Forms for Retirees

W-4P - Withholding Certificate for Periodic Pension or Annuity Payments

Change of Address form

  1. Retirement Change of Address Form

Check off list for joining Medicare Parts A & B

  1. Medicare Check Off List Retirees

Guidebook, Retirees Rights & Responsibilities

  1. Retirees Rights and Responsibilities

Insurance Billing Authorization form

  1. Authorization form to share address with HR for insurance purposes Retirees

Medicare Information

  1. Planning for Medicare
  2. How to Apply Online for Medicare only
  3. Social Security Benefits Planner: Retirement

Member and Retiree Links

  1. Retirement Seminar Slides, Group 1, August 2022

Option B Beneficiary Change Form

  1. Option B Beneficiary Change form (for Retirees Only)

Public Records Requests

  1. Public Records Announcement - Records Access Officer
  2. Guidelines for Requesting Public Records

Retiree Insurances

  1. Medex Plan
  2. Medex Prescription Drug Plan
  3. Dental Blue Plan

Retiree Payment Dates

  1. 2023 Retirement Paycheck/Direct Deposit Dates
  2. 2024 Retirement Paycheck/Direct Deposit Dates

Sample Domestic Relations Order (DRO)

  1. Sample Domestic Relations Order Template

Social Security 

  1. 2023 Social Security Presentation
  2. Understanding Social Security June 2019 Retirees
  3. 2023 Government Pension Offset
  4. 2023 Windfall Elimination Provision
  5. What Administrators and Members Need to Know
  6. Filing for Social Security - What Members and Spouses Should Know
  7. What You Can Do Online Retirees
  8. When to Start Receiving Retirement Benefits Retirees

Stop Tax Withholdings Form

  1. Stop Tax Withholdings Form Retirees