RETIREES

Miscellaneous

PERS Residency Status Certification Form to certify that you are or are not an Oregon state resident.

Information Change Request Form to change your name, Social Security number, date of birth, or address.

Direct deposit Set up automatic deposit of your benefit payments.

Verification of Age List of acceptable documents for verification of age, which is required before payment of distribution. 

Police and Fire Retiree Direct Insurance Premium Payment Election Form to withhold a specified portion of your retirement benefit and use it to make direct payment of insurance premiums on your behalf.

Special Power of Attorney for PERS

Tax

W-4P Tier One/Tier Two/IAP Form to withhold income tax from retirement benefit for Tier One/Tier Two/IAP members.

W-4P OPSRP Form to withhold income tax from retirement benefit for OPSRP members.

W-8BEN - Form to withhold income tax or claim treaty rights for non-resident, non-U.S. citizen persons. 

W-9 - Required for any person with a foreign address.

Tax Withholding form for IAP Rollover-Eligible Distribution  

Federal Tax Information & Acknowledgement  

Tier One/Tier Two

Post-Retirement Beneficiary Designation  For members who retired under the refund annuity or 15-year certain options or who are receiving lump-sum installments. This election does not impact your Individual Account Program (IAP) beneficiary designation.

Dispute Notice of Entitlement Tier One/Tier Two   Form to dispute the accuracy of information used in the computation of Tier One/Tier Two retirement benefits.

Acknowledgment of Potential Consequences Relating to Working After Retirement  

OPSRP

Dispute Notice of Entitlement OPSRP   Form to dispute the accuracy of information used in the computation of OPSRP retirement benefits. 

IAP

IAP Retirement Application For members who have retired from Tier One/Tier Two or OPSRP but not the IAP.

IAP: Beneficiary Non-Spouse Rollover Eligible Distribution

Retirement Designation of Beneficiary Packet  For IAP members who retired under the refund annuity or 15-year certain options or who are receiving lump-sum installments

IAP Dispute of Notice of Distribution Form to dispute the accuracy of information used in the computation of the IAP distribution.  

IAP Direct Transfer Rollover Acceptance 

IAP Rollover Eligible Distribution 

 

 

 

 

 

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