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for Members and Retirees
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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
IRS 402(F) IRS 402(f) - Special Tax Notice - VRS Defined Benefit Plans
Before taking a refund, read this notice, which explains the tax consequences of taking a refund versus direct rollover into another plan.
10-2020
VRS-3A Name and Address Declaration For Deferred Members 02-2011
VRS-3ORP Request for Transfer of Funds to ORP 07-2019
VRS-11 Employer Certification of Involuntary Separation Under the Workforce Transition Act 02-2016
VRS-11A Employer Certification of Basic Group Life Insurance Coverage Under Workforce Transition Act 02-2011
VRS-11B Employer Certification of Involuntary Separation Under the Transitional Benefits Program 06-2015
VRS-11C Employer Certification of VRS Basic Group Life Insurance Coverage Under the Transitional Benefits Program 02-2011
VRS-48 Request for Member Information Change 03-2013
VRS-70 Request for Review of Membership Records 02-2011
VRS-83 Certification of Eligibility to Participate in Virginia Supplemental Retirement Plan 01-2009
VRS-900 Authorization to Discuss VRS Account Information 02-2011
VRS-901 VRS Durable Power of Attorney 01-2021
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