VRS Logo Friday, March 23, 2018

Counseling Center
1111 East Main Street
Richmond, VA 23219
8:30 a.m.–4:00 p.m.
Map & Directions
graphic: contact us Contact Us

Administrative Offices
1200 East Main Street
Richmond, VA 23219

Connect with VRS
facebook icon linked-in icon

 > Forms


member Disability Retirement Forms
Form #DescriptionLast
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-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-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
Back to top
View VRS Expenses Valid XHTML 1.0! Level A conformance icon, W3C-WAI Web Content Accessibility Guidelines 1.0
Translate (Disclaimer)