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PDF Forms Index
The following forms are available in PDF format. You need Adobe Acrobat Reader to view and print these files. Click here to download Adobe Acrobat Reader. (Clicking these links will open a new browser window.) This is free software.
General Forms
- FORM 2040 - CHANGE OF ADDRESS NOTIFICATION
- FORM 2415 - REQUEST FOR DUPLICATE ANNUAL STATEMENT
- FORM 4527 - CERTIFICATION BY A “QUALIFIED PUBLIC SAFETY EMPLOYEE”
Membership Forms
- FORM 2001 - MEMBERSHIP INFORMATION
- FORM 2020 - ADVICE OF PERSONNEL ACTION
- FORM 2035 - BENEFICIARY DESIGNATION FORM
Service Purchase Forms
- FORM 4115 - VERIFICATION OF EMPLOYMENT WITH FEDERAL GOVERNMENT
- FORM 4120 - VERIFICATION OF EMPLOYMENT WITH A STATE UNIVERSITY
- FORM 4131 - VERIFICATION OF URBAN-COUNTY GOVERNMENT SERVICE
- FORM 4140 - CERTIFICATION OF OUT OF STATE SERVICE
- FORM 4170 - ACKNOWLEDGMENT FORM
- FORM 4225 - VERIFICATION OF EMPLOYMENT
- FORM 4226 - VERIFICATION OF SCHOOL BOARD EMPLOYMENT
Retirement Forms
- FORM 4172 - NOTICE OF INTENT TO TRANSFER MY LUMP-SUM PAYMENT ....
- FORM 6000 - NOTIFICATION OF RETIREMENT
- FORM 6017 - FEDERAL INCOME TAX WITHHOLDING PREFERENCE
- FORM 6030 - DEATH BENEFIT DESIGNATION
- FORM 6130 - AUTHORIZATION FOR DEPOSIT OF RETIREMENT PAYMENT
- FORM 6131 - BANK DRAFT AUTHORIZATION FOR DIRECT PAY ACCOUNTS
- FORM 6200 - 2009 MEDICARE ELIGIBLE INSURANCE ENROLLMENT FORM
- Form 6751 - MEMBER AND EMPLOYER CERTIFICATION REGARDING REEMPLOYMENT
- OUT OF STATE MEDICAL INSURANCE REIMBURSEMENT FORMS