Member Forms

Frequently requested forms are listed below. Each form opens in a PDF format, which is good for viewing and printing. You must have Adobe Reader installed on your computer. Some of these forms are also available if you log in to My Account.

Enrollment/Beneficiary Designation. Used to enroll new public employees in IPERS, this form also names the beneficiary who would receive your death benefits. You can check who your beneficiary is by logging in to My Account. It’s critical to keep this information up to date by filing a new form when necessary! online | pdf
Name or Address Change. If your name or address changes, you can let us know of the change by logging in to My Account. If you prefer, print the PDF of this form and mail it in. You must notify IPERS of an address change even if you already notified your employer or the post office. It’s important to keep your address up to date so IPERS can send important information to you. online | pdf
Application for IPERS Retirement Benefits. Please contact an IPERS retirement counselor to request a copy of this form. The counselor will discuss your options, provide information specific to your situation, and send you the forms you need.  
Application for IPERS Refund. Use this form when you have ended covered employment and would like to take a refund. The form is available in My Account and shows you an estimate of your refund amount. You have other alternatives to a refund, and IPERS recommends you weigh your options carefully before deciding. online | pdf
Application for Free Military Credit. Use this form if you served in the military and may be eligible for free service credits. online | pdf
Application for Military Leave Contributions. Use this form if you served in the military and want to make up IPERS contributions that were not paid while you were on active duty. online | pdf
Application for Service Purchase. Use this form if you are interested in purchasing service as a way to increase your benefit or allow you to retire earlier. online | pdf
Election for Termination of IPERS Coverage. Public employees and elected officials who can choose between IPERS and another plan use this to elect out of IPERS coverage. This option is not available to all public employees. online | pdf
Request for IPERS Benefit Estimate. Use this form to obtain a benefit estimate. This is recommended when you are within 3 years of your planned retirement, age 69½ or older, or are retiring because of disability. The online version of this form allows you to see your estimate right away, and can be used at any point in your career. online | pdf

IPERS QDRO. An IPERS Qualified Domestic Relations Order (QDRO) is a special court order that divides a Member's pension assets with an Alternate Payee, following a divorce.

  • IPERS Model QDRO in MS Word may be used as a sample by lawyers and the court to draft a QDRO.
  • Please use IPERS QDRO Instruction Packet in conjunction with the Model QDRO.

To learn more about QDROs and divorce, see the booklet Divorce & IPERS Benefits.



QDRO Packet (QDRO Instruction Packet)

Authorization for Release of Information. This form authorizes IPERS to release and discuss specified information from a member's IPERS account with another named party.
online | pdf
Change Text SizePrinter Friendly FormatDownload Adobe Reader
Contribution Rates
Helpful Links