|T-20879||State Health Benefits Program Enrollment Form For Retirees, Survivors And LTD Participants||12/2014||68kb|
|VRS-2||Designation of Beneficiary
To designate more than 3 beneficiaries, a continuation form, the VRS-2A, is also required.
|VRS-2A||Designation of Beneficiary - Continuation||12/2014||148kb|
|VRS-5||Application for Retirement||01/2016||314kb|
|VRS-15||Request for Income Tax Withholding||11/2016||97kb|
|VRS-45||Request for Health Insurance Credit
Retired participants who do not have premiums deducted from their VRS monthly benefit must complete this form.
|VRS-57||Authorization for Direct Deposit of Monthly Benefit||11/2016||81kb|
|VRS-170||Authorization of Coverage Retention for the Long Term Care Plan (VSDP or VLDP)||01/2014||130kb|
|VRS-171||Protection Against Unintentional Lapse of Long Term Care (VSDP or VLDP)||01/2014||126kb|
|VRS-900||Authorization to Discuss VRS Account Information||02/2011||33kb|
|VRS-901||VRS Durable Power of Attorney||07/2016||151kb|