Active - Inactive - DROP Members

PSPRS provides quick and easy access to the forms and resources that you may need as a member of one of our plans.  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:

If you are seeking an application to apply for benefits (i.e., Normal Retirement, enter/exit DROP, Survivor, etc.), you will need to contact your local board secretary in order to complete the necessary forms and documents; the secretary will guide you in this process. If you are not certain who your local board secretary is, please Contact Us.

EORP:

For EORP members electing retirement, disability, or survivor benefits, please Contact Us to assist you in this process.  PSPRS acts as the local board for EORP members.

Deadlines: 

For members electing to retire, our office will need to have the completed forms on or before the 10th of the month in order to process that same month.  You will want to consult with your local board secretary as there are additional board requirements that will have an impact on this process.  For Health Insurance Enrollment Form deadlines, please see the Health Insurance section under Retiree for the Plan in which you participate, PSPRS, CORP, or EORP

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 (using the incorrect form could cause a delay in your request).

Resources
PSPRS CORP EORP
Summary of Plan Provisions PSPRS CORP EORP
Member Handbooks PSPRS CORP EORP
Arizona Revised Statutes PSPRS CORP EORP
EORP Retirement Excel Spreadsheet Estimator EORP
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
Application to Contribute During Industrial Leave (Form 19) PSPRS CORP
EODCRS Nationwide Participation Agreement EORP
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 for RETIRED (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) for PS DROP Beneficiary, CORP Reverse DROP, or Death Benefits PSPRS CORP EORP
PS Exit DROP Distribution Form (For Primary Members Only) PSPRS
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
Service Purchase/Transfer
PSPRS CORP EORP
Application to Purchase Active Military Service (Form 18) PSPRS CORP EORP
Application to Transfer or Redeem Service Credits Between Arizona Retirement Plans (Form U2) PSPRS CORP EORP
PSPRS Affidavit to Redeem Prior Rural Metro Contract Service (Form P2A) PSPRS
Out of State Service Affidavit (Employee) (Form POSS, COSS, EOSS) PSPRS CORP EORP
Application to Redeem Prior Service within Same Retirement System (Form P2, C2, E2) PSPRS CORP EORP
Application to Calculate Severance Refund Repayment with Same Employer (Form P1B, C1B, E1B) PSPRS CORP EORP
Application to Redeem Time with an AZ Public Safety Employer Prior to Joinder Date (Form PSR and CSR) PSPRS CORP
Application to Transfer Service between Employers within Same Retirement Plan (Form P1A, C1A) PSPRS CORP
Application to Transfer Service Credit Between Municipal Retirement Systems and Special Retirement Plans (Form U2A) PSPRS CORP EORP
Misc. Forms
PSPRS CORP EORP
Authorization for Release of Information PSPRS CORP EORP
Domestic Relations Order (DRO) Template PSPRS CORP EORP
Safe Harbor Information Sheet / Taxation of Pension Amounts PSPRS CORP EORP
Special Tax Notice Regarding Plan Payments 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
Health Insurance
PSPRS CORP EORP
2018 Medical Enrollment Form PSPRS CORP EORP
2018 Dental Enrollment Form PSPRS CORP EORP
2018 ASRS Non-Medicare Enrollment Guide Book PSPRS CORP EORP
2018 ASRS Medicare Enrollment Guide Book PSPRS CORP EORP
2017 Medical Enrollment Form PSPRS CORP EORP
2017 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
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
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