OPSRP-IAP Retirement Application - As of January 1, 2011, you must retire from the OPSRP Pension Program and the Individual Account Program (IAP) at the same time.
W-4P Federal tax witholding form.

Direct Deposit – Required if you want to set up an automatic deposit of your benefit payments.

Federal Tax Information and Acknowledgement

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

​ IAP Direct Transfer Rollover Acceptance​ - Required only if you want to roll over your IAP balance to a qualified employer or deferred compensation plan.​

​​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.
Direct Deposit - Set up automatic deposit of your benefit payments.
IAP Pre-Retirement Designation of Beneficiary Packet​ (Please note that there is no form to designate a beneficiary for your OPSRP pension, as statute only allows PERS to pay a death benefit to a member's spouse, or to any other person who is constitutionally required to be treated in the same manner as a spouse for the purpose of retirement benefits. Therefore, the IAP Pre-Retirement Designation of Beneficiary form is the only beneficiary form you need to fill out)

Information Change Request - Change your name, SS number, or address.

Date of Birth Change Request - Notice: Please use this new form to update your date of birth.

Data Verification Additional Account Information This form allows you to provide additional information for your Data Verification Request. 

Data Verification Request - Tier One/Tier Two and OPSRP Pension Program active or inactive members who are within two years of their earliest retirement age can request a verification of certain data.

Estimate Request - Form to request an OPSRP benefit estimate.

Estimate Request Fee Agreement - Form to requesting more than two estimates in a year.

OPSRP Elective and Appointive Membership Election - Form for a person who holds an elective or appointive office and wants to elect not to become an OPSRP Pension Program member.

Special Power of Attorney - This form gives the person(s) you designate the power to make any and all decisions for PERS-related matters on your behalf.

Authorization to Release Account Information​ - This form allows you to authorize a third party to obtain information regarding your PERS account or benefits.

Account Reconciliation Request - Form to capture and document concerns about the accuracy of your employment information for subsequent review and reconciliation by PERS staff.​

Account withdrawal - For those who are not eligible to retire and not working for a PERS-covered employer.

OPSRP Dispute of Notice of Entitlement - This form allows a member to dispute the accuracy of the information used in the computation of their retirement benefit.

OPSRP Rollover-Eligible DistributionUsed only if you are eligible for a one-time, lump-sum OPSRP pension payment because your benefit is calculated as less than $200 a month. 

Workers' Compensation Certification - This form is to request service credit under Oregon Revised Statutes Chapter 238.175 for periods of workers’ compensation or disability.

OPSRP Lump-Sum Distribution Withholding Election - Form to elect lump-sum withholdings.

OPSRP Direct Transfer Rollover Acceptance​​​ - Roll over your benefit to a qualified employer or compensation plan​

Important information

Notice: If you are having difficulties finding a notary for your Service Retirement Application, you can submit your application without notarization and later re-submit that page once completed. PERS now accepts documents with remote online notarization by vendors that meet the requirements of the Oregon Secretary of State.​ ​All forms still must be received before your effective retirement date.
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