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Forms


Enrollment | Beneficiary | Special Risk | Senior Management Service Class | SMSOAP/SUSORP | Retirement | DROP | Survivor Benefit | Disability | Rollover | Creditable Service | QDROs | Miscellaneous | Tips & Techniques

These forms are saved in Adobe PDF format, and most have fill-in form fields. In order to view these files you will need a copy of Adobe Acrobat Reader loaded on your computer. To fill in forms online, we recommend that you have Adobe Acrobat Reader version 4.0 or higher. You can download a free copy of this program, or update your current version, by clicking on the Adobe Reader icon. Acrobat Reader


ENROLLMENT FORMS


PENSION PLAN AND INVESTMENT PLAN
#1 Adobe PDF icon ELE-1-EZ.PDF EZ Retirement Plan Enrollment Form for Regular, Special Risk, and Special Risk Administrative Support Class Employees
#2 Adobe PDF icon ELE-1.PDF Retirement Plan Enrollment Form for Regular, Special Risk, and Special Risk Administrative Support Class Employees
#3 Adobe PDF icon ELE-2.PDF 2nd Election Retirement Plan Enrollment Form
#4 Adobe PDF icon ELE-2-EZ.PDF EZ 2nd Election Retirement Plan Enrollment Form
#5 Adobe PDF icon EOC-1.PDF Retirement Plan Enrollment Form for Elected Officer's Class Employees
#6 Adobe PDF icon SMS-1.PDF Retirement Plan Enrollment Form for State Senior Management Service Employees
#7 Adobe PDF icon SMS-3.PDF Retirement Plan Enrollment Form for Local Senior Management Service Employees
#8 Adobe PDF icon CERT.PDF New Employee Certification Form

COMMUNITY COLLEGES AND UNIVERSITIES
#9 Adobe PDF icon OCC-2.PDF Retirement Plan Conversion Form for Community College Optional Retirement (CCORP) Members
#10 Adobe PDF icon OCC-1.PDF Retirement Plan Choice Form for Community College ORP-Eligible Employees
#11 Adobe PDF icon ORP-16.PDF Retirement Plan Enrollment Form for State University System ORP-Eligible Employees
#12 Adobe PDF icon ORP-16A.PDF State University System Optional Retirement Program (SUS/ORP)/ Change Form
#13 Adobe PDF icon ORP-2.PDF Retirement Plan Conversion Form for State University System Optional Retirement Program Members (includes cover letter)
#14 Adobe PDF icon CERT.PDF New Employee Certification Form


BENEFICIARY FORMS


PENSION PLAN
#15 Adobe PDF icon BEN-001.PDF Beneficiary Designation Form (Active Pension Plan Members Only) (NOTE: If you are already receiving monthly FRS benefits or you are currently participating in DROP, please use Form FST-12.
#16 Adobe PDF icon FST-12.PDF Beneficiary Designation Form (Retired Pension Plan Members Only). Note: Includes DROP participants.

INVESTMENT PLAN
#17 Adobe PDF icon IP BENEFICIARY.PDF Beneficiary Designation Form - Investment Plan Members Only (Active and Retired).


SPECIAL RISK FORMS


#18 Adobe PDF icon FRS-400.PDF Application for Special Risk Members
#19 Adobe PDF icon FRS-401.PDF Special Risk Credit for Past Service
#20 Adobe PDF icon FRS-402.PDF Application for Special Risk Equivalent Credit
#21 Adobe PDF icon FRS-404.PDF Application for Special Risk Administrative Support Class
#22 Adobe PDF icon FRS-405.PDF Application for Special Risk Membership - Firefighters/Paramedics/EMTs
#23 Adobe PDF icon FRS-415.PDF Application for Special Risk Class Membership - Forensic Discipline, Effective July 1, 2008


SENIOR MANAGEMENT SERVICE CLASS FORMS


#24 Adobe PDF icon SMSD-1.PDF Senior Management Service Class Designated Position Form


SMSOAP/SUSORP FORMS


#25 Adobe PDF icon OAP-ETF.PDF Supplemental Statement for Distributions for SMSOAP
#26 Adobe PDF icon ORP-ETF.PDF Supplemental Statement for Distributions for SUSORP
#27 Adobe PDF icon FR-SUSORP.PDF Verification of State University Optional Retirement System Service Dates


RETIREMENT FORMS


PENSION PLAN
#28 Adobe PDF icon FR-11.PDF Application for Service Retirement
#29 Adobe PDF icon FC-1.PDF Salary Certification
#30 Adobe PDF icon FRS-11O.PDF Option Selection for FRS Members
#31 Adobe PDF icon FST-12.PDF Beneficiary Designation Form (Retired Members Only) Note: Includes DROP participants
#32 Adobe PDF icon DFS-A1-26R.PDF Direct Deposit Authorization
#33 Adobe PDF icon W-4P.PDF Withholding for Pension Payments
#34 Adobe PDF icon ADDCH-1.PDF Mailing Address Change Request Form (suggested form) - FRS Pension Payment Recipients Only.
#35 Adobe PDF icon BVR-1.PDF Birth Verification Form (Request for Proof of Age)
#36 Adobe PDF icon FR-23.PDF Notification of Reemployment for Suspension of Retirement Benefits
#37 Adobe PDF icon FR-23A.PDF Application to Reactivate Retirement Benefits

INVESTMENT PLAN
Investment Plan Termination/Distribution Forms
#38 Adobe PDF icon TERMINATION KIT.PDF MyFRS Termination Kit - FRS Investment Plan Special Tax Notice and Distribution Options
#39 Adobe PDF icon EMPLOYMENT TERMINATION FORM.PDF FRS Investment Plan Employment Termination Form
#40 Adobe PDF icon SPECIAL TAX NOTICE.PDF Special Tax Notice
Investment Plan Miscellaneous Retirement Forms
#41 Adobe PDF icon HIS-IP.PDF FRS Application for Health Insurance Subsidy for Investment Plan Members
#42 Adobe PDF icon HIS-IP-2.PDF FRS Health Insurance Subsidy Certification for Investment Plan Members
#43 Adobe PDF icon AGE70 DISTRIBUTION FORM.PDF Age 70 1/2 Distribution Form

TRS AND SCOERS
#44 Adobe PDF icon FST-11O.PDF Option Selection for TRS and SCORES Members


DROP FORMS


#45 Adobe PDF icon DP-11.PDF Application for Service Retirement and the Deferred Retirement Option Program (DROP)
#46 Adobe PDF icon DT-11.PDF Teachers' Retirement System Application for Service Retirement and the Deferred Retirement Option Program (DROP)
#47 Adobe PDF icon DP-ELE.PDF Notice of Election to Participate in the Deferred Retirement Option Program (DROP) and Resignation of Employment
#48 Adobe PDF icon FST-12.FDF Beneficiary Designation Form (Retired Members Only) Note: Includes DROP participants
#49 Adobe PDF icon DP-EXT.PDF Extension of Deferred Retirement Option Program (DROP) for Specified K-12 Instructional Personnel
#50 Adobe PDF icon DROP DIRECT ROLLOVER.PDF DROP to Investment Plan Direct Rollover Form for Former Members
#51 Adobe PDF icon DROP DEPOSIT.PDF DROP to Investment Plan Direct Rollover Form for Current Members


SURVIVOR BENEFIT FORMS


#52 Adobe PDF icon DEATH BENEFIT CLAIM.PDF FRS Investment Plan Death Benefit Distribution Claim


DISABILITY FORMS


PENSION PLAN
#53 Adobe PDF icon FR-13.PDF Application for Disability Retirement - Pension Plan Members Only

INVESTMENT PLAN
#54 Adobe PDF icon PR-13.PDF Application for Disability Retirement - Investment Plan Members Only

PENSION PLAN AND INVESTMENT PLAN
#55 Adobe PDF icon FR-13A.PDF Statement of Disability by Employer
#56 Adobe PDF icon FR-13B.PDF Physician's Report


ROLLOVER FORMS


PENSION PLAN
#57 Adobe PDF icon PRO-1.PDF Pretax Direct Rollover Form

INVESTMENT PLAN
#58 Adobe PDF icon IP ROLLOVER.PDF FRS Investment Plan Employee Rollover Deposit Form

DROP
#59 Adobe PDF icon DROP DIRECT ROLLOVER.PDF DROP to Investment Plan Direct Rollover Form for Former Members
#60 Adobe PDF icon DROP DEPOSIT.PDF DROP to Investment Plan Direct Rollover Form for Current Members


CREDITABLE SERVICE FORMS


PENSION PLAN
#61 Adobe PDF icon FR-28.PDF Application to Purchase Retirement Credit for a Leave Absence
#62 Adobe PDF icon FR-30.PDF Verification for In-State or Out-of-State Service Credit
#63 Adobe PDF icon MF-1.PDF Statement of Military Eligibility
#64 Adobe PDF icon MF-2.PDF Statement of Military Eligibility to Purchase Military Service Under the Out-Of-State Provisions of Section 121.1115, F.S
#65 Adobe PDF icon WC-1.PDF Certification of Worker's Compensation


QDROs


PENSION PLAN
#66 Adobe PDF icon Instructions for Establishing an FRS Pension Plan QDRO Information on obtaining a Qualified Domestic Relations Order (QDRO) under the FRS Pension Plan.
#67 Adobe PDF icon Model Judicial Orders for FRS Pension Plan QDROs : Generic Version (PDF)
Alternate Payee is Former Wife (PDF)
Alternate Payee is Former Husband (PDF)

INVESTMENT PLAN
#68 Adobe PDF icon FRS Investment Plan QDRO Model Language and Procedures Guide Information on obtaining a Qualified Domestic Relations Order (QDRO) under the FRS Investment Plan,


MISCELLANEOUS FORMS


PENSION PLAN
#69 Adobe PDF icon FR-9.PDF Information Request

INVESTMENT PLAN
#70 Adobe PDF icon COMPLAINT PROCEDURES.PDF FRS Investment Plan Complaint Procedures


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