicate whether you are a new member or transferring from another Employees' Retirement System with a check mark.

Alabama ERS Enrollment Member Information Record ERS 100 Step 2: On the first blank line, enter your full name.

Alabama ERS Enrollment Member Information Record ERS 100 Step 3: On the second blank line, enter your Social Security number.

Alabama ERS Enrollment Member Information Record ERS 100 Step 4: Indicate your sex with a check mark.

Alabama ERS Enrollment Member Information Record ERS 100 Step 5: Indicate your marital status with a check mark.

Alabama ERS Enrollment Member Information Record ERS 100 Step 6: Enter your Social Security number on the third blank line.

Alabama ERS Enrollment Member Information Record ERS 100 Step 7: Enter your date of birth on the fourth blank line.

Alabama ERS Enrollment Member Information Record ERS 100 Step 8: Enter your street address or P.O. box, city, state and zip code on the fifth blank line.

Alabama ERS Enrollment Member Information Record ERS 100 Step 9: Enter your phone number on the sixth blank line.

Alabama ERS Enrollment Member Information Record ERS 100 Step 10: Enter the classification or title of the position or elected office you hold on the seventh blank line.

Alabama ERS Enrollment Member Information Record ERS 100 Step 11: Enter your employing agency on the eighth blank line.

Alabama ERS Enrollment Member Information Record ERS 100 Step 12: Enter your section or division on the ninth blank line.

Alabama ERS Enrollment Member Information Record ERS 100 Step 13: Answer the next five questions by checking "yes" or "no" as applicable.

Alabama ERS Enrollment Member Information Record ERS 100 Step 14: If you answered yes to any of the preceding five questions, complete the table below.

Alabama ERS Enrollment Member Information Record ERS 100 Step 15: Sign and date the form on the next two blank lines.

Alabama ERS Enrollment Member Information Record ERS 100 Step 16: Submit the form to your employing agency for completion.

INSTRUCTIONS: ALABAMA WITHHOLDING CERTIFICATE FOR PENSION OR ANNUITY PAYMENTS (Form RSA WCPAP)

To document your wishes regarding withholding federal tax deductions from monthly pensions or annuities administered by the Retirement Systems of Alabama, file the form discussed in this article. This document can be obtained from the website of the Retirement Systems of Alabama.

Alabama Withholding Certificate For Pension Or Annuity Payments RSA WCPAP Step 1: Enter the member's name on the first blank line.

Alabama Withholding Certificate For Pension Or Annuity Payments RSA WCPAP Step 2: Enter the member's Social Security number on the second blank line.

Alabama Withholding Certificate For Pension Or Annuity Payments RSA WCPAP Step 3: Check the box on line 1 if you do not wish to have federal tax deductions withheld from monthly pensions or annuities. If this is the case, do not complete any other areas of this form other than signing and dating the bottom of the page.

Alabama Withholding Certificate For Pension Or Annuity Payments RSA WCPAP Step 4: Check the box on line 2 if you wish to have federal withholding tax calculated using your marital status and the number of exemptions being claimed.

Alabama Withholding Certificate For Pension Or Annuity Payments RSA WCPAP Step 5: Indicate your marital status with a check mark on line A.

Alabama Withholding Certificate For Pension Or Annuity Payments RSA WCPAP Step 6: Enter the total number of exemptions being claimed on line B. If left blank, it will be assumed you meant 0.

Alabama Withholding Certificate For Pension Or Annuity Payments RSA WCPAP Step 7: Check the box on line 3 if you wish to have an amount withheld from your monthly pension or annuity payments greater than the amount on the tax tables. 

Alabama Withholding Certificate For Pension Or Annuity Payments RSA WCPAP Step 8: Indicate your marital status with a check mark on line A.

Alabama Withholding Certificate For Pension Or Annuity Payments RSA WCPAP Step 9: Enter the total exemptions being claimed on line B.

Alabama Withholding Certificate For Pension Or Annuity Payments RSA WCPAP Step 10: Check the box on line 4 if you want an additional amount withheld. Enter the amount, note your marital status on line A with a check mark, and enter the total exemptions being claimed on line B. Enter your signature and the date at the bottom of the page.

INSTRUCTIONS: ALABAMA RSA-1 ENROLLMENT (Form RSA-1 EN)

Alabama employees can enroll in the state-administered RSA-1 deferred compensation plan by filing the form discussed in this article. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama RSA-1 Enrollment RSA-1 EN Step 1: Enter your first name, middle or maiden name and last name on the first blank line.

Alabama RSA-1 Enrollment RSA-1 EN Step 2: Enter your street address or P.O. box number on the second blank line.

Alabama RSA-1 Enrollment RSA-1 EN Step 3: Enter your city, state or zip code on the third blank line.

Alabama RSA-1 Enrollment RSA-1 EN Step 4: Enter your Social Security number on the fourth blank line.

Alabama RSA-1 Enrollment RSA-1 EN Step 5: Enter your date of birth on the fifth blank line.

Alabama RSA-1 Enrollment RSA-1 EN Step 6: Indicate your sex with a check mark.

Alabama RSA-1 Enrollment RSA-1 EN Step 7: Enter your phone number, including the area code, on the sixth blank line.

Alabama RSA-1 Enrollment RSA-1 EN Step 8: Enter your email address on the seventh blank line.

Alabama RSA-1 Enrollment RSA-1 EN Step 9: Enter the name of your employing agency on the eighth blank line.

Alabama RSA-1 Enrollment RSA-1 EN Step 10: Enter your employer phone number on the ninth blank line.

Alabama RSA-1 Enrollment RSA-1 EN Step 11: Check the first statement if currently enrolled in the Employees' Retirement System (ERS).

Alabama RSA-1 Enrollment RSA-1 EN Step 12: Check the second statement if currently enrolled in the Judicial Retirement Fund (JRF).

Alabama RSA-1 Enrollment RSA-1 EN Step 13: Check the third statement if currently enrolled in the Teachers' Retirement System (TRS).

Alabama RSA-1 Enrollment RSA-1 EN Step 14: Check the fourth statement if not currently enrolled in the ERS, TRS or JRF.

Alabama RSA-1 Enrollment RSA-1 EN Step 15: Read the statements printed on the bottom half of the page. These include information about other forms which must be submitted in addition with this enrollment form.

Alabama RSA-1 Enrollment RSA-1 EN Step 16: Enter your signature on the next blank line.

Alabama RSA-1 Enrollment RSA-1 EN Step 17: Enter the date on the last blank line.

Alabama RSA-1 Enrollment RSA-1 EN Step 18: Submit the form to the address given at the top of the page.

INSTRUCTIONS: ARIZONA PUBLIC RECORDS INSPECTION OR REPRODUCTION REQUEST FORM 

To request an inspection or copies of Arizona public records in the care of the state retirement plans for public safety personnel, corrections officers or elected officials, you may file the form discussed in this document. This form can be obtained from the website maintained by the website of the Public Safety Personnel Retirement System of Arizona.

Arizona Public Records Inspection Or Reproduction Request Form Step 1: Check the first box if you are requesting a record inspection without any copies being made.

Arizona Public Records Inspection Or Reproduction Request Form Step 2: If you are seeking copies of these documents, check the box next to the applicable statement. Check the first box if requesting paper copies.

Arizona Public Records Inspection Or Reproduction Request Form Step 3: Check the second box if requesting computer printouts.

Arizona Public Records Inspection Or Reproduction Request Form Step 4: Check the third box if requesting electronic copies.

Arizona Public Records Inspection Or Reproduction Request Form Step 5: In the table provided, enter the records you are seeking to inspect or receive copies of.

Arizona Public Records Inspection Or Reproduction Request Form Step 6: Check the next box if you are requesting these records for an intended commercial purpose. If so, provide a brief explanation in the box provided. If approved, the charge for these copies will reserve a portion of the cost for the public body which obtained the original documents, as well as including a reasonable fee for the labor and materials involved in reproduction and a fee for the current market value of the reproduction.

Arizona Public Records Inspection Or Reproduction Request Form Step 7: Sign your name on the first blank line at the bottom of the page.

Arizona Public Records Inspection Or Reproduction Request Form Step 8: Print your name on the second blank line.

Arizona Public Records Inspection Or Reproduction Request Form Step 9: Enter your company name on the third blank line.

Arizona Public Records Inspection Or Reproduction Request Form Step 10: Enter your street address on the fourth blank line.

Arizona Public Records Inspection Or Reproduction Request Form Step 11: Enter your city, state and zip code on the fifth blank line.

Arizona Public Records Inspection Or Reproduction Request Form Step 12: Enter your phone number, fax number and email address on the sixth blank line.

INSTRUCTIONS: ALABAMA CHANGE OF BENEFICIARY FORM PRIOR TO RETIREMENT (Form RSA 100-C)

Alabama public employees who wish to change the beneficiaries of their retirement benefits and state-administered plans do so using a form RSA 100-C. This document can be obtained from the website of the Retirement Systems of Alabama.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 1: All parts of the form must be printed or typed in black ink. The first section, "Member Information," must be completed by all people filing this form. On the first blank line, enter your first name, middle or maiden name and last name.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 2: On the second blank line, enter your Social Security number.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 3: On the third blank line, enter your date of birth.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 4: On the fourth blank line, enter your home telephone number.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 5: Indicate whether you are an active or inactive member with a check mark.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 6: In the next section, designate your primary beneficiary. On the first blank line here, enter their name.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 7: On the second blank line, enter their relationship to you.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 8: On the third blank line, enter their date of birth.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 9: On the fourth blank line, enter their Social Security number.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 10: On the fifth blank line, enter their address.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 11: In the next section, provide the same information for the contingent beneficiary who will receive benefits if your primary beneficiary is deceased.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 12: If you wish to designate additional primary or contingent beneficiaries, enter the same information for them on the back of the form.

Alabama Change Of Beneficiary Form Prior To Retirement RSA 100-C Step 13: Sign and date the form before a notary public.