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All forms are fillable and ready for download and printing. VRS accepts all forms by mail or fax. Fax to: 804-786-9718. If on deadline when faxing a form, please call or email to alert VRS of its pending arrival. VRS does not accept forms via email, which is not a secure form of communication.

employer Disability Retirement Forms
Form #DescriptionLast UpdatedDownload
VRS-2 Designation of Beneficiary
To designate more than 3 beneficiaries, a continuation form, the VRS-2A, is also required.
VRS-2A Designation of Beneficiary - Continuation 02/2020
VRS-6 Application for Disability Retirement 04/2019
VRS-6A Explanation of Disability 01/2019
VRS-6B Physician's Report 01/2019
VRS-6C Request for Estimate of Disability Retirement Benefits 02/2011
VRS-6D Employer Information for Disability Application 04/2019
VRS-6E Certification of Alternate Employment for Disability Retiree for Political Subdivision Hazardous Duty Employees 08/2012
VRS-15 Request for Income Tax Withholding 10/2018
VRS-49 Change to Certification for Retirement
This form is no longer required. Employers make certification changes directly in myVRS Navigator.
VRS-57 Authorization for Direct Deposit of Monthly Benefit 08/2019

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