Forms

These are our most commonly used forms.  

Any form that requires notarization or attachments should be mailed to SCERS, 720 3rd Avenue, Suite 900, Seattle WA  98104.  Please note that active members should change their name and/or contact information through their department.   

If you prefer to drop off the form in person rather than mailing, you may place it in the City of Seattle Payment drop box located on the 4th floor of the Seattle Municipal Tower which is located in front of the Customer Service Center (to the left of Security & Information).  Please place your document(s) in a sealed envelope with "Attention Retirement" written on it.  Staff will pick up mail weekly.   

Forms may be submitted as follows:                                                                                                                                       

 

Document Name Submit Via Adobe Sign  Email   Fax   Mail   Drop Box   Secure Message via MSS Portal  
Beneficiary Designation Form         X X X
Benefit Estimate Request Form X X X X X
Change Form - Name, Mailing Address, Email, Phone X X X X
Change Form - Address, Email, Phone only X
Direct Deposit Authorization Form X X X
Disability Retirement Application Form X X X X
Exempt Employees - Membership Application X X X X X
Plan 2 Notice and Election Form X X X X X
Portability Claim Form X X X X X X
Rollover Request to Purchase Service Credit Form X X X X X
Service Credit Purchase Request Form X X X X X X
Tax Withholding Certificate IRS Form W-4P X X X X
Transfer of Funds: City Deferred Comp to SCERS X X X X
Withdrawal of Contributions - Beneficiary Application X X
Withdrawal of Contributions - Member Application X X

  • Fax to (206) 386-1506
  • Mail to SCERS, 720 3rd Avenue, Suite 900, Seattle WA  98104
  • Place in the City of Seattle Payment drop box located at the Seattle Municipal Tower (please put your document in a sealed envelope with "Attention Retirement" written on it).
  • Send the document via secure message on your Member Self-Service account
  • Email to retirecity@seattle.gov.  To protect your personal information, the only forms that can be emailed are:  Membership Application for Exempt Employees; Plan 2 Notice and Election Form; Portability Claim Form; Rollover Request to Purchase Service Credit; Service Credit Purchase Request; and Transfer of Funds (City Deferred Compensation to SCERS).

Staff are in the process of revising each document with updated instructions.  Please feel free to contact us at (206) 386-1293 if you have questions.