Retiree Forms

retiree Forms
Form #	Description	Non-fill	Fillable
N/A	Minnesota Life/VRS Life Insurance Forms Page
N/A	VRS Certificate of Life Insurance	322kb
T-20530	State Health Benefits Program Enrollment Form For Retirees, Survivors And LTD Participants	69kb
VRS-2	Designation of Beneficiary To designate more than 4 beneficiaries, a continuation form, the VRS-2A, is also required.	60kb	219kb
VRS-2A	Designation of Beneficiary - Continuation	58kb	194kb
VRS-7	Request for Termination of Monthly Benefit	32kb	176kb
VRS-15	Request for Income Tax Withholding	61kb	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.	75kb	169kb
VRS-57	Authorization for Direct Deposit of Monthly Benefit	44kb	130kb
VRS-58	Name/Address Declaration For Retirees	28kb	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.	47kb	165kb
VRS-900	Authorization to Discuss VRS Account Information	36kb	145kb
VRS-901	VRS Durable Power of Attorney	54kb	163kb