Florida Retirement System

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ENROLLMENT FORMS

PENSION PLAN AND INVESTMENT PLAN
1 ELE-1-EZ.PDF EZ Retirement Plan Enrollment Form for Regular, Special Risk, and Special Risk Administrative Support Class Employees
2 ELE-1.PDF Retirement Plan Enrollment Form for Regular, Special Risk, and Special Risk Administrative Support Class Employees
3 ELE-2.PDF 2nd Election Retirement Plan Enrollment Form
4 ELE-2-EZ.PDF EZ 2nd Election Retirement Plan Enrollment Form
5 EOC-1.PDF Retirement Plan Enrollment Form for Elected Officer's Class Employees
6 SMS-1.PDF Retirement Plan Enrollment Form for State Senior Management Service Employees
7 SMS-3.PDF Retirement Plan Enrollment Form for Local Senior Management Service Employees

COMMUNITY COLLEGES AND UNIVERSITIES
8 OCC-2.PDF Retirement Plan Conversion Form for Community College Optional Retirement (CCORP) Members
9 OCC-1.PDF Retirement Plan Choice Form for Community College ORP-Eligible Employees
10 ORP-ENROLL.PDF Retirement Plan Enrollment Form for State University System ORP-Eligible Employees
11 ORP-MAND.PDF Retirement Plan Enrollment Form for State University System ORP-Mandatory Employees
12 ORP-CHANGE.PDF State University System Optional Retirement Program (SUS/ORP)/ Change Form

BENEFICIARY FORMS

PENSION PLAN
13 FR-DS-ORP.PDF Beneficiary Designation Form State University System/State Community College Optional Retirement Program Distribution Statement.
14 BEN-001.PDF Beneficiary Designation Form (Active Pension Plan Members Only) (NOTE: If you are already receiving monthly FRS benefits or you are currently participating in DROP, please use Form FST-12.
15 FST-12.PDF Beneficiary Designation Form (Retired Pension Plan Members Only). Note: Includes DROP participants.

INVESTMENT PLAN
16 IP BENEFICIARY.PDF Beneficiary Designation Form - Investment Plan Members Only (Active and Retired).

SPECIAL RISK FORMS

17 FRS-400.PDF Application for Special Risk Members
18 FRS-401.PDF Special Risk Credit for Past Service
19 FRS-402.PDF Application for Special Risk Equivalent Credit
20 FRS-404.PDF Application for Special Risk Administrative Support Class
21 FRS-405.PDF Application for Special Risk Membership - Firefighters/Paramedics/EMTs
22 FRS-415.PDF Application for Special Risk Class Membership - Forensic Discipline, Effective July 1, 2008

SMSOAP/SUSORP FORMS

23 OAP-ETF.PDF Supplemental Statement for Distributions for SMSOAP
24 ORP-ETF.PDF Supplemental Statement for Distributions for SUSORP
25 FR-SUSORP.PDF Verification of State University Optional Retirement System Service Dates

RETIREMENT FORMS

PENSION PLAN
26 Service Retirement Forms Packet Packet containing all the forms needed to apply for Service Retirement including the FR-11, the FRS-11o and the SA-1
27 FR-11.PDF Application for Service Retirement
28 FRS-11O.PDF Option Selection for FRS Members
29 FST-12.PDF Beneficiary Designation Form (Retired Members Only) Note: Includes DROP participants
30 DFS-A1-26R.PDF Direct Deposit Authorization
31 W-4P.PDF Withholding for Pension Payments
32 ADDCH-1.PDF Mailing Address Change Request Form (suggested form) - FRS Pension Payment Recipients Only.
33 BVR-1.PDF Birth Verification Form (Request for Proof of Age)
34 FR-23.PDF Notification of Reemployment for Suspension of Retirement Benefits
35 FR-23A.PDF Application to Reactivate Retirement Benefits
36 SA-1.PDF Spousal Acknowledgement Form
37 FRS-M81.PDF Request for Refund of Employee Contributions
INVESTMENT PLAN
Investment Plan Termination/Distribution Forms
38 TERMINATION KIT.PDF MyFRS Termination Kit - FRS Investment Plan Special Tax Notice and Distribution Options
39 EMPLOYMENT TERMINATION FORM.PDF FRS Investment Plan Employment Termination Form
40 SPECIAL TAX NOTICE.PDF Special Tax Notice
Investment Plan Miscellaneous Retirement Forms
41 HIS-IP.PDF FRS Application for Health Insurance Subsidy for Investment Plan Members
42 HIS-IP-2.PDF FRS Health Insurance Subsidy Certification for Investment Plan Members
TRS AND SCOERS
43 FST-11O.PDF Option Selection for TRS and SCOERS Members

DROP FORMS

44 DROP Retirement Forms Packet Packet containing all the forms needed to apply for DROP including the DP-11, the DP-ELE, the FRS-11o and the SA-1
45 DP- 11.PDF Application for Service Retirement and the Deferred Retirement Option Program (DROP)
46 DT-11.PDF Teachers' Retirement System Application for Service Retirement and the Deferred Retirement Option Program (DROP)
47 DP-ELE.PDF Notice of Election to Participate in the Deferred Retirement Option Program (DROP) and Resignation of Employment
48 FST-12.PDF Beneficiary Designation Form (Retired Members Only) Note: Includes DROP participants
49 DP-EXT.PDF Extension of Deferred Retirement Option Program (DROP) for Specified K-12 Instructional Personnel
50 DROP DIRECT ROLLOVER.PDF DROP to Investment Plan Direct Rollover Form for Former Members
51 DROP DEPOSIT.PDF DROP to Investment Plan Direct Rollover Form for Current Members
52 KEEP YOUR DROP IN THE FRS This flyer explains how you can roll over your DROP lump sum into the FRS Investment Plan and take advantage of the low cost investment products offered in the Investment Plan.
53 SA-1.PDF Spousal Acknowledgement Form

SURVIVOR BENEFIT FORMS

54 DEATH BENEFIT INFORMATION NOTICE.PDF FRS Investment Plan Death Benefit Information Notice
[Remember to contact the Investment Plan Administrator at 1-866-446-9377, Option 4 (TRS 711) to report the death of a member.]

DISABILITY FORMS

PENSION PLAN
55 Disability Retirement Forms Packet - Pension Plan Packet containing all the forms needed for Pension Plan members to apply for Disability Retirement including the FR-13, FR-13a, FR-13b, FRS-11o and SA-1
56 FR-13.PDF Application for Disability Retirement - Pension Plan Members Only
57 FRS-11o.PDF Option Selection for Disability Retirement - Pension Plan Members Only
58 SA-1.PDF Spousal Acknowledgement Form for Pension Plan
INVESTMENT PLAN
59 Disability Retirement Forms Packet - Investment Plan Packet containing all the forms needed for Investment Plan members to apply for Disability Retirement including the PR-13, FR-13a, FR-13b, PR-11o and SA-2
60 PR-11o.PDF Option Selection for Disability Retirement - Investment Plan Members Only
61 PR-13.PDF Application for Disability Retirement - Investment Plan Members Only
62 SA-2.PDF Spousal Acknowledgement Form for Investment Plan Disability Retirement
PENSION PLAN AND INVESTMENT PLAN
63 FR-13B.PDF Physician's Report

ROLLOVER FORMS

PENSION PLAN
64 PRO-1.PDF Pretax Direct Rollover Form
INVESTMENT PLAN
65 IP ROLLOVER.PDF FRS Investment Plan Employee Rollover Deposit Form
66 THINK TWICE BEFORE ROLLING OUT.PDF Know the benefits you may be giving up if you roll your Investment Plan account over to another retirement plan
DROP
67 DROP DIRECT ROLLOVER.PDF DROP to Investment Plan Direct Rollover Form for Former Members
68 DROP DEPOSIT.PDF DROP to Investment Plan Direct Rollover Form for Current Members
69 KEEP YOUR DROP IN THE FRS This flyer explains how you can roll over your DROP lump sum into the FRS Investment Plan and take advantage of the
low cost investment products offered in the Investment Plan.

CREDITABLE SERVICE FORMS

PENSION PLAN
70 FR-28.PDF Application to Purchase Retirement Credit for a Leave Absence
71 FR-30.PDF Verification for In-State or Out-of-State Service Credit
72 MF-1.PDF Statement of Military Eligibility
73 MF-2.PDF Statement of Military Eligibility to Purchase Military Service Under the Out-Of-State Provisions of Section 121.1115, F.S

QDROs

PENSION PLAN
74 Establishing an FRS Pension Plan QDRO Information on obtaining a Qualified Domestic Relations Order (QDRO) under the FRS Pension Plan.
INVESTMENT PLAN
75 FRS Investment Plan QDRO Procedures Guide Information on obtaining a Qualified Domestic Relations Order (QDRO) under the FRS Investment Plan.
76 FRS Investment Plan QDRO Instructions and Model Language Guide Model language for a Qualified Domestic Relations Order (QDRO) under the FRS Investment Plan.

EMPLOYER FORMS

Forms to be used only by employers are located on the Employer Home page.

MISCELLANEOUS FORMS

PENSION PLAN
77 FR-9.PDF Information Request
INVESTMENT PLAN
78 COMPLAINT PROCEDURES.PDF FRS Investment Plan Complaint Procedures

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