Most requested forms

Current members

Tier One/Tier Two

Other retirement forms may be needed beyond those included in the packet. Find them on our Tier One/Tier Two Forms page.

Beneficiary designations:

Benefit estimate requests:

Written estimate — Use the Tier One/Tier Two Estimate Request form when you are within 24 months of the earliest date on which you are eligible to retire.
Online estimate — Log into Online Member Services to create an estimate at any point in your career.

OPSRP

Preretirement Guide

Service Retirement Application packet

Other retirement forms may be needed beyond those included in the packet. Find them on our OPSRP Member Forms page.

Benefit designations*:

IAP Preretirement Designation of Beneficiary Packet

*Note: No form exists for designating an OPSRP pension beneficiary. By law, beneficiary options for OPSRP pensions are limited. If you die before retirement, PERS will only pay a death benefit to your spouse, your former spouse under a court order (such as a divorce decree), or to any other person required to be treated like a spouse for the purpose of retirement benefits.

Benefit estimate requests:

Written estimate — Use the Oregon Public Service Retirement Plan (OPSRP) Estimate Request form when you are within 24 months of the earliest date on which you are eligible to retire.
Online estimate — Log into Online Member Services to create an estimate at any point in your career.

Retired members

W-4P

W-4P-OPSRP (Use this version of the W-4P form if you were hired as an OPSRP member [hired after August 28, 2003])
Information Change Request (Name/Address Change) (Please note you must also fill out a new W-4P form if you also need to make tax withholding changes)

Direct Deposit

Residency Status Certification (Some Tier One members only. View the tax remedy information page for more details. This form does not change your tax withholding.)

Inactive members

Hired on or before August 28, 2003? Use this packet:
Tier One/Tier-Two Member Withdrawal Application Packet

Hired on or after August 29, 2003? Use this packet:
OPSRP Member Withdrawal Application Packet

**Notice for OPSRP members** Due to Senate Bill 1049, if you withdraw on or after July 1, 2020, you will completely cancel your membership in the Oregon Public Employees Retirement System, including forfeiting your right to a pension or OPSRP withdrawal benefit.Read more.

Information Change Request (Name/Address Change)

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

Other forms

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.

Notarization

PERS accepts documents with remote online notarization by vendors that meet the requirements of the Oregon Secretary of State.

To be accepted by PERS, notarized documents also must meet the following requirements:

The signature date of the member and the notary must match.
If notarized spousal consent is required on a document, the signature dates of the spouse and the notary must match, and the spouse’s signature must be dated on or after the member’s signature date.