Retiree Info and Forms

These are the most commonly used and requested forms.
If you do not find what you need in this list, contact the Benefits Customer Service Team via email or at 703-228-3500, Option 1; 10 am to 4 pm.

• Application — Deferred Vested Retirement(PDF, 3MB)

• Policy on Retiree Health Insurance Changes(PDF, 187KB)
• Life Insurance Beneficiary Designation – The Hartford
• Direct Deposit Form for ACERS Pension
• Income Tax Withholding Changes for Federal Taxes
• Income Tax Withholding Changes for Virginia State Taxes(PDF, 187KB)

• ACERS Pension Refund or Rollover Packet(PDF, 231KB)

• ACREA Membership Form(PDF, 151KB)

• Medicare Creditable Coverage Notice(PDF, 151KB)

• 2025 Fall Retiree Newsletter(PDF, 2MB)