Helping Idaho Public Employees Build A Secure Retirement

Employer Forms and Publications

Some forms can be submitted online electronically. To submit a form online you will need to have an Employer PERSI web account. Click on the Submit Online icon for the form to login or to register.

Memos to Employers

Forms

Forms PDF
RS102 Membership Application - Only for use by Employers that submit paper transmittals.
RS110 Address change Download PDF Form
RS115 Beneficiary Designation (for your employees to fill out) Download PDF Form
RS118 Certification of Police Officer Status (PDF Fill-in Version) Download PDF Form 
RS118A Certification of PERSI Firefighter Status (PDF Fill-in Version) Download PDF Form 
RS119 Optional Retirement Plan (ORP) Sick Leave Submission Download PDF Form 
RS119JR Judicial Retiree Sick Leave Submission Download PDF Form 
RS130 Certification of City or County Employee's 8-Month Seasonal Status Download PDF Form
RS132 Certification of Employment of a Retired Member Download PDF Form
RS132A Certification of Employment of a Retired School Teacher or Administrator Download PDF Form
RS211 School District / Charter School Sick Leave Policy Certification Download PDF Form
RS415 Request for Premium Payments through the ORP Unused Sick Leave Program Download PDF Form
RS432C Insurance Carrier Certification of Group Insurance Policy Download PDF Form
RS432R Employer / Consortium Certification of Group Insurance Policy Download PDF Form
Easy Pay - PERSI's Electronic Payment System Download PDF Form
PERSI Employers Forms Version Log Download PDF Form