Forms and Publications
Most of the forms below are available in Portable Document Format (PDF). You may need to download a free copy of Adobe Acrobat® Reader™ to open them.
Retiree Forms
- Personal Information Change Form
- Direct Deposit Form
- Authorization for Release of Member Information
- Federal Tax Withholding Form
- Ohio State Tax Withholding Form
- Reemployed Retiree Payment Application
- Waiver and Cancellation of Health Care Coverage
- Health Care Automatic Payment Authorization Agreement
- Prescription Medication Cost Estimate
- Division of Property Order Form
- Notice of Privacy Practices – HIPAA
- Report the Death of a SERS Member or Benefit Recipient
Retiree Publications
