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.

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.

INSTRUCTIONS: ALABAMA PURCHASE TRANSFER REQUEST

To transfer funds from a qualified, tax-deferred plan for the purpose of purchasing service in the Alabama Employees' Retirement System or the Teachers' Retirement System of Alabama, you must file the form discussed in this article. This form can be found on the website of the Retirement Systems of Alabama.

Alabama Purchase Transfer Request Step 1: Part I is to be completed by you. Indicate with a check mark if you are applying for a transfer to the Employees' Retirement System or the Teachers' Retirement System.

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

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

Alabama Purchase Transfer Request Step 4: Enter your full name on the third line.

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

Alabama Purchase Transfer Request Step 6: Enter your home telephone number on the fifth line.

Alabama Purchase Transfer Request Step 7: Enter your work telephone number on the sixth line.

Alabama Purchase Transfer Request Step 8: Enter the amount of the transfer you are requesting on the seventh line. A copy of the purchase letter must be attached.

Alabama Purchase Transfer Request Step 9: Sign and date the form at the bottom of Part I.

Alabama Purchase Transfer Request Step 10: You must appear before a notary public. They will enter the county name in which you are filing and the date. They will then sign the form, give the date on which their commission expires, and affix their seal.

Alabama Purchase Transfer Request Step 11: Submit the form to the plan from which funds will be transferred. A plan representative is responsible for completing Part II. They should indicate the type of plan with a check mark.

Alabama Purchase Transfer Request Step 12: On the first line of Part II, they should enter the company name. On the second line, they should enter your account number.

Alabama Purchase Transfer Request Step 13: On the third line, the name of a contact person should be entered. On the fourth line their telephone number should be entered.

Alabama Purchase Transfer Request Step 14: On the fifth line the qualified transfer amount should be entered. The plan representative should sign, date and file the form.

INSTRUCTIONS: ALABAMA RETIREE EMPLOYMENT VERIFICATION FORM (Form IB16)

Alabama state employees who retired following September 30, 2005 and obtained employment with an employer who provides at least 50% of the cost of single health insurance coverage can re-enroll in the the State Employees' Health Insurance Plan if their employer stops paying at least 50% of this cost. This is done using the form discussed in this article, which can be obtained from the website maintained by the Alabama State Employees' Insurance Board.

Alabama Retiree Employment Verification Form IB16 Step 1: On line 1, indicate whether you are employed by checking "Yes" or "No." If no, you do not need to answer the remaining questions. Sign and return the form.

Alabama Retiree Employment Verification Form IB16 Step 2: If employed, enter the name of your employer on the first blank line.

Alabama Retiree Employment Verification Form IB16 Step 3: If employed, enter your employer's street address on the second blank line.

Alabama Retiree Employment Verification Form IB16 Step 4: If employed, enter your employer's city, state and zip code on the third blank line.

Alabama Retiree Employment Verification Form IB16 Step 5: If employed enter your employer's telephone number, including the area code, on the fourth blank line.

Alabama Retiree Employment Verification Form IB16 Step 6: If employed, give your hire date on the fifth blank line.

Alabama Retiree Employment Verification Form IB16 Step 7: On line 2, indicate whether your employer offers group health insurance by checking "Yes" or "No" as applicable. If no, skip the remaining questions and sign and return the form.

Alabama Retiree Employment Verification Form IB16 Step 8: On line 3, indicate whether your employer contributes at least 50% or more of the cost of single health insurance coverage for its employees by checking "Yes" or "No" as applicable. If no, skip the next question, then sign and return the form.

Alabama Retiree Employment Verification Form IB16 Step 9: On line 4, indicate whether you are eligible for your employer's group health insurance coverage by checking "Yes" or "No" as applicable. If no, provide a written explanation.

Alabama Retiree Employment Verification Form IB16 Step 10: Enter your signature on the next blank line.

Alabama Retiree Employment Verification Form IB16 Step 11: Enter the date on the last blank line.

INSTRUCTIONS: ALABAMA APPLICATION AND CERTIFICATION FOR OUT-OF-STATE SERVICE CREDIT (Form RSA 50B)

Alabama public employees enrolled in the state's retirement systems can use the form discussed in this article to apply for and receive credit for out-of-state service. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 1: Part I concerns the member. Enter your first name, middle name, last name and (if applicable) maiden name on the first blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 2: Enter your date of birth on the second blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 3: Enter your Social Security number on the third blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 4: Enter your home phone number on the fourth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 5: Enter your street address or P.O. box number on the fifth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 6: Enter your work phone number on the sixth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 7: Enter your city, state and zip code on the seventh blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 8: Enter your RSA account number, if known, on the eighth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 9: Enter the name of your out of state employer on the ninth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 10: Enter your total service on the tenth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 11: Write whether you were covered by a public retirement system or plan on the eleventh blank line. If yes, write the benefit on the twelfth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 12: Enter your signature on the thirteenth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 13: Document your former out-of-state employers in Part II as directed. Part III should be completed by your former employer's retirement system.

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

To terminate membership in the Alabama Deferred Retirement Option Plan (DROP), the form discussed in this article can be used. 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 ERS 10 D-CCE Step 1: Enter your first, middle and last name on the first blank line. 

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

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERS 10 D-CCE Step 3: Enter your employing agency on the third blank line.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERS 10 D-CCE Step 4: Enter your registered effective date of DROP termination on the fourth blank line. The date given must be the last day of the month in question.

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

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

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

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERS 10 D-CCE Step 8: The form must be certified by a notary public, who will complete the middle of the page.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERS 10 D-CCE Step 9: Section III concerns your employer's certification. On line 1, they will enter your last date of service prior to DROP termination. On line 2, they will enter the closing date of the last payroll for salary earned prior to the DROP termination date.

Alabama Deferred Retirement Option Plan (DROP) Participation Period Completed/Continued Service ERS 10 D-CCE Step 10: Line 3 concerns accrued sick leave. On line 4, the authorized official enter their signature, the date, the name of the employing institution and the employer phone number.

INSTRUCTIONS: ALABAMA SPECIAL CATCH-UP ELECTION AND WORKSHEET (Form RSA-1 CATCH UP)

Alabama public employees enrolled in the state-administered RSA-1 deferred compensation plan can file the form discussed in this article to make catch-up deferrals during the three calendar years ending prior to their normal retirement age. This document can be obtained from the website of the Retirement Systems of Alabama.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 1: On the first blank line, enter your first name, middle or maiden name, and last name.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 2: On the second blank line, enter your street address or P.O. box number, city, state and zip code.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 3: On the third blank line, enter your Social Security number.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 4: On the fourth blank line, enter your telephone number, including the area code.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 5: On the fifth blank line, enter your date of birth.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 6: On the sixth blank line, enter your email address.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 7: The next section concerns the special catch-up election. On the first blank line, enter your Normal Retirement Age.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 8: On the next blank line, enter the year in which you will achieve your Normal Retirement Age.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 9: The next section concerns employee certification. On the first blank line, enter the name of your current employer.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 10: On the second blank line, enter the street address or P.O. box number, city, state and zip code of your employer.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 11: On the third blank line, enter your signature.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 12: On the fourth blank line, enter the date.

Alabama Special Catch-Up Election And Worksheet RSA-1 Catch Up Step 13: Complete the worksheet on the second and third pages as instructed.

INSTRUCTIONS: ALABAMA RETIREMENT APPLICATION PACKET FOR NON-STATE EMPLOYEES PART I

Alabama residents who are not employees of the state must prepare for retirement by completing state Form 10. This Application for Retirement is combined with an optional Direct Deposit Authorization Form in a packet available on the website of the Retirement Systems of Alabama.

Alabama Retirement Application Packet For Non-State Employees Part I Step 1: The first page of this packet contains a checklist of steps to take in completing this packet.

Alabama Retirement Application Packet For Non-State Employees Part I Step 2: The second page contain Form 10. Enter your name, Social Security number, home address, date of birth, work and home telephone numbers, and the name of your employer.

Alabama Retirement Application Packet For Non-State Employees Part I Step 3: Indicate with a check mark whether you are retiring due to disability or on a service basis. If the former, you must submit a separate Report of Disability.

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

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

Alabama Retirement Application Packet For Non-State Employees Part I Step 6: Those who wish for retirement benefits to be administered through direct deposit should enter the name of their bank or financial institution.

Alabama Retirement Application Packet For Non-State Employees Part I Step 7: In the next section, give the name of your primary beneficiary in the event of your death. 

Alabama Retirement Application Packet For Non-State Employees Part I Step 8: Provide the relationship of your beneficiary to you, and their date and Social Security number. Answer the next questions with check marks.

Alabama Retirement Application Packet For Non-State Employees Part I Step 9: Sign and date the form. You must then appear before a notary to have the form witnessed.

Alabama Retirement Application Packet For Non-State Employees Part I Step 10: Your employer should complete the last section of this form.

Alabama Retirement Application Packet For Non-State Employees Part I Step 11: If you wish to receive retirement benefits through a direct deposit, provide all information requested on the next to last page. The last page should be completed by a representative of your financial institution.

INSTRUCTIONS: ARIZONA DIRECT DEPOSIT AUTHORIZATION FOR RETIRED MEMBERS (Form 13)

To authorize or cancel direct deposits to the bank account of retired members enrolled in Arizona's state-administered retirement plans for public safety personnel, corrections officers or elected officials, a form 13 should be filed. This document can be obtained from the website of the Public Safety Personnel Retirement System.

Arizona Direct Deposit Authorization For Retired Members 13 Step 1: In the first blank box, enter your Social Security number.

Arizona Direct Deposit Authorization For Retired Members 13 Step 2: In the second blank box, indicate with a check mark whether this authorization should be applied to a retired or DROP account, to a survivor or guardian account, or that of an ex-spouse. If the latter, provide their name.

Arizona Direct Deposit Authorization For Retired Members 13 Step 3: Enter your SYSID, if known, in the third blank box.

Arizona Direct Deposit Authorization For Retired Members 13 Step 4: Enter your date of birth in the fourth blank box.

Arizona Direct Deposit Authorization For Retired Members 13 Step 5: Enter your email address in the fifth blank box.

Arizona Direct Deposit Authorization For Retired Members 13 Step 6: Enter your last name in the sixth blank box. 

Arizona Direct Deposit Authorization For Retired Members 13 Step 7: Enter your first name and middle initial in the seventh blank box.

Arizona Direct Deposit Authorization For Retired Members 13 Step 8: Enter your street address in the eighth blank box.

Arizona Direct Deposit Authorization For Retired Members 13 Step 9: Enter your city, state and zip code in the ninth blank box. In the last three boxes of the first part, enter your home number, cell phone number and work phone number.

Arizona Direct Deposit Authorization For Retired Members 13 Step 10: In Section 2, indicate whether this is a checking or savings account with a check mark.

Arizona Direct Deposit Authorization For Retired Members 13 Step 11: Enter your routing number, account number and the name of the financial institution on the next three blank lines.

Arizona Direct Deposit Authorization For Retired Members 13 Step 12: Check the box in Section 3 if canceling a direct deposit authorization.

Arizona Direct Deposit Authorization For Retired Members 13 Step 13: Sign and date the bottom of the page.