JRS Forms

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Important Note: Photo ID required for most forms

Be advised that using the forms below, you may be required to provide a copy of your photo ID along with the form.

  • For forms with an asterisk (*), for faster service you can use your ERSGA secure online account and will not be required to provide photo ID.
  • Read the instructions carefully to ensure the correct photo ID is provided when submitting the form.
  • Important! Photo ID copy must be clear and legible. ERSGA must be able to read the ID number, name, date of birth, and expiration date on the submitted copy of your photo ID.
  • If a photo ID is not provided or is illegible or expired, the form will not be processed.
  • Only submit a copy of your photo ID. Do not send an original photo ID.

Active Members

Service Retirement Application
Active or Inactive Member Change of Beneficiary Form*
Spousal Benefit Change Form
GTLI Leave Without Pay Continuation Form
Pension Benefit Estimate Request Form*
GTLI Change of Beneficiary Forms*

*Use your ERSGA online account for faster service.

Retired Members

You can use your ERSGA online account to update your home address or direct deposit information, make changes to your federal and state withholding, create a benefit verification letter, and even update certain beneficiaries.  Using your online account is fast, easy, and secure!

Retiree or Inactive Change of Address Form
Retiree Pension Direct Deposit Form*
Federal Income Tax Form W-4P*
State Income Tax Substitute Form G-4P*
JRS Retiree Change of Beneficiary*

*Use your ERSGA online account for faster service.

Inactive or Terminated Members

You can use your ERSGA online account to update your home address or make changes to your beneficiary designations.

  • If you have 10 or more years of service, you can use your ERSGA online account to generate benefit estimates.
  • If you have less than 10 years of service, you can use your ERSGA online account to request a refund of your contributions and interest.

Using your ERSGA online account is fast, easy, and secure!

Requesting a Refund

If you are not able to apply for a refund online, please contact ERSGA for assistance.  Our contact information can be found by selecting Contact under the About menu.  You can call and speak to a customer care representative, or click Contact the Customer Care Group link on the right side of the Contact page. 

Special Tax Notice – Safe Harbor (if you are eligible to roll over the interest portion of your refund)*
Residency Affidavit Acceptable Documents (if you are requesting a refund and your employer paid part of your contributions – pick-up)
Service Retirement Application
Retiree or Inactive Change of Address Form
Active or Inactive Member Change of Beneficiary Form*
Pension Benefit Estimate Request Form*

*Use your ERSGA online account for faster service.