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Retirement Savings Plan(RSP) Forms

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The following documents are designed for members annuitizing or taking a lump-sum withdrawal from the Retirement Savings Plan (RSP). To access all other RSP forms, please contact SURS at 800-275-7877.

Document Date Pages Download

RSP Roll-In Form

Complete this form to roll money into your SURS Retirement Savings Plan account from an outside plan.

09/20 2 pdf icon

RSP Retirement Income Application

Compete this application if you are taking income either from the SURS Lifetime Income Strategy (LIS), or an annuity from TIAA and/or Principal.  You will need to complete additional forms listed below.

09/20 12 pdf icon

Voya to Principal Transfer Form

Complete this form if you intend to annuitize all or a portion of your SURS RSP Account balance at Voya with Principal.

09/20 1 pdf icon

TIAA Annuity Authorization Form

Complete this form if you intend to annuitize all or a portion of your SURS RSP Account balance with TIAA through TIAA. (Please note, only funds already invested at TIAA can be annuitized with TIAA)

09/20 3 pdf icon

TIAA to Principal Transfer Form

Complete this form if you intend to annuitize all or a portion of your SURS RSP Account balance with TIAA through Principal.

FY 2020 1 pdf icon

W-4P Form

This form is required.
Complete this form to determine Federal Income Tax Withholding.

01/20 6 pdf icon

State Insurance Participation Election Form

Complete this form to indicate your intent to participate in the State Group Health Insurance Plan.  You must meet the eligibility requirements , you must convert at least 50% of your LIS balance into income, and annuitize 100% of your balance that is not in LIS to be eligible to participate.

09/20 4 pdf icon

College Insurance Participation Election Form

Complete this form to indicate your intent to participate in the College Insurance Plan.  You must meet the eligibility requirements , you must convert at least 50% of your LIS balance into income, and annuitize 100% of your balance that is not in LIS to be eligible to participate.

09/20 4 pdf icon

RSP Retirement Lump-Sum Application

Complete this application if you are taking a lump-sum distribution from your SURS RSP account either as a Direct Rollover or a Cash Distribution. By taking a lump-sum distribution from your RSP account, you will be forfeiting your eligibility to participate in either the State Group Health Insurance Plan, or the College Insurance Plan.

09/20 9 pdf icon