Employer Forms and Publications
Forms and Publications
| Document Sort descending | Description | Topic |
|---|---|---|
| 2024 Annual Comprehensive Financial Report (PDF) | Review financial, investment, and other information about PERA's pension administration. |
Financial |
| 2024 Popular Annual Financial Report (PDF) | Review a financial summary that highlights several sections of the ACFR. |
Financial |
| Ambulance Service Questionnaire | An ambulance service uses this form to request participation in PERA's DCP Ambulance Plan. |
Eligibility |
| Annual Exclusion Report (PDF) | Only employers who lack technology to access ERIS may use this form. |
Reporting |
| Correctional Plan Certification (PDF) | Use this form to certify an employee's eligibility for the Correctional Plan. |
Eligibility |
| Election by Labor Organization Employee (PDF) | Members use this form to continue PERA as an employee of a labor organization. |
Eligibility |
| Exemption from Web Reporting (PDF) | This form must be completed by employers who lack technology to use ERIS. |
Reporting |
| Full-time Student Exclusion Certification (PDF) | Complete this form each semester for excluded full-time students under age 23. |
Eligibility |
| Guide to Reporting Salary Overview (PDF) | Handout for the Guide to Reporting Salary program. |
Refund |
| Guide to Reporting Salary Q&A (PDF) | Answers to your questions from the Guide to Reporting Salary program. |
Refund |
| How to Report PERA Contributions on a W-2 (PDF) | Instructions to report PERA contributions on the IRS Form W-2. |
Reporting |
| Increasing the SVF Plan Benefit Level (PDF) | What to review when considering an SVF benefit level increase. |
SVF |
| Independent Contractor or Employee (PDF) | Eligibility requirements of employees and independent contractors. |
Eligibility |
| Individual Record of Earnings (PDF) | Use this form upon request or when an employee wasn't enrolled. |
Eligibility |
| Leave Program Certification (PDF) | Use this form if you have a leave program as a budgetary savings measure. |
Reporting |
| Leave Reporting Overview | Handout for the leave reporting program. |
Reporting |
| Member Information Change Report (PDF) | Only employers who lack technology to access ERIS may use this form. |
Reporting |
| Membership Election for Certain Ambulance Rescue.pdf | Complete within the first 30 days of work for optional PERA membership. |
Eligibility |
| Membership Election for City Managers (PDF) | Complete within the first 30 days of work for optional PERA membership. |
Eligibility |
| Membership Election for Governmental Physicians (PDF) | Complete within the first 30 days of work for optional PERA membership. |
Eligibility |
| Membership Election for Public Officials (PDF) | Complete within the first 30 days of work for optional PERA membership. |
Eligibility |
| Membership Eligibility Checklist (PDF) | Use this checklist to determine if an employee is eligible for a PERA Defined Benefit Plan. |
Eligibility |
| Membership Eligibility Overview (PDF) | This publication is a supplemental handout for the Membership Eligibility webinar. |
Eligibility |
| Military Leave Verification (PDF) | Your employer completes this form for a military leave of absence. |
Purchase |
| Notice of Exclusion from PERA Membership (PDF) | Use this optional form for an employee excluded from PERA upon hire. |
Eligibility |
| Notice of Member Enrollment (PDF) | Only employers who lack technology to access ERIS may use this form. |
Reporting |
| Phased Retirement Option (PDF) | This fact sheet provides an overview of the Phased Retirement Option (PRO). |
Retirement |
| Phased Retirement Option Agreement (PDF) | Complete this form before phased retirement employment begins. |
Retirement |
| Privatization (PDF) | This publication will help you understand how privatization impacts your benefit. |
Retirement |
| Privatization Verification of Employment Status (PDF) | This form verifies a member's privatization employment status to start their PERA benefit. |
Retirement |
| Questionnaire for Prospective PERA Employers (PDF) | Use this form to have your organization reviewed to join PERA. |
Eligibility |
| Resolution Template for SVF Benefit Level Increase (Word) | Use this resolution template to increase the SVF benefit level. |
SVF |
| Resolution Template to Join SVF DBP for Governing Bodies (Word) | Use this resolution template to join the SVF DBP for governing bodies. |
SVF |
| Resolution Template to Join SVF DBP for Relief Associations (Word) | Use this resolution template to join the SVF DBP for relief associations. |
SVF |
| Resolution Template to Join SVF DCP for Governing Bodies (Word) | Use this resolution template to join the SVF DBP for governing bodies. |
SVF |
| Resolution Template to Join SVF DCP for Relief Associations (Word) | Use this resolution template to join the SVF DCP for relief associations. |
SVF |
| Sample Resolution - Provide DCP Coverage Option to Eligible Firefighters (Word) | Use this sample resolution to extend DCP coverage to eligible firefighters. |
Eligibility |
| Sample Resolution – Blanket Part-Time Firefighter (Word) | Use this sample resolution to include part-time firefighters in Police & Fire Plan. |
Eligibility |
| Sample Resolution – Blanket Part-Time Police Officer (Word) | Use this sample resolution to include part-time police officers in Police & Fire Plan. |
Eligibility |
| Sample Resolution – Part-Time Firefighter (Word) | Use this sample resolution to include a part-time firefighter in Police & Fire Plan. |
Eligibility |
| Sample Resolution – Police & Fire Member Transfer (Word) | Use this sample resolution to continue Police & Fire Plan for a member who transfers. |
Eligibility |
| SVF Cost Analysis for Defined Benefit Plan (PDF) | This form is completed by the department who is considering the SVF defined benefit plan. |
SVF |
| SVF Retirement Application (PDF) | This application is completed by SVF members for a lump-sum benefit. |
SVF |
| Understanding PERA (PDF) | This publication provides the basics about PERA benefits. |
Retirement |
| Verification of Termination (PDF) | This form is completed with the Retirement Application to verify termination requirements. |
Retirement |
| Virtual Benefit Fair | This publication highlights key resources about PERA benefits. |
Retirement |
| W-9 Request for Taxpayer Identification Number and Certification | PERA-signed Form W-9 to provide taxpayer identification and certification. |
Financial |