| Form 170 |
Authorizing Direct Deposit |
| Form 170S |
Survivor's Benefit: Authorizing Direct Deposit |
| Form 237 |
Reporting Your 2008 Income To Continue Your Retirement System Disability Benefit |
| Form 253 |
Reporting an Employee's Work Record in the Event of Death |
| Form 276 |
Designating Beneficiary(ies) for the Separate Insurance Benefit Plan for Law Enforcement |
| Form 290 |
Choosing Income Tax Withholding Preferences |
| Form 290S |
Survivor's Benefit: Choosing Income Tax Withholding Preferences |
| Form 296 |
Reporting Your 2008 Income To Continue Your Benefit Through the Disability Income Plan |
| Form 297 |
Reporting Your 2008 Income to Continue Your Disability Salary Continuation Plan Benefit |
| Form 2C |
Designating Beneficiary(ies) for Retirement System Contributions and the Death Benefit |
| Form 309 |
Estimating Your Service Retirement Benefits |
| Form 319 |
Choosing to Transfer Supplemental Income Plan Contributions for an Additional Monthly Benefit (LEOs only) |
| Sample 333 |
Choosing the Contributory Death Benefit for Retired Members |
| Sample Certificate |
Certificate of Coverage (duplicates available upon request) |
| Form 336 |
Designating Beneficiary(ies) for the Guaranteed Refund as a Retiree |
| Form 348 |
Requesting Leave of Absence in the Firemen's and Rescue Squad Workers' Pension Fund |
| Form 349 |
Purchasing Pension Fund Credit for Prior Fire or Rescue Service |
| Form 350 |
Enrolling in the Firemen's and Rescue Squad Workers' Pension Fund |
| Form 359 |
Transferring Accounts in the Firemen's and Rescue Squad Workers' Pension Fund |
| Form 398 |
Using A Distribution of Tax-Sheltered Savings to Purchase Retirement Credit |
| Form 430 |
Purchasing Retirement Credit for a Period of Interrupted Service Related to Parental Leave |
| Form 432 |
Purchasing Retirement Credit for a Period of Interrupted Service Due to Involuntary Furlough |
| Form 441 |
Purchasing Retirement Credit for a Period of Workers’ Compensation |
| Form 443 |
Purchasing Retirement Credit for State or Local Government Temporary Employment |
| Form 451 |
Purchasing Retirement Credit for a Period of Part-Time State or Local Government Employment |
| Form 452 |
Purchasing Retirement Credit for a Period of Service with a Non-Participating Local Unit |
| Form 455 |
Purchasing Retirement Credit for a Period of Out-of-State Employment |
| Form 461 |
Purchasing Retirement Credit for Withdrawn Service |
| Form 462 |
Purchasing Retirement System Credit or Requesting Free Credit for Military Service |
| Form 463 |
Purchasing Retirement Credit for a Period of Interrupted Service for Educational Purposes |
| Form 463F |
Requesting Continuation of Contributions and Credit for Planned Educational Leave |
| Form 466 |
Purchasing Retirement System Credit for Erroneously Omitted Service or Purchasing Contributions for Underreported Salary |
| Form 467 |
Purchasing Retirement Credit for a Period of Federal Service |
| Form 470 |
Purchasing Retirement Credit for a Waiting Period Imposed by a Local Unit |
| Form 478 |
Purchasing Retirement Credit for Withdrawn Optional Retirement Program Service |
| Form 479 |
Purchasing Retirement Credit for a Period of Federally-Funded Service |
| Form 481 |
Purchasing Retirement Credit for a Period of Service Not Credited by the Former LEORS |
| Form 485 |
Purchasing Retirement Credit for a Period of Interrupted Service Due to Extended Illness |
| Form 499 |
Purchasing Retirement Credit for a Period of Service with a Non-Participating Charter School |
| Form 5 |
Withdrawing Your Retirement Service Credit and Contributions |
| Form 5FR |
Withdrawing Contributions from the Firemen's and Rescue Squad Workers' Pension Fund |
| Sample 5ROC |
Choosing the Return of Contributions |
| Sample 5TR |
Transferring Service and Contributions Between Systems (See your employer) |
| Form 6 |
Claiming Your Retirement Benefit (all Systems) |
| Form 6C |
Reporting an Employee's Work Record for Retirement |
| Sample 6E |
Choosing Your Retirement Payment Option |
| Sample 6EJ |
Choosing Your Retirement Payment Option for the Consolidated Judicial Retirement System |
| Sample 6EL |
Choosing Your Retirement Payment Option for the Legislative Retirement System |
| Sample 6ER |
Authorizing Your New Spouse As Beneficiary |
| Form 6FR |
Retiring from the Firemen's and Rescue Squad Workers' Pension Fund |
| Sample 6SAB |
Choosing the Survivor's Alternate Benefit |
| Form 7 |
Requesting Disability Retirement Benefits |
| Form 700 |
Requesting Employer Information Required for Member Disability Income Plan Benefits |
| Form 701 |
Requesting Short-Term of Benefits Through the Disability Income Plan of North Carolina |
| Form 703 |
Medical Report for Eligibility Review of Short-Term Disability Benefits |
| Form 704 |
Requesting Additional Benefits Through the Disability Income Plan of North Carolina |
| Sample 705 |
Agreeing to Accept Long-Term Benefits through the Disability Income Plan of N.C. (duplicates available upon request) |
| Form 706 |
Confirming an Employee's Resignation |
| Form 707 |
Reporting Earnings Monthly While Receiving Extended Short-Term or Long-Term Benefits |
| Sample Form 708 |
Making the Decision Between Disability Income Plan or Disability Retirement Benefits |
| Form 709 |
Estimating Your Disability Retirement Benefits |
| Form 710 |
Determining the Waiting Period Before the Short-Term Begins |
| Form 711 |
Determining and Recording Short -Term Disability Benefits |
| Form 712 |
(Optional) Determining the Affect of Other Benefits on the Short-Term Benefit |
| Form 713 |
(Optional) Determining the Short-Term Benefit for Partial and Special Months |
| Form 714 |
Requesting Reimbursement and Service Credit for the Short-Term Period |
| Form 7A |
Medical Report for Disability Eligibility Review |
| Form 7AR |
Medical Report for Disability Re-examination |
| Sample 7E |
Choosing a Disability Retirement Payment Option (duplicates available upon request) |
| Form 7FR |
Requesting Disability Status from the Firemen's and Rescue Squad Workers' Pension Fund |
| Form COA |
Updating Your Addresses or Name (not for currently contributing members) |
| Form DB228 |
Choosing Tax Treatment for a Payment of Undistributed Contributions Due to a Death |
|
Form ESRR |
Certifying Employee Status Under Retirement Reemployment Laws |
| Form HM |
Selecting Health Coverage Through the State Health Plan |
| Form MR |
Authorizing the Release of Medical Records |
|
| Form SA |
Employer's Review of an Employee's Record of Service |
| Form SVC |
Reviewing Your Service Record and Requesting an Audit of Your Service Credit |