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Defined Contribution Plans
VRS Logo 22-01-2021
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All forms are fillable and ready for download and printing. VRS accepts all forms by mail or fax. Fax to: 804-786-9718. If on deadline when faxing a form, please call or email to alert VRS of its pending arrival. VRS does not accept forms via email, which is not a secure form of communication.

Note: VRS does not accept forms via email, which is not a secure form of communication.

Forms
Displays a list of available VRS publications in a table. Most publications are in Adobe PDF format and can be downloaded. When the form is not available on our server, we'll link to another website.
Form # Title/Description Last Updated Download/Link
N/A Approved Domestic Relations Orders - Defined Benefit Plan 08-2019
N/A Approved Domestic Relations Orders - Defined Contribution Account(s) 08-2019
ALL Securian Financial/VRS Life Insurance Forms
VRS-31, VRS-32, VRS-35, VRS-37, VRS-38, VRS-39, VRS-39A, VRS-39R and VRS Certificate of Life Insurance. 		N/A
T-20879 State Health Benefits Program Enrollment Form For Retirees, Survivors And LTD Participants 03-2020
VRS-2 Designation of Beneficiary
To designate more than 3 beneficiaries, a continuation form, the VRS-2A, is also required. 		02-2020
VRS-2A Designation of Beneficiary - Continuation 02-2020
VRS-7ORP Notice of Return to Covered Employment Optional Retirement Plan Retiree 11-2012
VRS-15 Request for Income Tax Withholding 08-2020
VRS-45 Request for Health Insurance Credit
Retired participants who do not have premiums deducted from their VRS monthly benefit must complete this form. 		12-2020
VRS-57 Authorization for Direct Deposit of Monthly Benefit 08-2019
VRS-58 Name and Address Declaration for Retirees
Just changing your address? Make the update using myVRS for quicker processing. 		12-2020
VRS-160 Certification of Eligibility for Critical Shortage Teachers and Administrators 07-2020
VRS-160C Certification of Eligibility for Retiree School Security Officers 07-2020
VRS-160D Certification of Eligibility for Critical Shortage Bus Drivers 07-2020
VRS-900 Authorization to Discuss VRS Account Information 02-2011
VRS-901 VRS Durable Power of Attorney 01-2021
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