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Form 18: Application to Purchase Military Service

Form 18: Application to Purchase Military Service

 

INSTRUCTIONS: ARIZONA APPLICATION TO PURCHASE ACTIVE MILITARY SERVICE (Form 18)

 

 

A member of the Arizona Elected Officials' Retirement Plan who has at least ten years of service within the plan may receive credited service for active military service prior to the employee's current employment. This is done by filing a form 18. This document can be obtained from the website maintained by the Elected Officials' Retirement Plan of the State of Arizona.

 

Arizona Application To Purchase Active Military Service 18 Step 1: Enter your name on the first line.

 

Arizona Application To Purchase Active Military Service 18 Step 2: Enter your Social Security number on the second line.

 

Arizona Application To Purchase Active Military Service 18 Step 3: Enter your address on the third line.

 

Arizona Application To Purchase Active Military Service 18 Step 4: Enter your telephone number on the fourth line. 

 

Arizona Application To Purchase Active Military Service 18 Step 5: Enter your email address on the fifth line.

 

Arizona Application To Purchase Active Military Service 18 Step 6: Enter your birthdate on the sixth line.

 

Arizona Application To Purchase Active Military Service 18 Step 7: Enter your current employer on the seventh line.

 

Arizona Application To Purchase Active Military Service 18 Step 8: Enter your membership date on the eighth line.

 

Arizona Application To Purchase Active Military Service 18 Step 9: Enter your current position or classification on the ninth line.

 

Arizona Application To Purchase Active Military Service 18 Step 10: On the tenth line, enter the number of months you wish to purchase. Alternately, enter the dollar amount you wish to purchase on the eleventh line.

 

Arizona Application To Purchase Active Military Service 18 Step 11: Enter your branch of military service on the twelfth line.

 

Arizona Application To Purchase Active Military Service 18 Step 12: Check the first box to indicate that you have attached a copy of your military service record.

 

Arizona Application To Purchase Active Military Service 18 Step 13: Check the second box to indicate you have attached a copy of your military discharge certificate. If not, explain why.

 

Arizona Application To Purchase Active Military Service 18 Step 14: Initial the next three lines.

 

Arizona Application To Purchase Active Military Service 18 Step 15: Sign and date the bottom of the page.

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Public Records Inspection or Repreoduction Request Form

Public Records Inspection or Repreoduction Request Form

 

INSTRUCTIONS: ARIZONA PUBLIC RECORDS INSPECTION OR REPRODUCTION REQUEST FORM

In order to inspect or reproduced Arizona public records pertaining to the state-administered retirement plans for public safety personnel, corrections officers or elected officials, you should file the form discussed in this article. This form can be used for both private and commercial uses. This document can be obtained from the website maintained by these retirement plans. Print or type all responses entered on this form.

Arizona Public Records Inspection Or Reproduction Request Form Step 1: Check the first box if requesting a records inspection without any copies.

Arizona Public Records Inspection Or Reproduction Request Form Step 2: Check the second box if requesting paper copies.

Arizona Public Records Inspection Or Reproduction Request Form Step 3: Check the third box if requesting computer printout copies.

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

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

Arizona Public Records Inspection Or Reproduction Request Form Step 6: If you are filing this request for commercial purposes, check the box where indicated and provide a brief explanation of how you will be using these records. The second page contains more information about lawful public commercial use.

Arizona Public Records Inspection Or Reproduction Request Form Step 7: On the first blank line at the bottom of the page, enter your signature.

Arizona Public Records Inspection Or Reproduction Request Form Step 8: On the second blank line, print your name.

Arizona Public Records Inspection Or Reproduction Request Form Step 9: On the third blank line, enter your company name.

Arizona Public Records Inspection Or Reproduction Request Form Step 10: On the fourth blank line, give the street address of your company.

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

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

Arizona Public Records Inspection Or Reproduction Request Form Step 13: Submit the form to the address given at the top of the page.

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Annual Investment Option Election

Annual Investment Option Election

 

INSTRUCTIONS: ALABAMA ANNUAL INVESTMENT OPTION ELECTION RSA-1 DEFERRED COMPENSATION PLAN (Form RSA-1 IOE)
 
Alabama public employees enrolled in the RSA-1 retirement plan can use a form RSA-1 IOE to transfer part of their fixed investment funds to stock investments or vice versa. This document can only be filed once a year and be found on the website maintained by the Retirement Systems of Alabama.
 
Alabama Annual Investment Option Election RSA-1 Deferred Compensation Plan RSA-1 IOE Step 1: On the first blank line, enter your full name.
 
Alabama Annual Investment Option Election RSA-1 Deferred Compensation Plan RSA-1 IOE Step 2: On the second and third blank lines, enter your Social Security number and date of birth.
 
Alabama Annual Investment Option Election RSA-1 Deferred Compensation Plan RSA-1 IOE Step 3: If the enrolled member is deceased, their beneficiary should complete the next three blank lines. Otherwise, leave these blank.
 
Alabama Annual Investment Option Election RSA-1 Deferred Compensation Plan RSA-1 IOE Step 4: Enter your full address, email address and phone number where indicated.
 
Alabama Annual Investment Option Election RSA-1 Deferred Compensation Plan RSA-1 IOE Step 5: Four options are available concerning your account balance. Check the first option if you wish to have a percentage of your month-end balance transferred from the fixed investment option to the stock investment option and write the percentage.
 
Alabama Annual Investment Option Election RSA-1 Deferred Compensation Plan RSA-1 IOE Step 6: Check the second option if you wish to have a certain dollar amount of your month-end balance transferred from the fixed investment option to the stock investment option and write the amount.
 
Alabama Annual Investment Option Election RSA-1 Deferred Compensation Plan RSA-1 IOE Step 7: Check the third option if you wish to have a percentage of your month-end stock investment balance transferred to the fixed investment option and write the percentage.
 
Alabama Annual Investment Option Election RSA-1 Deferred Compensation Plan RSA-1 IOE Step 8: Check the fourth option if you wish to have a fixed dollar amount of your month-end stock investment balance transferred to the fixed investment option and write the amount.
 
Alabama Annual Investment Option Election RSA-1 Deferred Compensation Plan RSA-1 IOE Step 9: Indicate your wishes for future deferrals where indicated.
 
Alabama Annual Investment Option Election RSA-1 Deferred Compensation Plan RSA-1 IOE Step 10: Sign and date the form before a notary public.
 

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RSA 14, Acceptable Proof of Age Documents

RSA 14, Acceptable Proof of Age Documents

 

INSTRUCTIONS: ALABAMA ACCEPTABLE PROOF OF AGE DOCUMENTS (Form RSA 14 APAD)

 

 

When a conflict arises between the age of a retiree or their beneficiary as listed with the Retirement Systems of Alabama, it will be necessary for you to submit acceptable proof of age for yourself or the beneficiary. This documentation is discussed in form RSA 14 APAD, which can be found on the website of the Retirement Systems of Alabama.

 

Alabama Acceptable Proof Of Age Documents RSA 14 APAD Step 1: The first listed acceptable proof of age document is an original or certified copy of a birth certificate issued by the state in which birth took place.

 

Alabama Acceptable Proof Of Age Documents RSA 14 APAD Step 2: The second listed acceptable proof of age document is a delayed birth certificate form from the state in which birth occurred. Either the original or certified copy can be submitted.

 

Alabama Acceptable Proof Of Age Documents RSA 14 APAD Step 3: The third listed acceptable proof of age document is a bureau of census report stating the individual's age during a census year in which they were less than 20 years old. This document can only be used to establish the year of birth.

 

Alabama Acceptable Proof Of Age Documents RSA 14 APAD Step 4: The fourth listed acceptable proof of age document is a baptismal or parish record giving the age of the individual during their baptism. Either the original or a certified copy may be submitted.

 

Alabama Acceptable Proof Of Age Documents RSA 14 APAD Step 5: The fifth listed acceptable proof of age document is a family bible record in either its original form or as a certified copy.

 

Alabama Acceptable Proof Of Age Documents RSA 14 APAD Step 6: The sixth listed acceptable proof of age document is an original or certified school yard giving the individual's date of birth.

 

Alabama Acceptable Proof Of Age Documents RSA 14 APAD Step 7: The seventh listed acceptable proof of age document is an insurance policy giving the date of birth provided it is dated prior to enrollment in the Retirement Systems of Alabama.

 

Alabama Acceptable Proof Of Age Documents RSA 14 APAD Step 8: The bottom of the page provides instructions about obtaining proper certification and submitting your documentation.

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Form ERS SS General Statement of Service

Form ERS SS General Statement of Service

 

INSTRUCTIONS: ALABAMA STATEMENT OF SERVICE (Form ERS SS)

 

 

To purchase credit for service for your retirement account as an Alabama public employee, file the document discussed in this article. This form can be obtained from the website of the Retirement Systems of Alabama.

 

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

 

Alabama Statement Of Service ERS SS Step 2: On the second blank line, enter your P.O. box number or street address.

 

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

 

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

 

Alabama Statement Of Service ERS SS Step 5: Check the box next to the first statement if you have not established credit with any other public retirement system for the service being claimed credit for with the Employees' Retirement System of Alabama. By checking this statement, you are agreeing to notify the Employees' Retirement System of Alabama if you become entitled to credit or benefits for the service being claimed with any other public retirement system at the time of your retirement. By checking this statement, you also agree that if you do receive credit or benefits for the service being claimed from any other public retirement system at the time of your retirement,  the purchased service credit will be withdrawn and you will be refunded the fee paid for this credit.

 

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

 

Alabama Statement Of Service ERS SS Step 7: Enter your signature on the next blank line.

 

Alabama Statement Of Service ERS SS Step 8: Enter the date on the next blank line.

 

Alabama Statement Of Service ERS SS Step 9: The form should be certified by a notary public, who will affix their seal, enter their signature and provide the date on which their commission expires.

 

Alabama Statement Of Service ERS SS Step 10: Mail the form to the address given at the top of the page.

 

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Form RSA SB Application for Survivor Benefit

Form RSA SB Application for Survivor Benefit

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Form TRS 12-T Insurance Authorization

Form TRS 12-T Insurance Authorization

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Form JRF MMCR – FEE Monthly Member Contribution Remittance Probate Judges on Fee

Form JRF MMCR - FEE Monthly Member Contribution Remittance Probate Judges on Fee

 

INSTRUCTIONS: ALABAMA MONTHLY MEMBER CONTRIBUTION REMITTANCE PROBATE JUDGES ON FEE (Form JRF MMCR – FEE)

 

 

Alabama probate judges compensated by fees who are members of the Judicial Retirement Fund must annually contribute 6% of their "base sum," which is defined as 90% of the annual state compensation paid to Circuit Court judges. These payments must be submitted on a monthly basis. The form used in such cases is discussed in this article and is available from the website maintained by the Retirement Systems of Alabama.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Fee JRM MMCR – FEE Step 1: On the first blank line, enter the end date of the month for which you are filing.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Fee JRM MMCR – FEE Step 2: On the second blank line, enter your county.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Fee JRM MMCR – FEE Step 3: On the third blank line, enter the member name.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Fee JRM MMCR – FEE Step 4: On the fourth blank line, enter your Social Security number.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Fee JRM MMCR – FEE Step 5: On line 1, enter the annual state compensation for circuit judges.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Fee JRM MMCR – FEE Step 6: Multiply the annual state compensation for circuit judges by .9. Enter the resulting product on line 1b. This is the "base sum."

 

Alabama Monthly Member Contribution Remittance Probate Judges On Fee JRM MMCR – FEE Step 7: On line 2, enter this base sum on the first blank line.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Fee JRM MMCR – FEE Step 8: Enter the monthly rate on line 2c. Multiply the base sum by the monthly rate and enter the resulting product on line 2d. This is your annual contribution.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Fee JRM MMCR – FEE Step 9: Transfer the annual contribution to line 3. Divide this by 12. Enter the resulting figure on line 2e. This is your monthly contribution.

 

Alabama Monthly Member Contribution Remittance Probate Judges On Fee JRM MMCR – FEE Step 10: Sign and date the bottom of the form.

 

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Form E20: Election not to Participate in the Elected Official’s Retirement Plan

Form E20: Election not to Participate in the Elected Official's Retirement Plan

 

INSTRUCTIONS: ARIZONA ELECTION NOT TO PARTICIPATE IN THE ELECTED OFFICIALS' RETIREMENT PLAN (Form E20)

 

 

Arizona state elected officials with term limits can file a form E20 if they wish to elect not to participate in the states' elected officials' retirement plan. This document can be obtained from the website maintained by the Elected Officials' Retirement Plan of the State of Arizona.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 1: On the first line, enter your name.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 2: On the second line, enter your Social Security number.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 3: On the third line, enter the title of your elected office.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 4: On the fourth line, enter your date of birth.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 5: On the fifth line, enter the beginning date of your current date of office.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 6: On the sixth line, enter your address.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 7: On the seventh line, enter today's date.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 8: The first two paragraphs provide a general statement that you are making this election.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 9: Six numbered benefits you are waiving are listed below. By signing and dating the form, you are acknowledging this waiver.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 10: Enter the date on the first blank line on the bottom of the page.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 11: Sign the second blank line.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 12: A witness should print and sign their name in the third blank line.

 

Arizona Election Not To Participate In The Elected Officials' Retirement Plan E20 Step 13: If the applicant has a spouse, their signature should be provided in the fourth blank line.

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Domestics Relation Order

Domestics Relation Order

 

INSTRUCTIONS: ARIZONA DOMESTIC RELATIONS ORDER

 

 

To assign an alternate payee a portion of the benefits payable to an Arizona public safety personnel, corrections officer or elected official's retirement plan, a domestic relations order should be completed. This document can be obtained from the website maintained by those retirement plans.

 

Arizona Domestic Relations Order Step 1: Enter your name and address at the top of the form.

 

Arizona Domestic Relations Order Step 2: Enter the name of both spouses where indicated and your county.

 

Arizona Domestic Relations Order Step 3: In section 1, indicate your type of retirement plan with a check mark.

 

Arizona Domestic Relations Order Step 4: In section 2, indicate whether the participant in the plan is the plaintiff or respondent with a check mark. Give their address and date of birth.

 

Arizona Domestic Relations Order Step 5: In section 3, indicate whether the alternate payee is the plaintiff or respondent with a check mark. Give their address and date of birth.

 

Arizona Domestic Relations Order Step 6: In section 4, enter the date of marriage and the date on which community property interest ended.

 

Arizona Domestic Relations Order Step 7: Section 5 should only be completed if the participant has not yet retired or is not participating in the deferred retirement option plan.

 

Arizona Domestic Relations Order Step 8: Section 6 concerns division of monthly pension payments.

 

Arizona Domestic Relations Order Step 9: Section 7 concerns post-retirement benefit increases.

 

Arizona Domestic Relations Order Step 10: Section 8 should only be completed if the participant has not yet retired and/or is not a participation in the deferred retirement option plan.

 

Arizona Domestic Relations Order Step 11: Section 9 concerns employee contributions during participation in the deferred retirement option plan, if applicable.

 

Arizona Domestic Relations Order Step 12: Section 10 is optional and concerns disposition of the alternate payee's share in the event the alternate payee's death precedes that of the participant.

 

Arizona Domestic Relations Order Step 11: Sections 11 through 14 contain information about how this domestic relations order will take effect.

 

Arizona Domestic Relations Order Step 12: The judge of your superior court will sign and date the last page.

 

Arizona Domestic Relations Order Step 13: Both the participant and alternate payee should sign the last page.

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