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) (R0259X)
  An EDRO is used by active members who are dividing a pension as part of a divorce.
• Name and Address Change Form (R0357X) 
• Service Credit Payment Options (R0648H)
• Publication: Retirement Guidelines (R0159H) Addition: Addendum to 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)
• Publication: Retirement Guidelines (R0159H) Addition: Addendum to 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 Federal Income Tax Withholding Authorization (R0012X)
• Domestic Relations Order (DRO)(R0323X)
  A DRO is for retirees dividing a pension as part of a divorce.
• 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 (EDRO) (R0259X)
  An EDRO is used by active members who are dividing a pension as part of a divorce.
• Domestic Relations Order (DRO)(R0323X)
  A DRO is for retirees dividing a pension as part of a divorce.

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