Member forms

All PERS forms must be printed and signed. You can submit completed forms by fax, by mail, or by dropping them off at PERS offices in Tigard or Salem.

For forms assistance, call PERS Member Services at 888-320-7377 (toll-free) or TTY 503-603-7766. PERS provides, upon request, reasonable accommodations, including large print versions of forms and support reviewing and completing your forms over the phone or in person. You can also request to have forms mailed to you or pick up blank forms at a PERS office.

Forms by plan

IAP forms webpage

Judge member forms webpage

OPSRP member forms webpage

Tier One/Tier Two member forms webpage

430B Legislator Retirement Plan Election for PERS Members form

Forms for requesting a written benefit estimate (which includes cost of purchasing service time for Tier One/Tier Two)

For members within two years of retirement —

Tier One/Tier Two Benefit Estimate Form (for single or married member)

Tier One/Tier Two Benefit Estimate Form (for a member who's been divorced)

OPSRP Benefit Estimate Request Form (single, married, or divorced)

Instructions for filling out the forms

Information about purchasing service time

Full-Cost Purchases Q&A

Wait-Time Purchases Q&A

Purchasing Retirement Credit for Military Service Prior to PERS Employment

Purchasing Retirement Credit for Out-of-State School Service Prior to PERS Employment

Additional forms needed for certain purchases

Certification of Seasonal Service form

Certification of Out-of-State Teaching Service form

Certification of Nonparticipating Oregon PERS Employer for Police or Firefighter form

Certification of Out-of-State Police Officer form

Forms for purchasing Police and Fire units (Tier One/Tier only)

Police Officer and Firefighter (P&F) Unit Purchase form #459-093 (monthly deductions)

Police Officer and Firefighter Unit Purchase Election at Retirement form #459-073 (lump sum payment)

Forms for life changes

Divorce forms webpage

Beneficiary forms webpage

429 Notice of Leave Without Pay for Career Development form

019 Cancellation of Application for Disability Benefits form

433 IAP: Revocation of Spousal Consent of Beneficiary Designation

451 USERRA - Uniformed Services Employment and Reemployment Rights Act form

665 PERS Residency Status Certification

713 Deceased Member Benefit Inquiry form

Instructions

Instructions for filling out and submitting a form