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Employers Forms
Important Notice - Instructions
PERS provides all online forms and publications in .pdf format. To view them, you must have the most recent version of Adobe Reader®. Click here to download Adobe Reader®.
 
Please follow these instructions. If you do not, we may not be able to process your form(s).
  • Step 1: Click on the appropriate link below to select the desired form.
  • Step 2: Refer to the instructions attached to the form. You can also refer to the Employer Manual for specific instructions for the form and to determine any additional documentation that may be needed.
  • Step 3: Submit the form and additional documentation to the Oregon Public Employees Retirement System.
  • Step 4: Complete and sign the form in blue or black ink. Do not use pencil.
 
How to Submit the Forms
  • By mail: Mail the form(s) and documentation to the Oregon Public Employees Retirement System, P.O. Box 23700, Tigard, Oregon 97281-3700.
  • By Fax: 503-603-7626 (Attention: Membership and Employer Relations).
  • In person: Deliver the form(s) and documentation to the Oregon Public Employees Retirement System offices at: 11410 SW 68th Parkway, Tigard, Oregon.
 
Caution
  • We will not accept electronic (e-mail) documents.
  • Material should not be sent via e-mail for confidentiality reasons.

 
Reporting - EDX
One-Time Request for Review/Waiver
Demographics Report
New Employer (ER) Data
PERS Wage and Service Data
Web Administrator Agreement 
Instructions: Retroactive Domestic Partner Med. Premiums Template
Retroactive Domestic Partner Medical Premiums Reporting Template

 
Paper Reporting - Payroll/Electronic Remittance
Notice of Unit Election
P&F Discontinue Unit Contribution
ACH Agreement 
ACH Debit Authorization 
Employer Request for Penalty Waiver 

 
Paper Reporting - Personnel
Data Verification Employer Request for an Extension
Certification of Individual Contract for 2002-03 school year lookback calculation (Only use this form for 2002-03 lookback calculations.)
Certification of Individual Contract
Salary Certification for Retirement Benefits
Employment Class Change
Notice of Leave Without Pay for Career Development
Notice of Separation from a PERS Covered Position 
Sick Leave Information Request
Sick Leave Information Request for 2003 Lookback 
USERRA - Uniformed Services Employment and Reemployment Rights Act 
Corrected Separation from a PERS covered employer 

 
Paper Reporting - Member and Beneficiary
Pre-Retirement Designation of Beneficiary Packet
PERS (Tier One/Tier Two) Elective and Appointive Membership Election
OPSRP Elective and Appointive Membership Election
IAP: Pre-Retirement Designation of Beneficiary Packet  
IAP: Revocation of Spousal Consent of Beneficiary Designation
Legislator Retirement Plan Election for PERS Members 
Legislator Retirement Plan Election for Non-PERS Members   
Transfer of Legislator PERS Chapter 238 Account
Certification of Out-of-State Police Service