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Form 1, Membership Application (revised 12/13/11)
Form 1B, Beneficiary Designation (revised 12/16/11)
Form 1C, Change of Information (revised 12/16/11)
Form 4A, Non-Covered Employment Acknowledgment (revised 12/19/11)
Form 4B, Reemployment of PERS Service Retiree Certification/Acknowledgement (revised 12/21/11)
Form 5, Member Refund Application (revised 03/07/11)
Form 5A, Member Waiver of Monthly Benefits (revised 01/18/11)
Form 5B, Spousal Waiver of Monthly Benefits (revised 07/08/11)
Form 5D, Beneficiary Refund Application (revised 10/26/10)
Form 5W, Request to Waive Refund Waiting Period (revised 03/25/11)
Form 9A DSBL, Pre-Application for Disability Retirement Benefits
Form 9A SRVC, Pre-Application for Service Retirement Benefits (revised 12/21/11)
Form 9A SRVR, Pre-Application for Survivor Retirement Benefits
Form 9C, Local County or Municipal Elected Official Annual Reemployment Acknowledgement and Election (revised 12/21/11)
Form 12, Payment/Purchase Acknowledgement (revised 05/02/11)
Form 19, Out-of-State Public Employment Certification (revised 07/25/11)
Form 25A, Acknowledgment of Veteran’s Right to Purchase Service Credit (revised 09/09/11)
Form 25D, Determination of Entitlement of Purchase Pension Service Credit under the Veteran’s Reemployment Rights Laws (revised 09/09/11)
Form 25M, Statement of Qualified Military Service (revised 09/09/11)
Emp vs. Indpdt, Employee vs. Independent Contractor Determination Questionnaire (revised 01/05/11)
(Please confirm eligibility with PERS before submitting this form)
Form 16, Advanced Application (revised 12/19/11)
Form 17, Certificate of Withholding Preference (revised 05/04/11)
Form 20, Election for Monthly Cost-of-Living Adjustment (revised 05/04/11)
Form 21, Direct Deposit Authorization (revised 05/04/11)
Form R, Application for Recalculation of Benefits (revised 12/19/11)
Form 8P, Employer Pre-Arranged Payment Authorization (revised 10/17/11)
Form 10, Report of Adjustments (revised 10/10/11)
Form 18, Employer Certification of Termination and Accumulated Unused Leave (revised 07/29/11)
WEB-ERS, WEB-ERS Authorization (revised 10/03/11)
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