Media Category: Member and Retiree Forms

Direct Rollover Distribution Form

September 4, 2025

Direct Rollover Distribution Form

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BEN-0050 – Reemployed Retiree Payment Application

June 25, 2024

BEN-0050 – Reemployed Retiree Payment Application

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REF – Taxes – Special Tax Notice

June 25, 2024

REF – Taxes – Special Tax Notice

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ACK-0008 -Service Retirement Application

January 19, 2024

ACK-0008 -Service Retirement Application

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DIS – Medical Release – HIPPA Auth Dr to SERS

August 22, 2023

DIS – Medical Release – HIPPA Auth Dr to SERS

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Ohio State Tax Withholding

May 8, 2023

Ohio State Tax Withholding

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MBS-0002 – Authorization for Release of Info

May 8, 2023

MBS-0002 – Authorization for Release of Info

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2023.01.20 Virtual Roundtable Handouts

January 17, 2023

2023.01.20 Virtual Roundtable Handouts

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MBS-0012 – Direct Deposit Form

March 1, 2022

MBS-0012 – Direct Deposit Form

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COU-7007 MIO COVID Protocol

April 16, 2021

COU-7007 MIO COVID Protocol

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