Employers

PSPRS provides quick and easy access to the forms and resources that you may need as a local board or employer.  All forms and resources are available to download or print in PDF format.  Most forms may be mailed, faxed or emailed using the information noted on the form.  In some cases, however, the original form must be mailed in to our office, as noted on the form or in the instructions; please pay careful attention. For all forms, double-check all fields and signatures (we cannot accept an electronic signature) and before submitting a form, please make a copy for your records.

PSPRS or CORP:

As a local board or employer, if a member or survivor is seeking an application to apply for benefits, please refer to the Employers & Local Board section to guide you in this process. 

EORP:

For EORP members electing retirement, disability, or survivor benefits, please Contact Us.

Since the PSPRS manages 3 separate pension Plans (PSPRS, CORP and EORP), it is very important that you select the appropriate retirement Plan forms from the drop-down listing (utilizing the incorrect form could cause a delay in your request).

Resources
PSPRS CORP EORP
Retirement Manual Prior to 1-1-2012 PSPRS CORP
Retirement Manual After 1-1-2012 PSPRS CORP
Summary of Plan Provisions PSPRS CORP EORP
Member Handbooks PSPRS CORP EORP
Arizona Revised Statutes PSPRS CORP EORP
Model Uniform Rules of Local Board PSPRS CORP
EORP Administrative Hearing Procedures EORP
Membership Forms
PSPRS CORP EORP
Membership Form PSPRS CORP EORP
PSPRS Application for Membership Waiver (Form P22) PSPRS
CORP Request to Remain in the CORP (Form C20) CORP
CORP Request to Remain in the ASRS (Form C21) CORP
EORP Request to Not Participate in EORP (Form E20) EORP
Application to Contribute During Industrial Leave (Form 19) PSPRS CORP
EODCRS Nationwide Participation Agreement EORP
Retirement Spreadsheets
PSPRS CORP EORP
PSPRS Retirement Spreadsheet w/ Membership Date PRIOR TO 1/1/2012 - Tier 1 PSPRS
PSPRS Retirement Spreadsheet w/ Membership Date AFTER 1/1/2012 - Tier 2 PSPRS
PSPRS DROP Spreadsheet w/ Membership Date PRIOR TO 1/1/2012 - Tier 1 PSPRS
CORP Retirement Spreadsheet w/ Membership Date PRIOR TO 1/1/2012 - Tier 1 CORP
CORP Retirement Spreadsheet w/ Membership Date AFTER 1/1/2012 - Tier 2 CORP
CORP Reverse DROP w/ Membership Date PRIOR TO 1/1/2012 - Tier 1 CORP
CORP Reverse DROP w/ Membership Date AFTER 1/1/2012 - Tier 2 CORP
CORP Reverse DROP Lump Sum Estimator w/ Membership Date PRIOR TO 1/1/2012 - Tier 1 CORP
CORP Reverse DROP Lump Sum Estimator w/ Membership Date AFTER 1/1/2012 - Tier 2 CORP
Common Change Forms
PSPRS CORP EORP
Address & Name Change (Form 9) PSPRS CORP EORP
Beneficiary Designation (Form 8) PSPRS CORP EORP
DROP Beneficiary Designation (Form P8 DROP) PSPRS
Direct Deposit Authorization (Form 13) PSPRS CORP EORP
W-4P - Federal Tax Withholding for Pension Payment PSPRS CORP EORP
A-4P - Arizona Voluntary Income Tax Withholding for Pension Payments PSPRS CORP EORP
Lump Sum Distribution Election for RETIRED (Form U3) PSPRS CORP EORP
Refunds
PSPRS CORP EORP
Complete Refund Packet (12 pages) PSPRS CORP EORP
Refund Application (P6, C6, E6) (1 of 2 required docs) PSPRS CORP EORP
Lump Sum Distribution Form for REFUNDS (Form U3 - Refunds) (2 of 2 required docs) PSPRS CORP EORP
Direct Deposit Authorization for REFUNDS (Form 13 - Refunds) (optional) PSPRS CORP EORP
Special Tax Notice Regarding Plan Payments PSPRS CORP EORP
Refund form for EX-SPOUSE (Form U3 - Refunds) PSPRS CORP EORP
Health Insurance
PSPRS CORP EORP
2017 ASRS Medical Enrollment Form PSPRS CORP EORP
2017 ASRS Dental Enrollment Form PSPRS CORP EORP
2017 ASRS Non-Medicare Enrollment Guide Book PSPRS CORP EORP
2017 ASRS Medicare Enrollment Guide Book PSPRS CORP EORP
Employer Request for Subsidy (Form ER SUB) PSPRS CORP EORP
Cancer Insurance Forms
PSPRS CORP EORP
PSPRS and CORP Cancer Insurance Initial Claim PSPRS CORP
PSPRS and CORP Cancer Insurance Pharmacy Claim PSPRS CORP
PSPRS and CORP Cancer Insurance Supplemental Claim PSPRS CORP
CORP Employer Cancer Insurance Terms of the Plan CORP
CORP Employer Cancer Insurance Enrollment Form CORP
CORP Employee NEW HIRE Cancer Insurance Enrollment Form CORP
CORP Employee ANNUAL Open Enrollment Cancer Insurance Form CORP
PSPRS and CORP Plan Descriptions (2015-07-01_CIP) PSPRS CORP
PSPRS and CORP Schedule of Revised Benefits (2015-07-01_CIP_SOB) PSPRS CORP
Misc. Forms
PSPRS CORP EORP
Authorization for Release of Information PSPRS CORP EORP
Domestic Relations Order (DRO) Template PSPRS CORP EORP
Special Tax Notice Regarding Plan Payments PSPRS CORP EORP
Safe Harbor Information Sheet / Taxation of Pension Amounts PSPRS CORP EORP
Return to Work (RTW) Acknowledgment (Form 16) PSPRS CORP
Power of Attorney (POA) Template (Provided by Maricopa County Superior Court) PSPRS CORP EORP
Public Records Inspection or Reproduction Request Form PSPRS CORP EORP
Local Board Oath of Office PSPRS CORP