Oklahoma Police Pension & Retirement System - Forms

Skip to Content

FAQs | Contact | Site Index

�

FORMS

Note: All forms are in PDF format. You will need to download Adobe Acrobat Reader to view these forms.

Most Commonly Downloaded Forms for Previously Retired Members:
Form115: Notice of Change of Address
Form 110: Authorization for Direct Deposit
Tax: Federal and State Tax Withholding Form

�

All Forms for New and Active Members:

Form 100: Application for Participation

Form 101: Notice of Salary Increases for Active Officers

Form 103: Application for Disability Pension

Form 103A: Municipality Application for Disability Pension in Line of Duty

Form 104: Application for Survivor's Pension for Death In Line of Duty and Death Benefit

Form 105: Application for Survivor's Pension for Death Not In Line of Duty and Death Benefit

Form 106: Application for Service Pension

Form 107: Application for Survivor's Continuation of Pension and Death Benefit

Form 108: Application for Vested Benefit

Form 109: Application for Refund of Contributions

Form 109A: Application for Refund of Contributions and Death Benefit (Beneficiary or Estate Admn.)

Form 110: Authorization for Direct Deposit

Form 111: Deferred Option Plan Application

Form 112: Deferred Option Plan Notice of Termination

Form 112A: Deferred Option Plan Notice of Termination and Death Benefit (Beneficiary or Estate Admn.)

Form 113: Application for Monies Due the Estate

Form 114: Physical/Medical Examination

Form 115: Notice of Change of Address

Form 117: Authorization for Release of Medical/Psychiatric Information

Form 118: Verification of Employment Status

Form 119: Affidavit of Heirship

Form 120: Application for Participation Under the Back Drop Provision

Form 125: Notice of Leave of Absence for Military Service

Form 126: Notice of Return from Leave of Absence for Military Service

Form 127: Service Credit Purchase Application (for Military Service Under USERRA)

Form 130: Historical Payroll Record for Military Service Leave

Form 134: Deferred Option Payout Provision Election

Form 135: Health Election/Change form Form for Eligible Retired Public Safety Officer

Form 136: Deferred Option Payout Provision Notice of Termination

Tax: Federal and State Tax Withholding Form

�

get adobe reader

get adobe reader

get adobe reader