Qualified Plan-to-Plan Transfer Certification (Form R0158X, PDF, 1.7 MB)
Judges Retirement Application (Form R0169B, PDF, 835 KB)
Judges Refund Application (Form R0172B, PDF, 333 KB)
Withholding Certificate Form W-4R (Form R2035X, PDF, 1.4 MB) — Use this form only if you wish to have more than 20% federal tax withheld from your refund payment. You will be required to complete a Withholding Certificate Form W-4R (R2035X) and submit it to ORS with your completed Refund Application (R0172B).
Application for Deferred Service Retirement (Form R0175B, PDF, 1.6 MB)
Eligible Domestic Relations Order: Background and Instructions (Form R0911X, PDF, 227 KB) — Important instructions, background information, and examples for completing an Eligible Domestic Relations Order (EDRO) that complies with retirement statutes. This information will help you understand how an EDRO will affect your pension.
Eligible Domestic Relations Order (EDRO) (Form R0259B, PDF, 986 KB) — 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. The Michigan Office of Retirement Services (ORS) developed this online fillable form to allow members of the 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 (Form R0911X, PDF, 227 KB).
Name Change Request for Active Employees (Form R1131X, PDF, 1.3 MB) — 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 (Form R0400B, PDF, 818 KB) — This form designates a beneficiary for a monthly pension in the event of the death of an active employee.
Judges Retirement Application (Form R0169B, PDF, 835 KB)
Income Tax Withholding Authorization (Form R0012X, PDF, 497 KB) — Use this to change the federal and Michigan income tax withholding on your retirement pension.
Direct Deposit Application (Form R0277X) — You must provide your direct deposit information by contacting ORS to have a form mailed to your home address.
Insurance Enrollment/Change Request (Form R0452B, PDF, 309 KB) — Use this form to enroll in one or more of the retirement system's 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, your spouse, or any of your covered dependents become eligible for Medicare or other health, dental, vision, or prescription group insurance coverage.
Life Insurance Beneficiary Designation (Form R0782GHB, PDF, 784 KB) — If applicable: Use this form if you want to designate a different beneficiary from any previous beneficiaries. This form must be notarized.
Direct Deposit Application (Form R0277X) — You may update your direct deposit information by logging in to miAccount or contacting us to have a form mailed to your home address.
Name, Address, and Contact Information Change (Form R0357X, PDF, 1.3 MB) — Use this form to change your physical address, mailing address, email address, name, or phone number with ORS.
Insurance Enrollment/Change Request (Form R0452B, PDF, 309 KB)
Income Tax Withholding (Form R0012X, PDF, 497 KB) — Use this to change the federal and Michigan income tax withholding on your retirement pension.
Domestic Relations Orders: Background and Instructions (Form R0912CGB, PDF, 186 KB) — Important instructions, background information, and examples for completing a Domestic Relations Order (DRO) that complies with retirement statutes. This information will help you understand how a DRO affects your pension.
Domestic Relations Order (DRO) (Form R0323B, PDF, 1.4 MB) — A 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 pre-filling information, preventing typographical errors, and by offering pop-up help screens. It is the preferred document to file with ORS. 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 (Form R0912CGB, PDF, 186 KB).
Domestic Relations Order to Void the Survivor Option Only (Form R0914B, PDF, 366 KB) — This downloadable, fillable form simplifies the voiding of a survivor option of a DRO in circumstances when the void language is not included in the judgment of divorce. This interactive PDF prevents errors by pre-filling information, preventing typographical errors, and by offering pop-up help screens. It is the preferred document to file with ORS. 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 (Form R0912CGB, PDF, 186 KB).
Refund Beneficiary Designation (Form R0748X, PDF, 1.3 MB)
Life Insurance Beneficiary Designation (Form R0782GHB, PDF, 784 KB) — If applicable: Use this form if you want to designate a different beneficiary from any previous beneficiaries. This form must be notarized.
Release of Information Authorization (Form R3488CGHBD, PDF, 1.2 MB) — If you need to request a copy of documents located in your account, please complete and submit this form.
Plan Summary (Form R0159B, PDF, 185 KB) — 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 (Form R0911X, PDF, 227 KB) — Important instructions and background information, and examples for completing an Eligible Domestic Relations Order (EDRO) 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.
