Forms

You can complete many forms online in myMOSERS. Submitting them online means you won’t need to print and mail them to MOSERS. Below are links to forms that you may complete, print, sign, date, and mail to MOSERS.

Retire Online – The easiest and most convenient way to apply for retirement is through myMOSERS. Complete both steps in the two-step retirement process all at once or leave and come back later. If you choose not to retire online, contact a benefit counselor to request a personalized Retirement Application.

Title Type Size
Designation of Agent Designation of Agent 165 KB
Direct Deposit Authorization form Direct Deposit Authorization form 905 KB
Division of Benefits Order - Request for Estimate form Division of Benefits Order - Request for Estimate form 271 KB
Request for Refund of Employee Contributions - Member form Request for Refund of Employee Contributions - Member form 553 KB
Tax Withholding Authorization and IRS W-4P form Tax Withholding Authorization and IRS W-4P form 373 KB
Tax-Free Rollover Certification Form (Purchasing or Transferring Service Credit) Tax-Free Rollover Certification Form (Purchasing or Transferring Service Credit) 302 KB

Federal Tax Forms

W-8BEN Certificate of Foreign Status of Beneficial Owner for United States Tax Withholding and Reporting for Individuals

W-9 Request for Taxpayer Identification Number and Certification