Forms and Publications

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For Active Member 

• Military Service Credit Application (R0081H)
• Qualified Plan-to-Plan Transfer Certification (R0158X)
• Eligible Domestic Relations Order (EDRO) (R0259H)
  An EDRO is a specific type of court order that provides instructions for dividing a public pension as part of a divorce. It applies only to active and deferred members of a pension system. ORS developed this online fillable form to allow members of the State Police Retirement System to created accurate and complete EDROs that can be administered under the retirement statutes. It is the preferred document to file with ORS. Background information and instructions are provided separately in Eligible Domestic Relations Orders: Background and Instructions (R0911X).
• Eligible Domestic Relations Order: Background and Instructions (R0911X)
  Important instructions and background information, and examples for completing an Eligible Domestic Relations Order that complies with retirement statutes. This information will help you understand how an EDRO will affect your pension.
• Name and Address Change Form (R0357X) 
• Service Credit Payment Options (R0648H)
• Publication: Retirement Guidelines (R0159H)
• Brochure: DROP: Deferred Retirement Option Plan for State Police (R0627H)

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Retirement Application Forms

For a complete retirement application packet, contact ORS.

• Application for Retirement or DROP (R0732H)
• Health, Dental, Vision, and Life Insurance Options (R0423GH)
• Insurance Rates
  Health, dental, and vision insurance rates for retirees are published by the Department of Civil Service - Employee Benefits Division.
• Life Insurance Beneficiary Designation (R0782GHB)
• Federal Income Tax Withholding Authorization Worksheets (R0727X)
  Use this form to determine how many allowances to claim or if you should request additional money to be withheld on your Federal Income Tax Withholding Authorization in your retirement application.
• Publication: Retirement Guidelines (R0159H)

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DROP Participants

• Application for Retirement or DROP (R0732H)
• Deferred Retirement Option Plan (DROP) Beneficiary Designation  (R0626H)
  Use this form after you retire to change your beneficiary who will receive the balance of your DROP benefit if you die before withdrawing the entire balance.
• Early Termination form for Deferred Retirement Option Plan (DROP) (R0667H)
• Deferred Retirement Option Plan (DROP) Account Distribution Request (R0665H)
• Deferred Retirement Option Plan (DROP) Account Distribution Request to Transfer to ING (R0751H)
• Brochure: DROP Deferred Retirement Option Plan for State Police (R0627H)

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For Retirees

• Electronic Funds Transfer (Direct Deposit) Application (R0277X) 
• Name and Address Change Form (R0357X) 
• Insurance Enrollment/Change Request (R0452H)
  Use this form to enroll in one or more of the retirement system insurance plans, change from one health plan to another, or add, delete, or change a name for anyone on your existing insurance coverage. Also use this form to notify the Office of Retirement Services (ORS) if you or any of your covered dependents become eligible for Medicare or other health, dental, vision or prescription group insurance coverage.
• Insurance Rates  
  Health, dental, and vision insurance rates for retirees are published by the Department of Civil Service - Employee Benefits Division.
• Pension Recipient's Income Tax Withholding Authorization (R0012X)  
  Use this to change the federal and Michigan income tax withholding on your retirement pension.
• Domestic Relations Order (DRO) (R0323X)  
  A Domestic Relations Order (DRO) is a specific type of court order that provides instructions for dividing a public pension as part of a divorce. It applies only to retired members of a pension system. ORS has developed a downloadable, fillable form to allow you to create accurate and complete DROs that can be administered under the retirement statutes. This interactive PDF prevents errors by not allowing contradicting selections, by prefilling information, preventing typographical errors, and by offering pop-up help screens. It is the preferred document to file with the Office of Retirement Services. This is the fastest, most efficient way to complete your filing. Complete it online, save it, print it, then take the printed copy to the court for the judge's signature. Background information, instructions, and examples are provided separately in Domestic Relations Orders: Background and Instructions (R0912X).
• Domestic Relations Orders: Background and Instructions (R0912X)  
  Important instructions, background information, and examples for completing a Domestic Relations Order that complies with retirement statutes. This information will help you understand how a DRO affects your pension.
• Refund Beneficiary Designation for Retirees (R0748X)
• Life Insurance Beneficiary Designation (R0782GHB)

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Publications

• Retirement Guidelines (R0159H)
• DROP Deferred Retirement Option Plan for State Police (R0627H) 
• Comprehensive Annual Financial Report (CAFR)
• Eligible Domestic Relations Order: Background and Instructions (R0911X)
  Important instructions and background information, and examples for completing an Eligible Domestic Relations Order that complies with retirement statutes. This information will help you understand how an EDRO will affect your pension.
• Domestic Relations Order (DRO)(R0323X)
  A DRO is for retirees dividing a pension as part of a divorce.

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