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1111 East Main Street
Richmond, VA 23219
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Administrative Offices
1200 East Main Street
Richmond, VA 23219

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Forms

member Retirement Forms
Form #DescriptionLast
Updated
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ALL Hybrid Forms for Members opens web page
VRS-2 Designation of Beneficiary
To designate more than 3 beneficiaries, a continuation form, the VRS-2A, is also required.
01/2014 opens pdf 180kb
VRS-2A Designation of Beneficiary - Continuation 12/2014 opens pdf 148kb
VRS-3ORP Request for Transfer of Funds to ORP 03/2017 opens pdf 321kb
VRS-6 Application for Disability Retirement 10/2015 opens pdf 344kb
VRS-6A Explanation of Disability 12/2012 opens pdf 156kb
VRS-6B Physician's Report 08/2016 opens pdf 194kb
VRS-6C Request for Estimate of Disability Retirement Benefits 02/2011 opens pdf 33kb
VRS-6D Employer Information for Disability Application 02/2011 opens pdf 26kb
VRS-7ORP Notice of Return to Covered Employment Optional Retirement Plan Retiree 11/2012 opens pdf 217kb
VRS-15 Request for Income Tax Withholding 11/2016 opens pdf 97kb
VRS-57 Authorization for Direct Deposit of Monthly Benefit 12/2017 opens pdf 222kb
VRS-65 Election of Retirement Plan - Optional Retirement Plan for Higher Education 02/2017 opens pdf 219kb
VRS-65D Termination Certification Form- Optional Retirement Plan for Higher Education 01/2017 opens pdf 303kb
VRS-65E Termination Certification Form - Optional Retirement Plan for Political Appointees 01/2017 opens pdf 236kb
VRS-71B Termination Certification Form - Optional Retirement Plan for School Superintendents 01/2017 opens pdf 303kb
VRS-75 Optional Retirement Plan Health Insurance Credit Employer Certification of Service
Completed only by employers certifying Optional Retirement Plan participants.
01/2017 opens pdf 211kb
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