INSTRUCTIONS: ALABAMA SERVICE CALCULATION (Form ERS F SC)

To establish retirement credit with the Employees' Retirement System of Alabama, file the form discussed in this article. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Service Calculation ERS S FC Step 1: Enter your name on the first blank line.

Alabama Service Calculation ERS S FC Step 2: Enter your Social Security number on the second blank line.

Alabama Service Calculation ERS S FC Step 3: Enter your registration number on the third blank line.

Alabama Service Calculation ERS S FC Step 4: Enter your street address or P.O. box number, city, state and zip code on the fourth blank line.

Alabama Service Calculation ERS S FC Step 5: The remainder of the form is to be completed by the employing agency, not the employee. Two tables are provided to document service. In the first column of each table, the dates being covered are listed. In the second column, the total salary paid during that period should be entered. In the third column, the dates of service for that period should be entered. In the fourth column, the number of months of service should be entered. Provide this information for all applicable dates.

Alabama Service Calculation ERS S FC Step 6: Check the first box below the tables if this form is being filed to establish retirement credit for full-time hourly rate employment.

Alabama Service Calculation ERS S FC Step 7: Check the second box if this form is being filed to establish retirement credit for part-time employment on a percentage basis. Enter the percentage.

Alabama Service Calculation ERS S FC Step 8: Check the third box if this form is being filed to establish retirement credit for provisional (non-temporary) employment.

Alabama Service Calculation ERS S FC Step 9: Check the fourth box if this form is being filed to establish retirement credit for full-time employment during a period of non-enrollment due to administrative error.

Alabama Service Calculation ERS S FC Step 10: Check the fifth box if this form is being filed to establish retirement credit as an elected official. Specify the office. If "other," check the sixth box and explain.

Alabama Service Calculation ERS S FC Step 11: The certifying official should enter their signature and title, the date, and the name of the agency.

INSTRUCTIONS: ALABAMA MULTIPLE BENEFICIARIES ATTACHMENT DEFERRED RETIREMENT OPTION PLAN (DROP) (Form ERA 10 DMB)

Alabama public employees who are enrolled in the state-administered Deferred Retirement Option Plan (DROP) can use the form discussed in this article to designate multiple beneficiaries who will receive their benefits in the event of their death. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Multiple Beneficiaries Attachment Deferred Retirement Option Plan (DROP) ERA 10 DMB Step 1: Enter your full name on the first blank line.

Alabama Multiple Beneficiaries Attachment Deferred Retirement Option Plan (DROP) ERA 10 DMB Step 2: Enter your Social Security number on the second blank line.

Alabama Multiple Beneficiaries Attachment Deferred Retirement Option Plan (DROP) ERA 10 DMB Step 3: In the table provided, you may document up to eight beneficiaries. Under Alabama law, benefits will be disbursed on a "joint survivorship" basis among all the beneficiaries. Enter the first name, middle or maiden name and last name of each beneficiary in the first column.

Alabama Multiple Beneficiaries Attachment Deferred Retirement Option Plan (DROP) ERA 10 DMB Step 4: Enter the date of birth of each beneficiary in the second column.

Alabama Multiple Beneficiaries Attachment Deferred Retirement Option Plan (DROP) ERA 10 DMB Step 5: Enter the address of each beneficiary in the third column.

Alabama Multiple Beneficiaries Attachment Deferred Retirement Option Plan (DROP) ERA 10 DMB Step 6: Enter each beneficiary's relationship to you in the fourth column.

Alabama Multiple Beneficiaries Attachment Deferred Retirement Option Plan (DROP) ERA 10 DMB Step 7: Check the first statement if the designated beneficiaries above are different from those listed on your active account and you wish for the change to become effective upon the submission of this signed and mailed application to the Employees' Retirement System Of Alabama.

Alabama Multiple Beneficiaries Attachment Deferred Retirement Option Plan (DROP) ERA 10 DMB Step 8: Check the second statement if the designated beneficiaries above are different from those listed on your active account and you wish for the change to become effective on the date your DROP participation begins.

Alabama Multiple Beneficiaries Attachment Deferred Retirement Option Plan (DROP) ERA 10 DMB Step 9: Enter your signature on the last blank line. Have the form certified by a notary public.

INSTRUCTIONS: ALABAMA DEFERRED RETIREMENT OPTION PLAN (DROP) PARTICIPATION PERIOD COMPLETED/CONTINUED SERVICE (Form TRS 10 D-CCE)

Members of the Teachers' Retirement System of Alabama may choose to terminate their enrollment in the Deferred Retirement Option Plan (DROP) following the completion of a participation period by filing the form discussed in this article. This document can be obtained from the website of the Retirement Systems of Alabama.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service TRS 10 D-CCE Step 1: On the first blank line, enter your first, middle and last name.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service TRS 10 D-CCE Step 2: On the second blank line, enter your Social Security number.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service TRS 10 D-CCE Step 3: On the third blank line, enter your employing school system or agency.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service TRS 10 D-CCE Step 4: On the fourth blank line, enter your requested effective date of DROP termination.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service TRS 10 D-CCE Step 5: On the fifth blank line, enter your phone number.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service TRS 10 D-CCE Step 6: If you will continue to be employed on a full-time basis after DROP termination, check the box on line I.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service TRS 10 D-CCE Step 7: On line II, enter your signature.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service TRS 10 D-CCE Step 8: Section III is for completion by your employer. On line 1, they will enter your last date of service prior to the DROP termination date.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service TRS 10 D-CCE Step 9: Your closing date of the last payroll for salary earned prior to the DROP termination date will be entered on line 2, your total accrued unused sick leave days on line 3, your current contract salary on line 4, your days worked prior to DROP termination on line 5, the days in your current contract period on line 6 and the authorized official's signature on line 7. Have the form certified by a notary.

INSTRUCTIONS: ALABAMA RETIREE EMPLOYMENT VERIFICATION (Form PEEHIP REV)

A form PEEHIP REV is used to verify the employment statue of a retiree enrolled in the Alabama Public Education Employees' Health Insurance Plan (PEEHIP). This document can be obtained from the website of the Retirement Systems of Alabama.

Alabama Retiree Employment Verification PEEHIP REV Step 1: The first section concerns the PEEHIP subscriber. On the first line, enter the subscriber's Social Security number, first name, middle name or initial and last name.

Alabama Retiree Employment Verification PEEHIP REV Step 2: On the second line, enter the subscriber's mailing address, city, state and zip code.

Alabama Retiree Employment Verification PEEHIP REV Step 3: On the third line, enter the subscriber's home phone number.

Alabama Retiree Employment Verification PEEHIP REV Step 4: The next section concerns your employment. Indicate with a check mark whether you are employed. If no, skip to the Medicare section beneath.

Alabama Retiree Employment Verification PEEHIP REV Step 5: On the first line, enter the name of your current employer, their phone number, and your date of hire.

Alabama Retiree Employment Verification PEEHIP REV Step 6: On the second line, enter your employer's address, city, state and zip code.

Alabama Retiree Employment Verification PEEHIP REV Step 7: Indicate whether your employer offers group health insurance with a check mark. If no, skip to the Medicare section below.

Alabama Retiree Employment Verification PEEHIP REV Step 8: Indicate whether your employer contributes at least 50% or more of single health insurance coverage for employees. If no, skip to the Medicare section below.

Alabama Retiree Employment Verification PEEHIP REV Step 9: Indicate whether you are eligible for your employer's group health insurance coverage with a check mark. If yes, enter the date on which you are eligible. If no, explain.

Alabama Retiree Employment Verification PEEHIP REV Step 10: The next section concerns Medicare. Indicate whether you are eligible with a check mark.

Alabama Retiree Employment Verification PEEHIP REV Step 11: If you or your dependents are eligible for Medicare, the next section must be completed. Enter the name, Medicare card number, and effective date for the subscriber. Additionally, indicate with a check mark whether you are eligible for Part A, Part B or Part D.

Alabama Retiree Employment Verification PEEHIP REV Step 12: Sign and date the form where indicated.

INSTRUCTIONS: APPLICATION TO TRANSFER OR REDEEM SERVICE CREDITS BETWEEN ARIZONA RETIREMENT PLANS (Form U2)

Public safety personnel, corrections officers and elected officials in Arizona can all use a form U2 in order to request that service credits from another retirement service or plan in the state be transferred to their current plan. This document can be obtained from the website maintained by the Elected Officials' Retirement Plan of the State of Arizona.

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 1: On the first line of section I, enter your name.

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 2: On the second line, enter your telephone number.

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 3: On the third line, enter your complete address.

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 4: On the fourth line, enter your Social Security number.

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 5: On the fifth line, enter your date of birth.

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 6: On the first line of section II, enter the name of your former retirement system or plan.

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 7: On the second line, enter the name of your former employer while contributing to this plan.

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 8: On the third line, enter your former position or classification.

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 9: On the fourth and fifth lines, enter your beginning and ending previous service dates.

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 10: Indicate with a check mark whether you withdrew member contributions from your previous plan. If redeeming refunded credit, enter how many months you wish to have calculated.

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 11: In section III, enter your current retirement system or plan, current employer, service date, and current position or classification. 

Application To Transfer Or Redeem Service Credits Between Arizona Retirement Plans U2 Step 12: Sign and date the bottom of the page.

INSTRUCTIONS: ALABAMA DEFERRED RETIREMENT OPTION PLAN (DROP) PARTICIPATION PERIOD COMPLETED REQUEST FOR DROP TERMINATION (Form ERS 10 D-C)

INSTRUCTIONS: ALABAMA INELIGIBLE MEMBER REFUND REQUEST (Form 7IR)

Temporary employees of the state of Alabama who are ineligible for contributions to the state Employees' Retirement System, as well as others who are ineligible, can request a refund using a form 7IR. This document can be obtained from the website of the Retirement Systems of Alabama and should be completed by the employer.

Alabama Ineligible Member Refund Request 7IR Step 1: Enter the employee's full name on the first blank line.

Alabama Ineligible Member Refund Request 7IR Step 2: Enter the employee's Social Security number on the second blank line.

Alabama Ineligible Member Refund Request 7IR Step 3: Enter your register number on the third blank line.

Alabama Ineligible Member Refund Request 7IR Step 4: On the fourth blank line, provide a written explanation of why the employee is ineligible.

Alabama Ineligible Member Refund Request 7IR Step 5: On the fifth blank line, enter the sum of the total retirement deductions taken from the employee's salary.

Alabama Ineligible Member Refund Request 7IR Step 6: On the sixth blank line, enter the sum of the total matching employer contributions which were remitted.

Alabama Ineligible Member Refund Request 7IR Step 7: On the seventh blank line, enter the sum of these two values. This is the size of the total refund being requested.

Alabama Ineligible Member Refund Request 7IR Step 8: On the eighth blank line, enter the date of the last deduction made from the employee's salary.

Alabama Ineligible Member Refund Request 7IR Step 9: On the ninth blank line, enter the name of the employing agency.

Alabama Ineligible Member Refund Request 7IR Step 10: On the tenth, eleventh and twelfth blank lines, enter the complete mailing address of the employing agency.

Alabama Ineligible Member Refund Request 7IR Step 11: On the twelfth blank line, the employing official should provide their signature.

Alabama Ineligible Member Refund Request 7IR Step 12: On the thirteenth blank line, the employing official should enter the date.

Alabama Ineligible Member Refund Request 7IR Step 14: On the fourteenth blank line, the employing official should enter their title.

Alabama Ineligible Member Refund Request 7IR Step 15: Submit this return to the address given at the top of the page. However, do not do so until you have ceased withholding retirement deductions from the wages of the employee in question and have remitted your final contribution.

INSTRUCTIONS: ALABAMA FIREFIGHTER CERTIFICATION (Form RSA FCFERS)

Alabama firefighters can purchase credit for prior service by using the document discussed in this article. This form can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Firefighter Certification RSA FCFERS Step 1: Part I should be completed by your current employer. Your name should be entered on the first blank line.

Alabama Firefighter Certification RSA FCFERS Step 2: Your Social Security number should be entered on the second blank line.

Alabama Firefighter Certification RSA FCFERS Step 3: Your street address or P.O. box number, city, state and zip code should be entered on the third blank line.

Alabama Firefighter Certification RSA FCFERS Step 4: Your work telephone number, including the area code, should be entered on the fourth blank line.

Alabama Firefighter Certification RSA FCFERS Step 5: Your home telephone number, including the area code, should be entered on the fifth blank line.

Alabama Firefighter Certification RSA FCFERS Step 6: The box next to "Firefighter" should be checked.

Alabama Firefighter Certification RSA FCFERS Step 7: Your position title should be entered on the next blank line.

Alabama Firefighter Certification RSA FCFERS Step 8: Your employment status should be indicated with a check mark.

Alabama Firefighter Certification RSA FCFERS Step 9: The name of your employing agency should be entered.

Alabama Firefighter Certification RSA FCFERS Step 10: The certifying official should enter their signature on the next blank line.

Alabama Firefighter Certification RSA FCFERS Step 11: The certifying official should enter the date on the next blank line.

Alabama Firefighter Certification RSA FCFERS Step 12: The certifying official should enter their title on the next blank line. 

Alabama Firefighter Certification RSA FCFERS Step 13: Part II should be completed by the employer to which eligible periods of service were rendered. In the table provided, your position title, beginning and ending dates of service and total service rendered should be entered.

Alabama Firefighter Certification RSA FCFERS Step 14: On the next blank line, the agency name should be entered.

Alabama Firefighter Certification RSA FCFERS Step 15: On the last three blank lines of Part II, the date, the signature of the certifying official and their title should be entered.

Alabama Firefighter Certification RSA FCFERS Step 16: Mail the form to the address given in the instructions on the second page.

INSTRUCTIONS: ALABAMA DEFERRED RETIREMENT OPTION PLAN (DROP) REQUEST FOR EARLY TERMINATION OF DROP (Form ERS 10 D-E)

Alabama public employees enrolled in the state-administered Deferred Retirement Option Plan (DROP) use the form discussed in this article if they wish to terminate their enrollment early. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP ERA 10 D-E) Step 1: Enter your name on the first blank line.

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP ERA 10 D-E) Step 2: Enter your Social Security number on the second blank line. 

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP ERA 10 D-E) Step 3: Enter your street address or P.O. box number, city, state and zip code on the third blank line.

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP ERA 10 D-E) Step 4: Enter your work phone number on the fourth blank line and your home phone number on the fifth blank line.

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP ERA 10 D-E) Step 5: Enter your employing agency on the sixth blank line.

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP ERA 10 D-E) Step 6: Enter your requested effective date of DROP termination on the seventh blank line. This must be the last day of the month.

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP ERA 10 D-E) Step 7: Enter your date of birth on the eighth blank line.

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP ERA 10 D-E) Step 8: In Section I, indicate the reason for your requested termination with a check mark.

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP ERA 10 D-E) Step 9: In Section II, answer all questions concerning the withholding certificate for pension or annuity payments with check marks as applicable.

Alabama Deferred Retirement Option Plan (DROP) Request For Early Termination Of DROP ERA 10 D-E) Step 10: Only complete Section III if your employing agency allows conversion of sick leave days to your retirement credit. Sign Section IV. Your employer should complete Section V.