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Forms and Publications

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Michigan Office of Retirement Services

Forms and Publications

Forms and Publications

Apply for
Retirement
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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For Active Members 

Beneficiary Nomination (R0315C)
This form designates a beneficiary for a monthly pension in the event of the death of an active public school employee.

Name Change Request for Active Employees (R1131X)
Use this form to change your name if you are not receiving a pension benefit from the Michigan Office of Retirement Services (ORS) and are actively working for the Michigan Public School Employees' Retirement System.

Eligible Domestic Relations Order: Background and Instructions (R0911X)
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.

Eligible Domestic Relations Order (EDRO) (R0259C)
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 Public School Employees' 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).

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Service Credit Applications

Act 88 Application (R3571C)
Use this form to apply for Public Act 88, Reciprocal Retirement Act of 1961.

Military Service Credit Application (R0081C)
Use this form to apply for service credit for time you spent in active-duty military service.

Application for Weekly Workers' Compensation (WWC) Credit (R0285C)
Use this form to request service credit for weekly workers' compensation paid to you before July 1, 1992, only.

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Tax-Deferred Payment and Rollover Forms

Service Credit Payment Options (R0648C) 
Summarizes the ways you can pay for your service credit purchase.

TDP Agreement (R0392C) — Contact ORS to request.

Qualified Plan-to-Plan Transfer Certification (R0158X)
This form is used if you want to transfer funds from a qualified retirement plan - 401(a), 401(k), 403(b), or 457 - to purchase service credit.

Supplemental TDP Agreement (R0654C)
Use this form only if you have a current tax-deferred payment agreement and want to increase a tax-deferred payroll deduction.

Payoff Payment Options for a TDP Agreement (R0518C) and Paying Off a TDP Agreement (R0718C) Worksheet
You can use this form only if you are retiring or terminating employment and need to pay off a current tax-deferred payment agreement. 

Tax-Deferred Payment (TDP) Agreement Addendum (R0625C)
Use this form to transfer a TDP agreement to a new Michigan public school employer.

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For Terminating or Deferred Members

Beneficiary Nomination (R0315C) 
This form designates a beneficiary for a monthly pension in the event of the death of an active public school employee.

Refund Application (R0311C)
Use this form if you have terminated employment and would like to withdraw your contributions on account with the Michigan Public School Employees' Retirement System. 

Withholding Certificate Form W-4R (R2035X).
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 ORS with your completed Refund Application (R0311C).

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.

Payoff Payment Options for a TDP Agreement (R0518C) and Paying Off a TDP Agreement (R0718C) Worksheet
You can use this form only if you are retiring or terminating employment and need to pay off a current tax-deferred payment agreement.

Publication: Leaving Public School Employment (R0661C)
If you're not yet eligible to retire, either because you don't have enough service credit or you're too young to qualify for a monthly pension, this publication will help you understand how your retirement plan will be affected.

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Apply for Retirement

Application for Retirement — miAccount
miAccount is the fastest and easiest way to apply for retirement — five simple steps and you're done. For increased security, you’ll use MiLogin to access miAccount. When you click on miAccount from the ORS website, you’ll be redirected to the MiLogin page.

Preparing to Apply for Retirement (R0870C)
Print this worksheet to use as a reference when you apply online. This will help you gather the information you'll need to complete your application. You can also take notes that will be helpful as you apply, especially if you're not using your own computer.

Pension Election and Spousal Waiver (R0869C)
Use this form if you're married and name someone other than your spouse as your beneficiary, or you elect any option other than the 100% survivor option. The form — if needed in your situation — will be available in miAccount when you apply for retirement.

Insurance Information (R0058C)
This document provides you with basic information about the health, dental, and vision insurance coverage available to retirees.

Insurance Options Summary (R0379C)

Publication: Planning Your Retirement (R0613C)
For members who are within a few years of retiring. This book contains specifics on how pensions are calculated, the various payment options, how to prepare for retirement, and the application process.

Publication: Additional Resources for Retirement Planning
For Defined Benefit Plan members who are within a few years of retiring. This info sheet contains planning details for Voya retirement savings, Social Security, and Medicare coverage.

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For Disability Applicants

Publication: Disability Protection (R0638C)
For members who are facing an illness or injury that prevents them from working. This publication defines the criteria to receive a disability benefit and gives an overview of the application process.

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For Retirees

Insurance Enrollment/Change Request (R0452C) 
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 your covered dependents become eligible for Medicare or other health, dental, vision, or prescription group insurance coverage.

Direct Deposit Application (R0277X) 
You may update your direct deposit information by logging in to miAccount, or contact us to have a form mailed to your home address.

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 Information (R0058C)  
This document provides you with basic information about the health, dental, and vision insurance coverage available to retirees.

Insurance Options Summary (R0379C)

Monthly Insurance Rates (R0072C) 

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 (R0912CGB)
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) (R0323C)
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 (R0912CGB).

Domestic Relations Order to Void the Survivor Option Only (R0914C)
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 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 (R0912CGB).

Refund Beneficiary Designation (R0748X)
Use this form to change your retirement refund beneficiary.

Publication: After Retirement (R0614C)
You will receive this pamphlet when you apply for your pension. It tells you what to expect, and how and when you should contact ORS after your retirement benefits begin.

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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

Planning Your Retirement (R0613C)
For members who are within a few years of retiring. This book contains specifics on how pensions are calculated, the various payment options, how to prepare for retirement, and the application process.

After Retirement (R0614C)
You will receive this pamphlet when you apply for your pension. It tells you what to expect, and how and when you should contact ORS after your retirement benefits begin.

Leaving Public School Employment (R0661C)
If you're not yet eligible to retire, either because you don't have enough service credit or you're too young to qualify for a monthly pension, this publication will help you understand how your retirement plan will be affected.

Disability Protection (R0638C) 
For members who are facing an illness or injury that prevents them from working. This publication defines the criteria to receive a disability benefit and gives an overview of the application process.

Annual Comprehensive Financial Reports

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Proactive — Our e-newsletter for active members.

June 2024
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