For most account changes, you don't need a paper form. Simply access your account online to name a beneficiary, change your address, view and apply for service credit, estimate your pension, apply for retirement, and much more.
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Refund Application (Form R0138GH, PDF, 364 KB) — Use this form if you have terminated employment and would like to withdraw your contributions on account with the State Employees' Retirement System or the Michigan State Police Retirement System. This will forfeit your rights to a future pension with the retirement system.
Withholding Certificate Form W-4R (Form R2035X, PDF, 1.4 MB) — Use this form only if you want 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 the Michigan Office of Retirement Services (ORS) with your completed Refund Application (R0138GH).
Military Service Credit Application (Form R0081H, PDF, 924 KB)
Parental Leave Service Credit Application (Form R0126H, PDF, 845 KB) — If you reduced your hours or left state police employment for parental leave — maternity, paternity, or child-rearing time — you may be eligible to buy up to 2 years of retirement credit for these time periods.
Qualified Plan-to-Plan Transfer Certification (Form R0158X, PDF, 1.7 MB)
Beneficiary Nomination (Form R0400H, PDF, 767 KB) — Use this form to nominate one pension beneficiary and one or more refund beneficiaries.
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 R0259H, PDF, 1.1 MB) — 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 State Police 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 Michigan State Police Retirement System.
Service Credit Payment Options (Form R0648H, PDF, 137 KB)
Publication: Your Retirement Overview (Form R0159H, PDF, 1.7 MB)
Brochure: Deferred Retirement Option Plan (DROP) (Form R0627H, PDF, 166 KB)
Application for Retirement — miAccount — miAccount is the fastest and easiest way to apply for retirement — five simple steps and you're done.
Insurance Options Sheet (Form R0423GH, PDF, 168 KB)
Insurance Rates — Health, dental, and vision insurance rates for retirees are published by the Michigan Civil Service Commission — Employee Benefits Division.
Life Insurance Beneficiary Designation (Form R0782GHB, PDF, 784 KB)
Reliance Standard Group Insurance Beneficiary Designation/Change (PDF, 182 KB) — If you purchased supplemental life insurance as an active member, you may choose to continue your coverage in retirement. As of Nov. 1, 2020, Reliance Standard is the current administrator of this policy. For more information, contact your state police human resources office. If you choose to continue this benefit in retirement, complete the Reliance Standard Beneficiary Designation Form and mail it to ORS, PO Box 30171, Lansing, MI 48909-7671 or fax to 517-284-4416. For questions completing the form, contact the Benefit Resource Group at 810-735-6500.
Publication: Your Retirement Overview (Form R0159H, PDF, 1.7 MB)
Retirement or DROP Application (Form R0732H, PDF, 498 KB)
Deferred Retirement Option Plan (DROP) Beneficiary Designation (Form R0626H, PDF, 773 KB) — 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.
DROP Early Termination Form (Form R0667H, PDF, 771 KB)
DROP Account Distribution Request (Form R0665H, PDF, 750 KB)
Deferred Retirement Option Plan (DROP) (Form R0627H, PDF, 166 KB)
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 R0452H, PDF, 307 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 drug group insurance coverage.
Insurance Rates — Health, dental, and vision insurance rates for retirees are published by the Civil Service — Employee Benefits Division.
Opt-In Form (Form R2031H, PDF, 171 KB) — Use this form if you are a Medicare-eligible state police troopers or sergeants retired on or after Oct. 1, 1987.
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 R0912HD, PDF, 124 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 R0323H, 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 R0912HD, PDF, 124 KB).
Refund Beneficiary Designation (Form R0748X, PDF, 1.3 MB)
Life Insurance Beneficiary Designation (Form R0782GHB, PDF, 784 KB)
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.
Your Retirement Overview (Form R0159H, PDF, 1.7 MB)
Deferred Retirement Option Plan (DROP) (Form R0627H, PDF, 166 KB)
Annual Comprehensive Financial Reports
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.
Domestic Relations Order (DRO) (Form R0323X, PDF, 98 KB) — A DRO is for retirees dividing a pension as part of a divorce.
