|
PSRS 8 | Application for Retirement | Retirement |
|---|
| PSRS 27 |
Application to Purchase Credit for Full-Time Service | Purchase of Service |
|---|
| PSRS 28 |
Application for Credit for Military Service | Purchase of Service |
|---|
| PSRS 100 | Application to Purchase Credit for Part time Service | Purchase of Service |
|---|
| PSRS 112 | Application to Purchase Credit for an Approved Leave of Absence | Purchase of Service |
|---|
| PSRS 116 |
Authorization for Direct Deposit - Electronic Transfer of Monthly Benefit | Retired Member | |
|---|
| PSRS 123 |
Disability Retirement Explanation | Retirement |
|---|
| PSRS 151 | Request for Retirement Estimate | Retirement |
|---|
| PSRS 187 |
Nomination of Beneficiaries | Nomination of Beneficiary |
|---|
| PSRS 248 |
Power of Attorney | Power of Attorney |
|---|
| PSRS 248-1 |
Agent's Acknowledgement | Power of Attorney |
|---|
| PSRS 248-2 |
POA Florida Affidavit | Power of Attorney |
|---|
| PSRS 248-3 |
POA Non-Durable Affidavit | Power of Attorney |
|---|
| PSRS 248-4 |
POA Relationship Affidavit | Power of Attorney |
|---|
| PSRS 278 | Application for Credit for Out-of- State Service | Purchase of Service |
|---|
| PSRS 293 |
Guide to your PSERS-Issued Form 1099R (SAMPLE)
| Retired Member |
|---|
| PSRS 349 |
Questionnaire to determine the applicant's eligibility for PSERS membership | Active Member |
|---|
| PSRS 600 |
Application for Credit for U.S. Government Service | Purchase of Service | |
|---|
| PSRS 607 | Release for Medical Records | Retirement |
|---|
| PSRS 631 | Option Designation | Retired Member |
|---|
| PSRS 696 |
Application to Return Withdrawn Contributions | Purchase of Service |
|---|
| PSRS 708 |
Application for Service as a County Nurse Employee in Pennsylvania | Purchase of Service |
|---|
| PSRS 928 |
Rollover Certification for Purchase of Creditable Service | Taxes
|
|---|
PSRS 996
| W-4P Federal Tax Withholding Certificate for Pension or Annuity Payments
| Taxes
|
|---|
| PSRS 1012 |
Vital Papers and Other Important Information | Active Member |
|---|
| PSRS 1127 | Purchase Maternity Leave of Absence (Commencing Prior to November 1, 1978) | Purchase of Service |
|---|
| PSRS 1128 | Application to Purchase Credit for Cadet Nurse Service | Purchase of Service |
|---|
| PSRS 1165 |
PSERS Health Options Program | Retired Member | |
|---|
| PSRS 1245 |
Tax Information for Refunds | Taxes | |
|---|
| PSRS 1253 | Nomination of Beneficiaries Addendum | Nomination of Beneficiary |
|---|
| PSRS 1259 | Application for Multiple Service Membership | Active Member |
|---|
| PSRS 1264 |
Authorization for Direct Rollover (Retirement) | Retirement |
|---|
| PSRS 1273 |
Authorization for Release of Information | Active Member | |
|---|
| PSRS 1286 | Waiver of Pension Benefits | Active Member |
|---|
| PSRS 1301 | Change of Address for PSERS Retirees | Retired Member |
|---|
| PSRS 1309 |
Request for Recalculation Estimate Due to Change in Marital Status or Death of Survivor Annuitant | Retired Member |
|---|
| PSRS 1326 | PSERS Verification of Deposit
| Active Member |
|---|
PSRS 1332
| Executor Request for PSERS Documents
| Taxes
|
|---|
| PSRS 99400 |
Retirement Packet | Retirement |
|---|
| Major Medical Comprehensive Claim Form | Retired Member |
|---|