[email protected]      Toll-free: 1-888-275-5737 or Topeka: 785-296-6166

Forms

Request a paper form

Active Member Forms

Designation of Beneficiary
KPERS-7/99, (PDF, 257KB)
Designation of Beneficiary - Spanish
KPERS-7/99SPAN, (PDF, 243KB)
Designation of Beneficiary for Life Insurance - Board of Regents
KPERS-7/99A, (PDF, 203KB)
Additional Beneficiaries - Retirement Benefits
Use this form if you have more retirement beneficiaries than space allows on the KPERS-7/99, (PDF, 178KB).
Additional Beneficiaries - Life Insurance Benefits
Use this form if you have more life insurance beneficiaries than space allows on the KPERS-7/99, (PDF, 180KB).

Application for Retirement Benefits, Related Forms and Information
for KPERS 1, KPERS 2, KP&F, Judges
KPERS-15 Booklet, revised 4/18 (PDF, 444KB) Available in print
Application for Retirement Benefits
for KPERS 3
revised 4/18 (PDF, 444KB) Available in print
New! Solicitud de jubilaciĆ³n
(Application for Retirement)
KPERS-15Spanish, revised 7/16 (PDF, 491KB)
Direct Deposit - Agreement for Payment of Benefit to Financial Institution
KPERS-15B, revised 2/17 (PDF, 218KB)
Retirement Benefit Estimate Request
KPERS-15E, revised 4/14 (PDF, 155KB)
Date of Birth Affidavit
KPERS-40DOB, revised 6/11 (PDF, 134KB)
Name Change Affidavit
KPERS-40NC, revised 6/11 (PDF, 200KB)

Application for Withdrawal of Contributions, Related Forms and Information
KPERS-13 Booklet, (PDF, 340KB) -
Order printed copy here.
Solicitud para Retirar Ahorros de KPERS (Application for Withdrawal),
KPERS-13Spanish, (PDF, 227KB)
Authorization to Release Information
KPERS-14, (PDF, 156KB)
Important Tax Information Booklet, revised 11/15 (PDF, 195KB) - contains important information about rollover and lump-sum payments.

Retired Member Forms

Designation of Beneficiary - Retired
KPERS-7/99R (PDF, 235KB)
Additional Beneficiaries - Retirement Benefits (PDF, 178KB)
Use this form if you have more retirement beneficiaries than space allows on the KPERS-7/99.

Please call KPERS Toll-free at 1-888-275-5737 to report a member's death. We'll provide the necessary form.


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Kansas Public Employees Retirement System
611 S. Kansas Ave, Topeka, KS 66603
Toll-free: 1 888 - 275-5737
Email: [email protected]