VRS Logo Friday, July 4, 2008

Virginia Retirement System
1200 East Main Street
P.O. Box 2500
Richmond, VA 23218-2500
1-888-827-3847

Retiree Forms

retiree Forms
Form #DescriptionNon-fillFillable graphic:help with fillable pdf forms
N/A Minnesota Life/VRS Life Insurance Forms Page opens web page 
N/A VRS Certificate of Life Insurance opens pdf 322kb 
T-20530 State Health Benefits Program Enrollment Form For Retirees, Survivors And LTD Participants opens pdf 69kb 
VRS-2 Designation of Beneficiary
To designate more than 4 beneficiaries, a continuation form, the VRS-2A, is also required.
opens pdf 60kb opens fillable pdf 219kb
VRS-2A Designation of Beneficiary - Continuation opens pdf 58kb opens fillable pdf 194kb
VRS-7 Request for Termination of Monthly Benefit opens pdf 32kb opens fillable pdf 176kb
VRS-15 Request for Income Tax Withholding opens pdf 61kb opens fillable pdf 164kb
VRS-45 Request for Health Insurance Credit
Retired participants who do not have premiums deducted from their VRS monthly benefit must complete this form.
opens pdf 75kb opens fillable pdf 169kb
VRS-57 Authorization for Direct Deposit of Monthly Benefit opens pdf 44kb opens fillable pdf 130kb
VRS-58 Name/Address Declaration For Retirees opens pdf 28kb opens fillable pdf 34kb
VRS-76 Certification of Employment for Health Insurance Credit Eligibility
Completed only by employers certifying general registrars, local officers, employees of these referenced positions and local social service employees.
opens pdf 47kb opens fillable pdf 165kb
VRS-900 Authorization to Discuss VRS Account Information opens pdf 36kb opens fillable pdf 145kb
VRS-901 VRS Durable Power of Attorney opens pdf 54kb opens fillable pdf 163kb
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