Forms Library

Here you'll find all VRS Defined Contribution Plan forms and applications you'll need to enroll in the plan and manage necessary activities. Select a button below to filter the selections by plan.

Hybrid

Approved Domestic Relations Orders – Defined Benefit

Approved Domestic Relations Orders – Voya Defined Contribution

Beneficiary Designation - VRS Defined Contribution Plans

College and University Opt-Out Form (VSDP-2)

Direct Rollover/Transfer Request

Distribution Request

Incoming Rollover Form – Hybrid Plan Defined Contribution

Information Release Authorization Form

IRS 402(f) - Special Tax Notice

IRS Form W-4P: Withholding Certificate for Pension or Annuity Payments

Self-Certification Unforeseeable Emergency Withdrawal Application - Hybrid Plan Defined Contribution

State Health Benefits Program Enrollment Form for Retirees, Survivors and LTD Participants (A10741)

Unforeseeable Emergency Withdrawal Application - Hybrid Plan Defined Contribution

Uniform Service Leave Make-up Form - Hybrid Plan Defined Contribution

VRS Life Insurance Forms/Securian Financial

VRS-15: Request for Income Tax Withholding

VRS-170: Authorization of Coverage Retention for the Long-Term Care Plan (VSDP or VLDP)

VRS-171: VRS Protection Against Unintentional Lapse of Long-Term Care

VRS-2: VRS Beneficiary Designation-Defined Benefit

VRS-26: Application for Purchase of Prior Service Credit

VRS-26C: Authorization for After-Tax Payroll Deduction to Purchase Service Credit

VRS-26E: Agreement for Pre-Tax Salary Reduction to Purchase Service Credit

VRS-3: Request for Refund

VRS-3A: VRS Name and Address Declaration for Deferred Members

VRS-3ORP: Request to Transfer of Funds to ORP

VRS-5: Application for Service Retirement

VRS-70: Request for Review of Membership Records

VRS-900: Authorization to Discuss VRS Account Information

VRS-901: Durable Power of Attorney

Workforce Transition Act (WTA) Distribution/ Rollover Request Form

COV 457

Approved Domestic Relations Orders – Voya Defined Contribution

Beneficiary Designation - VRS Defined Contribution Plans

Direct Rollover/Transfer Request

Distribution Request

Dual Employment Form

In-Service Distribution Request Form - COV 457

Incoming Direct Rollover Form - COV 457 Deferred Compensation Plan

Information Release Authorization Form

IRS Form W-4P: Withholding Certificate for Pension or Annuity Payments

Payroll Authorization - One-Time Deferral Form - COV 457

Personal Information Change Request For Inactive Wage/Part-Time Employees

Self-Certification Unforeseeable Emergency Withdrawal Application - COV 457 Deferred Compensation Plan

Standard Catch-up Form - COV 457

Unforeseeable Emergency Withdrawal Application - COV 457 Deferred Compensation Plan

Uniform Service Leave Make-up Form - COV 457

Wage/Hourly Participant Enrollment Form - COV 457

Workforce Transition Act (WTA) Distribution/ Rollover Request Form

Virginia Cash Match

Approved Domestic Relations Orders – Voya Defined Contribution

Beneficiary Designation - VRS Defined Contribution Plans

Direct Rollover/Transfer Request

Distribution Request

In-Service Distribution Request Form - Cash Match Plan

Incoming Direct Rollover Form - Virginia Cash Match Plan

Information Release Authorization Form

IRS Form W-4P: Withholding Certificate for Pension or Annuity Payments

Personal Information Change Request For Inactive Wage/Part-Time Employees

Workforce Transition Act (WTA) Distribution/ Rollover Request Form

ORPHE

Approved Domestic Relations Orders – Voya Defined Contribution

Beneficiary Designation - VRS Defined Contribution Plans

Direct Rollover/Transfer Request

Distribution Request

In-Service Distribution Request Form - ORPHE, ORPPA, ORPSS, VSRP

Incoming Rollover Form – ORPHE

Information Release Authorization Form

IRS Form W-4P: Withholding Certificate for Pension or Annuity Payments

VRS-65D: Termination Certification Form (ORPHE)

VRS-7ORP: Notice of Return to Covered Employment (ORPHE, ORPPA, ORPSS, VSRP)

Workforce Transition Act (WTA) Distribution/ Rollover Request Form

ORPPA

Approved Domestic Relations Orders – Voya Defined Contribution

Beneficiary Designation - VRS Defined Contribution Plans

Direct Rollover/Transfer Request

Distribution Request

In-Service Distribution Request Form - ORPHE, ORPPA, ORPSS, VSRP

Incoming Rollover Form – ORPPA, ORPSS & VSRP

Information Release Authorization Form

IRS Form W-4P: Withholding Certificate for Pension or Annuity Payments

VRS-65E: Termination Certification Form (ORPPA)

VRS-7ORP: Notice of Return to Covered Employment (ORPHE, ORPPA, ORPSS, VSRP)

Workforce Transition Act (WTA) Distribution/ Rollover Request Form

ORPSS

Approved Domestic Relations Orders – Voya Defined Contribution

Beneficiary Designation - VRS Defined Contribution Plans

Direct Rollover/Transfer Request

Distribution Request

In-Service Distribution Request Form - ORPHE, ORPPA, ORPSS, VSRP

Incoming Rollover Form – ORPPA, ORPSS & VSRP

Information Release Authorization Form

IRS Form W-4P: Withholding Certificate for Pension or Annuity Payments

VRS-71B: Termination Certification Form (ORPSS)

VRS-7ORP: Notice of Return to Covered Employment (ORPHE, ORPPA, ORPSS, VSRP)

Workforce Transition Act (WTA) Distribution/ Rollover Request Form

VSRP

Approved Domestic Relations Orders – Voya Defined Contribution

Beneficiary Designation - VRS Defined Contribution Plans

Direct Rollover/Transfer Request

Distribution Request

In-Service Distribution Request Form - ORPHE, ORPPA, ORPSS, VSRP

Incoming Rollover Form – ORPPA, ORPSS & VSRP

Information Release Authorization Form

IRS Form W-4P: Withholding Certificate for Pension or Annuity Payments

VRS-7ORP: Notice of Return to Covered Employment (ORPHE, ORPPA, ORPSS, VSRP)

Workforce Transition Act (WTA) Distribution/ Rollover Request Form

Forms Library

Hybrid

COV 457

Virginia Cash Match

ORPHE

ORPPA

ORPSS

VSRP

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