Self-Managed Plan Retirement Application Builder

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This Retirement Application Builder is used to gather the necessary forms needed to apply for your retirement benefits.

First select your options from the questions below, then click on the links provided at the bottom of the page to download the forms.
While the forms are available online, you are still required to print them, fill them out, and mail them to the SURS office.

Please note: A complete application should contain all of the following parts.

  • Benefit Application - Complete with original signature and notarization
  • Insurance Form(s) - Only if you are eligible and are annuitizing your funds.*
  • Tax Form(s) - Complete forms based on your distribution type and citizenship status.
  • Authorization to Annuitize Form(s) - Only if you are taking your funds as a monthly retirement benefit.
  • Provider to Provider Transfer Form(s) - Optional form if you wish to move your funds to a different Self-Managed Plan provider.

* You must annuitize your entire SURS SMP account to be eligible to enroll in health insurance. Additionally, when annuitizing if your account balance is not sufficient to pay a monthly amount you will not be eligible for health insurance. Employees of City Colleges of Chicago are exempt from this requirement. You must choose a Joint & Survivor Annuity for your spouse or eligible survivor to remain eligible for insurance at your death.


Please Select Your Options Below


Please Print Your Lump-Sum Distribution Forms Below


Please Print Your Monthly Retirement Annuity Documents Below


Please Print Your Rollover Distribution Documents Below

Application Instructions
Monthly Retirement Annuity Application

For more information on the retirement process, insurance, and provider to provider forms available, Click here.

Application Instructions
Rollover Application

If your Direct Rollover Distribution is to a Simple IRA, complete the Simple IRA Certification form.

Special Tax Notice

U.S. Citizens not required to complete tax forms for a rollover . Please see the Rollover Application and Special Tax Notice above for details on taxation.

U.S. Citizens not required to complete tax forms for a lump-sum distribution. Please see the Lump-Sum Application and Special Tax Notice above for details on taxation.

Tax Form - W-8BEN for Nonresident Aliens. For instructions on completing the W-8BEN form, Click here.

Tax Form - W-8BEN for Nonresident Aliens. For instructions on completing the W-8BEN form, Click here.

Tax Form - W-4P Withholding Certificate Pension or Annuity Payments
Tax Form - W-8BEN for Nonresident Aliens. For instructions on completing the W-8BEN form, Click here.

If you do not know your citizenship status, Click Here.

Insurance Enrollment Information Packet - State Insurance Program Includes Required State Insurance Participation Election Form

Insurance Enrollment Information Packet - College Insurance Program Includes Required College Insurance Participation Election Form

If you think you might be eligible for both State and College Insurance, worked for one of the agencies listed here, or you are simply unsure which insurance plan you qualify for, Click Here for more information.

  • City Colleges of Chicago
  • Reciprocal System (i.e. Illinois Municipal Retirement Fund or State Teacher's Retirement System)
  • Other State Agencies

Provider to Provider Transfer Forms
If you are annuitizing with TIAA only, complete the Authorization form below and transfer all funds from Fidelity to TIAA, if applicable.
TIAA Annuity Authorization Form - Required - Use this form to authorize TIAA to annuitize your funds.
TIAA Form - Use this form to transfer all funds from Fidelity to TIAA.
Please return all forms and paperwork to the SURS office.

Provider to Provider Transfer Forms
If you are annuitizing with Principal Life Insurance only, you must transfer your funds to Principal.
Fidelity Form - Use this form first to transfer all funds in TIAA to Fidelity (must be done before transferring from Fidelity to Principal).
Fidelity to Principal - Required - Use this form to transfer all funds from Fidelity to Principal Life Insurance Company for Annuity Purchase.
Please return all forms and paperwork to the SURS office.

Provider to Provider Transfer Forms
If you are annuitizing with both TIAA and Prinicpal, complete the provider transfer forms below, if applicable.
TIAA Annuity Authorization Form - Required - This is a TIAA only form that is mandatory if annuitizing through TIAA.
TIAA Form - Use this form to transfer any funds from Fidelity to TIAA.

Fidelity Form - Use this form first to transfer any funds in TIAA to Fidelity (must be done before transferring from Fidelity to Principal).
Fidelity to Principal - Required - Use this form to transfer funds from Fidelity to Principal Life Insurance Company for Annuity Purchase.
Please return all forms and paperwork to the SURS office