Retirement Systems Forms

 

Form Name Form Description
  The following forms are in PDF format.
Dental Form Retiree Dental Enrollment
Dental Rates Retiree Dental Enrollment
DesignationofBenForm Designation of Beneficiary Form
Federal Withholding Worksheet Retirement Office Worksheet Form
RetireeChangeofAddress Retiree Change of Address Form
RetireeDirectDeposit Retiree Direct Deposit Form
State Withholding Worksheet Retirement Office Worksheet Form
W-4P IRS Tax Withholding Form
W-4VT Vermont Tax Withholding Form
Teachers Forms
Application To Purchase Service Credit Application To Purchase Service Credit
Teacher Retiree Under 65 Medical Form Teacher Retiree Under 65 Medical Form
Teacher Retiree Over 65 Medical Form Teacher Retiree Over 65 Medical Form
Teacher Retiree Blue Medicare Rx Form Teacher Retiree Blue Medicare Rx Form

 State Forms

Application To Purchase Service Credit Application To Purchase Service Credit
State Retiree Medical Form State Retiree Medical Form
Municipal Forms
Application To Purchase Service Credit Application To Purchase Service Credit