PERS forms updated to direct applicants to select federal tax-withholding on IRS forms

Several PERS forms have been updated to instruct applicants to complete and submit either IRS Form W-4P or IRS Form W-4R for federal tax-withholding preferences. These changes were necessary, as the federal forms are required by the IRS. 

Attention retirees: Only changes to your federal tax-withholdings preferences will require submission of IRS forms. You will not need to submit the federal forms if you have no changes to your preferences. 

All updated forms are listed below.

Note: Some of the listed forms are provided on the PERS website and are hyperlinked. The rest are mailed by PERS as part of the application process.

Thank you!

Forms directing applicants to submit IRS Form W-4P

• Form R, Application for Recalculation of Benefits
• Form 17, Certificate of Withholding Preference 
• Form 14, Survivor Retirement Application
• Form DSBL 10, Payroll Authorization
• Form 9P, Payroll Authorization

Forms directing applicants to submit IRS Form W-4R

• Form 5, Member Refund Application 
• Form 5C, Rollover Distribution Election 
• Form 5D, Beneficiary Refund Application 
• PLSO Form, Partial Lump Sum Option Distribution Election

As always, PERS is here to serve you. Please, let us know if you have any questions regarding these changes by contacting us at 800-444-7377, 601-359-3589, or [email protected].