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Forms

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member Service Retirement Forms

Form #	Description	Last Updated	Non-fill	Fillable
VRS-2	Designation of Beneficiary To designate more than 3 beneficiaries, a continuation form, the VRS-2A, is also required.	04/2011	51kb	179kb
VRS-2A	Designation of Beneficiary - Continuation	02/2011	29kb	48kb
VRS-5	Application for Retirement	12/2012	58kb	227kb
VRS-15	Request for Income Tax Withholding	02/2011	30kb	45kb
VRS-45	Request for Health Insurance Credit Retired participants who do not have premiums deducted from their VRS monthly benefit must complete this form.	02/2011	62kb	76kb
VRS-57	Authorization for Direct Deposit of Monthly Benefit	02/2011	22kb	31kb
VRS-60	Request for Estimate of Retirement Benefits	03/2013	50kb	167kb
VRS-170	VSDP Long-Term Care Plan Authorization of Coverage Retention	08/2008	27kb	140kb
VRS-171	VSDP Long-Term Care Plan Protection Against Unintentional Lapse	08/2008	26kb	130kb

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