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.
|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|
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.
|T-20879||State Health Benefits Program Enrollment Form For Retirees, Survivors And LTD Participants||03-2020|
Designation of Beneficiary
To designate more than 3 beneficiaries, a continuation form, the VRS-2A, is also required.
|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|
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||08-2019|
Name and Address Declaration for Retirees
Just changing your address? Make the update using myVRS for quicker processing.
|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|