Forms and Publications

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• For Active Members
• Apply For Retirement
• For Retirees
• Release Authorization
• Publications

For Active Members 

• Qualified Plan-to-Plan Transfer Certification (R0158X)
• Judges Retirement Application (R0169B)
• Judges Refund Application (R0172B)
• Application for Deferred Service Retirement (R0175B)
• 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.
• Eligible Domestic Relations Order (EDRO) (R0259B)
  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 Michigan Judges Retirement System to create 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).
• Name Change Request for Active Employees (R1131X)
  Use this form to change your name if you are not receiving a pension benefit from ORS and are actively working for the Judges Retirement System.
• Beneficiary Nomination (R0400B)
  This form designates a beneficiary for a monthly pension in the event of the death of an active employee.
• 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.

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Apply For Retirement

• Judge's Retirement Application (R0169B)
• Income Tax Withholding Authorization (R0012X)
  Use this to change the federal and Michigan income tax withholding on your retirement pension.
• Direct Deposit Application for Pension Recipients (R0277X)
  All pension payments will be made electronically. Complete this application to have your monthly pension deposited electronically to your financial institution(s).
• Insurance Enrollment/Change Request (R0452B)
  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 ORS if you or any of your covered dependents become eligible for Medicare or other health, dental, vision or prescription group insurance coverage.
• Life Insurance Beneficiary Designation (R0782GHB)
  If applicable: Use this form if you want to designate a different beneficiary from any previous beneficiaries. This form must be notarized.

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For Retirees

• Direct Deposit Application (R0277X) 
• Name, Address, and Contact Information Change (R0357X) 
  Use this form to change your physical address, mailing address, email address, name, or phone number with ORS.
• Insurance Enrollment / Change Request (R0452B) 
• Income Tax Withholding Authorization (R0012X)
  Use this to change the federal and Michigan income tax withholding on your retirement pension.
• Domestic Relations Orders: Background and Instructions (R0912CBG)
  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.
• Domestic Relations Order (DRO) (R0323B)
  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 (R0912CBG).
• Domestic Relations Order to Void the Survivor Option Only (R0914B)
  This downloadable, fillable form simplifies the voiding of a survivor option of a Domestic Relations Order (DRO) in circumstances when the void language is not included in the judgment of divorce. This interactive PDF prevents errors 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 (R0912CBG).
• Refund Beneficiary Designation for Retirees (R0748X)
• Life Insurance Beneficiary Designation (R0782GHB)
  If applicable: Use this form if you want to designate a different beneficiary from any previous beneficiaries. This form must be notarized.

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Release Authorization

Release Of Information Authorization (R3488CGHBD)  
If you need to request a copy of documents located in your account, please complete and submit this form.

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Publications

• Plan Summary (R0159B)
  This plan overview provides detailed information about your retirement plan and can be a useful reference at any stage in your career.
• 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.
• Annual Comprehensive Financial Report
  The latest annual report presents the financial position and results of operations of the Judges Retirement System.


• ProActive - our e-newsletter for active members.

  June 2022
  March 2022
  December 2021
  September 2021
  June 2021
  March 2021
  December 2020
  Summer 2020
  December 2019
  Summer 2019
  Fall 2018
  Spring 2018
  Fall 2017
  Spring 2017
  Fall 2016
  Spring 2016
  Fall 2015
  Spring 2015
  Fall 2014

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