Forms for Retirees

Forms

Beneficiary Designation Form

Direct Deposit Authorization Form

Federal W-4P Tax Withholding Certificate

Member Mailing Address Change Form
* If you are still working for a PERSI employer, your address must be updated through your employer’s payroll transmittal.

Member Name Change Form
* If you are still working for a PERSI employer, your name must be updated through your employer’s payroll transmittal.

PERSI Durable Limited Power of Attorney Form

Release of Information Form

Request For Account Information By Spouse or Former Spouse Form

Retirement Application Kit

State of Idaho Tax Withholding Form

Third-Party Verification Request

* All other Choice 401(k) Plan forms are available by calling Empower Retirement at 1-866-437-3774 or by logging into your Choice 401(k) Plan account. You can log in to your Choice 401(k) Plan account either via the link in your myPERSI account or directly to the Choice 401(k) Plan website.