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OPSRP Member Forms

Required Retirement Forms
​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.
Forms that may Be Required for Retirement
​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.
Additional Forms
 
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 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 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 Distribution - Used 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.

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