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    • BOARD
    • Agenda
  • FAQs
    • Membership Handbook
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    • Retired Member Forms
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  • FINANCIALS
    • Annual Audit
    • Monthly Investment Returns
    • Actuary Reports
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Retired Member Forms

Below we have all of our forms for retired members. If you need to search forms for active members, you will find them here.

All Forms

  • Form 5 – Application for Surviving Spouse to Receive Monthly Retirement Benefit
  • Form 12 – $5,000 Death Benefit Beneficiary Designation
  • Form 13 – Address Change
  • Form 13Q – Address Change – QDRO
  • Form 15 – Personal Information Change
  • Form 17 – Death Benefit Beneficiary Application
  • Form 18 – Funeral Home – Death Benefit Beneficiary Application
  • Form 19 – Health Election/Change Form for Eligible Retired Public Safety Officers
  • Form 20 – Qualified Death Benefit Disclaimer
  • Special Tax Notice
  • IRS Form W-4P – Withholding Certificate for Periodic Pension or Annuity Payments
  • IRS Form W-4R – Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions
  • OK Form W-4P – Withholding Certificate for Periodic Pension or Annuity Payments
  • OK Form W-4R – Withholding Certificate for Nonperiodic Payments and Eligible Rollover Distributions

Forms can be submitted to forms@olers.ok.gov, or through fax or mail. 

Please reach out if you have any questions about our forms.

Contact

421 NW 13th, Ste. 100 Oklahoma City, OK 73103

(405) 522-4931
1-877-213-0856

405-522-5004 (Fax)

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