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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 Miscellaneous Forms
Form #DescriptionLast UpdatedDownload
IRS 402(F) IRS 402(f) ‐ Special Tax Notice ‐ VRS Defined Benefit Plans
Before taking a refund, read this notice, which explains the tax consequences of taking a refund versus direct rollover into another plan.
12/2018
VRS-3A Name and Address Declaration For Deferred Members 02/2011
VRS-3ORP Request for Transfer of Funds to ORP 07/2019
VRS-7ORP Notice of Return to Covered Employment Optional Retirement Plan Retiree 11/2012
VRS-11 Employer Certification of Involuntary Separation Under the Workforce Transition Act 02/2016
VRS-11A Employer Certification of Basic Group Life Insurance Coverage Under Workforce Transition Act 02/2011
VRS-11B Employer Certification of Involuntary Separation Under the Transitional Benefits Program 06/2015
VRS-11C Employer Certification of VRS Basic Group Life Insurance Coverage Under the Transitional Benefits Program 02/2011
VRS-48 Request for Member Information Change 03/2013
VRS-58 Name and Address Declaration For Retirees 03/2013
VRS-61 Notification of Electronic Payment Information 03/2018
VRS-67A Authorization of Administrative Contacts 01/2013
VRS-70 Request for Review of Membership Records 02/2011
VRS-83 Certification of Eligibility to Participate in Virginia Supplemental Retirement Plan 01/2009
VRS-160 Certification of Eligibility for Critical Shortage Teachers and Administrators 04/2010
VRS-160A Certification of Non-Participation of Critical Shortage Teachers and Administrators 04/2013
VRS-180 Employer Request for Forfeiture of Member Benefits 12/2015
VRS-900 Authorization to Discuss VRS Account Information 02/2011
VRS-901 VRS Durable Power of Attorney 10/2019

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