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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

SURS RSP TIAA to Voya Transfer Form

Complete this form to move all, or a portion of your existing SURS RSP funds invested with TIAA to Voya. Please note that this form must be returned to TIAA at the address listed on the bottom of the form to be processed.

09/20 1 pdf icon

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