Forms by Subject
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Document drop off – You can drop off documents at the TRSL office. But...don’t forget! Documents can be submitted to us through normal delivery methods, including mail, email, or fax. Please note that TRSL requires originals (not copies or scans) of some TRSL forms. If an original is required, it will be noted at the top of the form.
| Address or name changes |
|---|
| Change of Address Authorization (Form 2AC) - For active members, retirees, survivors, beneficiaries, & alternate payees |
| Member Name Change Request (Form 2NC) - For retirees and active members |
| ORP Member Change of Address Authorization (Form 16AC) |
| ORP Member Name Change Request (Form 16NC) |
| Beneficiary (Designations by member) |
|---|
| Beneficiary Designation for Non-Retired Members (Form 3) |
| Change of Beneficiary for Option 1 Retiree (Form 3A) |
| Beneficiary Designation for DROP and ILSB Accounts (Form 3B) |
| Beneficiary Designation for Retiree Return-to-Work Employee Contributions (Form 3C) |
| Direct deposit |
|---|
| Direct Deposit for Refund of Contributions (Form 7D) |
| Direct Deposit of DROP or ILSB Account Withdrawals (Form 11R) - Use 15D for regular benefits |
| Direct Deposit of Benefits (Form 15D) - Use 11R for DROP or ILSB account withdrawals |
| Addendum to Direct Deposit of Benefits - Nonspousal Joint Signer(s) (Form 15JS) |
| Disability retirement |
|---|
| Application for Disability Retirement (Form 12) |
| Disability Report by Supervisor (Form 12A) |
| Physician Report of Disabling Condition (Form 12C) |
| Physician Annual Report of Disabling Condition (Form 12D) - For retirees only |
| Statement of Child's Permanent Disabling Condition (Form 12PDMC) |
| Employers |
|---|
| Authorized Contacts (Form 1) |
| Employer Directory Contacts (Form 1EDC) |
| Forfeiture of Retirement Benefits - Attestation of Understanding (Form 2FRB) |
| Employment Terminations (Form 4C) |
| Payment Distribution Voucher (Form 4D) |
| Prior Year Correction of Earnings and Contributions (Form 4F) |
| Agency Certification (Form 11B) |
| Retiree Return-to-Work Critical Shortage Certification (Form 15CS) |
| Return-to-Work (RTW) of TRSL Retiree - La. R.S. 11:710.1 (Form 15ELEC) |
| RTW of TRSL Retiree - Special Transfer Group Election of 2010 Group Coverage (Form 15TR) |
| Electronic Reporting Registration (Form 18) |
| Enrollment |
|---|
| Enrollment Application/Employment Notification (Form 2) |
| Certification of Membership in State System (Form 2C) |
| Enrollment Application for Secondary Part-Time Position with Same Employer (Form 2PT) |
| Election to Retain Membership (Form 2R) |
| Statement Concerning Your Employment in a Job Not Covered by Social Security (Form 2SS) |
| Election to Join TRSL after ORP Participation (Form 2TR) |
| Application for ORP or Change of Carrier (Form 16) |
| Federal forms | ||
|---|---|---|
| 10-W4 | Withholding Certificate for Periodic Pension or Annuity Payments (for retirement benefits, including DROP) | IRS form |
| 05-W4P | Withholding Certificate for Periodic Pension or Annuity Payments (for DROP/ILSB Account withdrawals) | IRS form |
| 05-W4R | Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions (for DROP/ILSB withdrawals) | IRS form |
| 10-W4R | Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions (for refund payments) | IRS form |
| Miscellaneous |
|---|
| Forfeiture of Retirement Benefits - Attestation of Understanding (Form 2FRB) |
| Company Application Retiree Payroll Deduction Program (Form 14A) |
| Retiree Return-to-Work Notification (Form 15) obsolete refer to Procedures Manual for enrollment instructions, Index 15.0 |
| Power of Attorney and Agent's Affidavit for Acceptance (Form 15PA) |
| Option to Continue Contributions during Time of Furlough without Pay (Form FBR) |
| Petition for TRSL Administrative Rule Adoption, Amendment, or Repeal (Form PARC) |
| Purchases and transfers of service credit |
|---|
| Application for Reciprocal Recognition of Service (Form 8) |
| Application for Transfer of Creditable Service (Form 8A) |
| Application for Purchase of Refunded Service to Reciprocate (Form 8BR) |
| Application for Purchase of Refunded Service to Transfer (Form 8BT) |
| Application for Purchase of In-state Service (Form 9) |
| Application for Purchase of Out-of-State Public School Employment (Form 9A) |
| Application for Purchase of Military Service (Form 9B) |
| Application for Purchase of U.S. Dependent School Teaching Service (Form 9C) |
| Application for Purchase of Refunded Service (Form 9D) |
| Application for Purchase of In-state Private / Charter School Service (Form 9E) |
| Rollover/Trustee-to-Trustee Transfer Acceptance (Form 9R) |
| Refunds (Please see "Special Tax Notice Regarding TRSL Payments") |
|---|
| Application for Refund (Form 7) |
| Retiree Refund Application (Form 7A) |
| Direct Deposit for Refund of Contributions (Form 7D) Please note: You must also complete and submit a Form 7. If you’re retired, you will need to submit a Form 7A instead of a Form 7. |
| Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions (Form 10-W4R) - IRS form |
| Retirees |
|---|
| Withholding Certificate for Periodic Pension or Annuity Payments (Form 10-W4) - IRS form |
| Retiree Refund Application (Form 7A) |
| Application for Return-to-Work (RTW) Supplement (Form 11RTW) |
| Retiree Return-to-Work Notification (Form 15) obsolete refer to Procedures Manual for enrollment instructions, Index 15.0 |
| Retiree Return-to-Work Critical Shortage Certification (Form 15CS) |
| Return-to-Work (RTW) of TRSL Retiree - La. R.S. 11:710.1 (Form 15ELEC) |
| Power of Attorney and Agent's Affidavit for Acceptance (Form 15PA) |
| RTW of TRSL Retiree - Special Transfer Group Election of 2010 Group Coverage (Form 15TR) |
| Retirement |
|---|
| Benefit Estimate Request (Form 10) |
| Application for Service Retirement, ILSB, or DROP (Form 11) - Replaces old forms 11A and 11F |
| Termination of Employment at End of DROP Participation/Employment (Form 11H) |
| Application for Return-to-Work (RTW) Supplement (Form 11RTW) |
| Direct Deposit of Benefits (Form 15D) - Use 11R for DROP or ILSB account withdrawals |
| Survivor benefits |
|---|
| Application for Survivor Benefits (Form 13) |
| Application for Refund of Deceased Member's Contributions (Form 13A) |
| Student Attendance Certification (Form 13C) |
| Application for Payment to Surviving Spouse/Children (Form 13E) |
| Statement of Dependent's Marital Status (Form 13M) |