Teachers' Retirement Fund Forms
To search this catalog: From the toolbar in the Edit menu, select "Find". When the Find search box appears, enter a keyword or form number. The first search result will display with the keyword or number highlighted, at the top of the page. Click "Find next" until the desired form is highlighted.
For forms labeled "PDF", the free Adobe Acrobat Reader software is required to view and in some cases fill them out. Forms in other formats (MS Word, MS Excel, etc) are indicated where appropriate.
To open a form once you have chosen it, click on the linked State Form Number (such as 01365.pdf).
For questions about individual forms, please contact this agency's forms coordinator, Bethaney Matlock at 317-234-2949.
For questions about how to use this catalog, or to inform us of a technical problem, please send e-mail to the Forms Management Division.
Forms marked "read-only" cannot be filled in on your computer. They must be printed out and filled in by hand or typewriter.
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Title |
Form Number |
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Active Member Data Change (read-only) |
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Affidavit of Applicant for Disability Benefit (read-only) |
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Affidavit of Distributee for Death Benefit of Deceased Member (read-only) |
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Application For Direct Deposit (read-only) |
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Application For Direct Deposit |
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Application for Retired Member Change of Beneficiary/Survivor Beneficiary and/or Retirement Option (read-only) |
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Application for Retired Member Change of Beneficiary/Survivor Beneficiary and/or Retirement Option |
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Application for Retirement Benefits - Part I (read-only) |
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Application for Retirement Benefits - Part I (read-only) |
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Application for Retirement Benefits - Part II (read-only) |
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Application for Retirement Benefits - Part II (read-only) |
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Application for Rollover Account Withdrawal (read-only) |
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Application for Surviving Dependent Benefit (read-only) |
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Application for Surviving Spouse Benefit (read-only) |
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Application for Surviving Spouse Pension Benefit (read-only) |
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Application for Surviving Spouse Pension Benefit (read-only) |
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Application for Voluntary Withdrawal |
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Application for Withdrawal from the Fund Due to Death of Member (read-only) |
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Application for Withdrawal from the Fund Due to Death of Member (read-only) |
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ASA 5/ASA 6 Post-Retirement Election (read-only) |
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ASA 5/ASA 6 Post-Retirement Election |
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Attending Physician's Statement (read-only) |
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Attending Physician's Statement |
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Calculator for Retirement Benefits (read-only) |
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Calculator for Retirement Benefits (read-only) |
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Certification by Employer of Deceased Member (read-only) |
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Certification by Employer of Deceased Member |
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Claim for Refund Due to Death of a Member or Death Settlement (read-only) |
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Claim for Refund Due to Death of a Member or Death Settlement (read-only) |
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Death Report (read-only) |
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Death Report (read-only) |
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Disability Computation (read-only) |
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Election for Payees of Nonperiodic Payments (W-4P) (read-only) |
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Employer Contact Information (read-only) |
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Employer Contact Information |
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Enrollment for a School or Charter School as a New Employer (read-only) |
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Enrollment for a School or Charter School as a New Employer (read-only) |
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Enrollment Form For New Members (read-only) |
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Enrollment Form For New Members |
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Enrollment for New Members Employed by a Charter School (read-only) |
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Enrollment for New Members Employed by a Charter School (read-only) |
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Estimate Information (read-only) |
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Estimate Information |
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Federal and Indiana State Income Tax Withholding for Monthly Benefit (read-only) |
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Federal and Indiana State Income Tax Withholding for Monthly Benefit |
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Forgery Affidavit (read-only) |
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Indiana State Income Tax Withholding for Lump Sum Distribution (read-only) |
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Indiana State Income Tax Withholding for Lump Sum Distribution |
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Information Regarding Retiree Change of Beneficiary/Survivor Beneficiary and/or Retirement Option (read-only) |
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Information Regarding Retiree Change of Beneficiary/Survivor Beneficiary and/or Retirement Option |
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Irrevocable Payroll Deduction Authorization (read-only) |
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Irrevocable Payroll Deduction Authorization (read-only) |
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Leave of Absence Verification (read-only) |
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Leave of Absence Verification (read-only) |
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Power of Attorney for Active Members (read-only) |
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Power of Attorney for Active Members (read-only) |
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Power of Attorney for Retired Members or Recipients (read-only) |
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Power of Attorney for Retired Members or Recipients (read-only) |
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Preliminary Estimate Request Retiree Change of Beneficiary/Survivor Beneficiary and/or Retirement Option (read-only) |
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Preliminary Estimate Request Retiree Change of Beneficiary/Survivor Beneficiary and/or Retirement Option |
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Primary And Secondary Education Retirement Payment Transmittal (read-only) |
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Primary And Secondary Education Retirement Payment Transmittal |
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Request for Rollover Account Beneficiary Designation Change (read-only) |
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Request to Allocate Annuity Savings Account (read-only) |
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Request to Allocate Annuity Savings Account |
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Request to Allocate Rollover Account (read-only) |
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Request to Purchase Additional Service Credit (read-only) |
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Retired Member Data Change (read-only) |
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Service Credit Purchase Form (read-only) |
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Service Credit Purchase Form |
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Social Security Consent Form (read-only) |
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Social Security Consent Form |
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Statement of Superintendent Disability Benefits Application (read-only) |
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Transfer of Service Credit (read-only) |
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Transfer of Service Credit |
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Verification of Indiana Accredited Private School Teaching Service (read-only) |
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Verification of Out-of-State Teaching Service (read-only) |
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Verification of Out-of-State Teaching Service (read-only) |
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Verification of Prior In State Teaching Service (read-only) |
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Verification of Prior In State Teaching Service (read-only) |
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Voluntary Contribution to Annuity Savings Account (read-only) |
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