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Employer Forms
Using the following list, we hope you are able to locate the form you need.
- If you know a form number or wish to know if a form you have is the most recent revision, you may have an easier time locating the form by using our forms by number page.
- If the form you are looking for is not on this page, you can check the Member Forms page.
- If you are unsure what form you need, feel free to email us or to call 1-800-ASK-IMRF (1-800-275-4673).
All IMRF forms available online are in a Portable Document Format (PDF). These files require the Adobe Acrobat Reader Software to view and print. To download a free copy of the Adobe software click here. If you have problems viewing any of these documents, we recommend that you make sure you are using the latest version of the Adobe Acrobat Reader Software.
Forms Index by Subject
- Authorized Agent Duties -- appointment of an AA, forms request, employer access, etc.
- Enrolling an employee in IMRF
- Changing member information
- Terminating a member -- member retires, resigns, is dismissed, dies, or no longer qualifies for IMRF participation
- Disability
- Leave of Absence
- Wage Reporting - current or prior years (prior year includes purchase of past service)
- Resolutions -- Military Service Credit or Military Leave
- Resolutions -- Miscellaneous Resolutions, Certificates, Suggested Form for Resolutions
- Spreadsheet -- Microsoft Excel spreadsheet for estimating member and employer costs of purchasing elected official retroactive service
- Dissolution of School District(s) or Unit(s) of Government
- Change account IMRF uses for electronic deposit of health insurance premiums deducted from members’ benefit payments
Authorized Agent Administration
| Check Lists for Authorized Agents |
| Notice of Appointment of Authorized Agent (AA), Form 2.20 |
| Notice of Election or Appointment of Township Supervisor, Form 2.30 |
| Request for Blank Forms, Form 2.50 |
| Employer Access User ID, Form 2.80 Form Obsolete, Click here to register for an account |
| Change the account IMRF will use to send electronic payment for health premiums deducted from employer's retired members’ benefit payments, Form 3.00 |
Enrolling an employee in IMRF
| All eligible employees | Notice of Enrollment in IMRF, Form 6.10 |
| In addition: | |
| City Hospital Employees | Election to Participate for Qualifying Position, Form 6.21 |
| All Elected Officials | Election to Participate for Qualifying Position, Form 6.21 |
| Resolution for Elected Officials, Form 6.64, if not previously filed | |
| Elected County Officials | Election by Elected County Official to participate in IMRF Elected County Official Plan, Form 6.21B |
| Resolution to Adopt Alternative Benefit Program for County Officers, form 6.80, if not previously filed | |
| Chief of Police | Election of Police Chief to participate as SLEP Member, Form 6.22 |
| Airport Police participating in SLEP | Resolution to adopt the IMRF SLEP Program for Airport Police, Form 1.55 |
| If the employee will not participate in Social Security | Statement Concerning Employment in a Job Not Covered by Social Security, Social Security Administration Form 1945 |
Changing information for a member
| Changes to member's employment or plan | Member Employment Information, Form 6.19 |
| ECO Member changes plans to SLEP or to Regular IMRF | Revocation of Election to Participate in ECO Plan, Form 6.28 |
| Changes to Address, Social Security number, name, birth date, sex |
Submit via Employer
Access |
| Member wishes to change beneficiary | Designation of Beneficiary, Form 6.11 |
Terminating an employee
| For all terminated members (retires, dismissed, resigns, dies, or no longer eligible for IMRF participation) | Submit
via Employer
Access May also use Notice of Termination of IMRF participation, Form 6.41 |
| Member retirement - in addition to Form 6.41 file the following forms | |
| Member retires | Application for Retirement Annuity (Pension), Form 5.20 |
| Copies of birth certificate, marriage certificate and spouse's birth certificate if not previously filed | |
| Member retires under ERI | Application for Retirement Annuity (Pension), Form 5.20 |
| Notice of Intent to Retire under IMRF ERI, Form 5.21 (filed with members retirement application) | |
| Resolution to Adopt IMRF Early Retirement Incentive, Form 6.77, if not previously filed | |
| Copies of birth certificate, marriage certificate and spouse's birth certificate if not previously filed | |
| Member or member's surviving spouse wants health insurance premiums deducted from pension payments | Health Insurance Premium Deduction Authorization, Form 7.10 |
| Member is a public safety employee when and wants to have health or long-term care insurance premiums deducted on a pre-tax basis from pension payments | Election For Pre-Tax Deductions For Health or Long Term Care Insurance Premiums, Form 7.12 |
| Member wants to have his or her pension payments “revert” (become payable) to someone else upon the member's death. | Reversionary
Annuity Application, Form 5.20R |
| Member resigns, is dismissed, or job reclassified and no longer qualifies for IMRF | |
| Member stops participating in IMRF and is leaving member contributions on deposit and not forfeiting (not giving up) IMRF service credit |
Submit termination notice via Employer
Access May also use Notice of Termination of IMRF participation, Form 6.41 |
| Member stops participating in IMRF and is taking a refund of IMRF contributions* | Submit
termination notice via Employer
Access |
Application for Separation Refund, Form 5.10 |
| *Note - To be eligible for a refund, the member must terminate employment as well as IMRF participation. The member is not eligible for a refund if he or she will continue working for the same unit of government in a position that is not eligible for IMRF or in a position that will participate in a reciprocal or local police or fire fund. |
|
| Death of a member | |
| Member was actively participating | Submit
termination notice via Employer
Access | Application for Death Benefit, Form 5.30 |
| Death certificate, marriage certificate (if beneficiary is surviving spouse), beneficiary's birth certificate, divorce decree, if applicable. | |
| Member
was receiving IMRF pension
|
Application for Death Benefit, Form 5.30 |
| Copies of death certificate, marriage certificate (if beneficiary is surviving spouse) | |
Disability
| Member becomes disabled | Member's Application for Disability Benefits, Form 5.40 |
| Submit
Employer Statement via Employer
Access May also use Employer Statement--Disability Claim, Form 5.41 |
|
| Physician's Statement - Disability Claim, Form 5.42 | |
| If member also wants health insurance premiums deducted from total and permanent disability benefit payments |
Health Insurance Premium Deduction Authorization, Form 7.10 |
| If member is a public safety employee and wants health or long term care insurance premiums deducted from total and permanent disability benefit payments | Election
For Pre-Tax Deductions For Health or Long Term Care Insurance Premiums, Form 7.12 |
| Member returns to work for trial work period after disability | Employer's Notice of Termination of Disability or Trial Work Period, Form 5.45 |
Leave of Absence
| Member is taking unpaid leave of absence and wants to continue to earn IMRF service and maintain IMRF disability and death benefit protection | IMRF Benefit Protection Leave, Form 6.32 |
| Seasonal Leave: Granted automatically for school districts and park districts |
Other employers indicate seasonal months on Notice of Enrollment, Form 6.10 |
Wage Reporting - Current Year
| In the month paid | |
| Submit via
Employer Access |
|
| Submit
via Employer Access May also use Monthly Report of IMRF Wages & Contributions, Form 3.11, Form not available online |
|
| To correct previously reported earnings |
Submit via Employer
Access Can also use Employer's Report of Adjustments to IMRF Earnings, Form 3.20 |
| For members paid irregularly | Employers indicate months member will be paid on Notice of Enrollment, Form 6.10 |
| Reporting Seasonal Leave | Granted automatically for school districts and park districts, other employers indicate seasonal months on Notice of Enrollment, Form 6.10 |
| Paying ERI costs | |
| Establish Electronic Funds Transfer | IMRF Electronic Funds Transfer (EFT) Enrollment Form, Form 3.00 |
Wage Reporting - Prior Years (Includes Purchase of Past Service)
| Member's wages and/or contributions were reported in error |
Report via Employer
Access May also use Employer's Report of Adjustments to IMRF Earnings, Form 3.20 |
| Member was reported as Regular IMRF, should have been reported as SLEP | Certificate of Sheriff's Law Enforcement Service, Form 6.71 |
|
Report via Employer
Access |
|
| Member wants to convert military service to IMRF service credit | Application to Purchase Military Service Credit,Form 6.02J |
| Member wants to repay a separation refund | |
| A member may repay a refund and reinstate forfeited service credit after he or she participates in IMRF or in a reciprocal system for two years. | Application for Reinstatement of Service Credit , Form 6.03 |
| Member wants to purchase retroactive service | |
|
Elected official held office qualifying for IMRF before he or she elected to participate (maximum 50 months) |
Application for Retroactive Service Credit , Form 6.04 |
| Elected official held office qualifying for IMRF before he or she elected to participate and wishes to purchase more than 50 months. Please note: In order to purchase more than 50 months of Retroactive Service Credit, the employer or governing body must have passed a resolution allowing this before December 31, 2001. If this resolution is not already on file with IMRF, the member may not purchase more than 50 months of service credit. |
Application
for Retroactive Service Credit, Form 6.04
|
| City hospital employee worked in a position qualifying for IMRF before he or she elected to participate (maximum 50 months) |
Application for Retroactive Service Credit , Form 6.04 |
| Member worked in a position qualifying for IMRF but was barred from participation because of age |
Application for Retroactive Service Credit for employees previously barred by age, Form 6.04A |
| Member wants to purchase omitted service | |
| Member worked in a position qualifying for IMRF but earning and contributions were never reported to IMRF | Omitted Service Credit Verification, Form 6.05 |
| Member wants to purchase prior service | |
| Member worked in a position qualifying for IMRF before his or her employer joined IMRF | Application for Prior Service Credit, Form 6.07 |
| Member wants to purchase out-of-state service | |
| Member worked for a local unit of government in another state and participated in its public retirement program. Member must have participated with current IMRF employer for two years | Out-of-state Service Credit Authorization, Form 6.33 |
| General Assembly member wants to purchase service earned as an elected official | |
| General Assembly member held office qualifying for IMRF and did not elect to participate in IMRF. Must be a current General Assembly member | Application by Member of General Assembly for Service Credit as Elected Official, Form 6.34 |
| Resolution for Elected Officials, Form 6.64, if not previously filed | |
| ECO member wants to convert existing Regular and/or SLEP service to ECO service | |
| Member previously participated in Regular IMRF or SLEP, now participates in ECO | Conversion of Regular or SLEP Service Credit to ECO Service Credit, Form 6.06 |
| Member payment for past service | |
| Member wants to pay for past service (military, retroactive, omitted, prior, etc.) with a distribution (money) from an IRA or qualified pension plan | Rollover Certification for Payment of Past Service Credit, Form 6.01 |
Resolutions -- Military Service Credit or Military Leave
| Resolution for Military Leave Authorization, Form 6.62 |
| Resolution to Allow LIMITED Service Credit for Military Leave that INTERRUPTED IMRF Participation, Form 6.62a |
Miscellaneous Resolutions and Certificates, and Suggested Forms for Resolutions
Dissolution of School District(s) or Unit(s) of Government
| Types of Dissolutions: | |
| Annexation | One employer completely dissolves and is annexed by two or more employers that may be new or already existing IMRF employers |
| Consolidation | Two or more employers completely dissolve and merge to form a completely new employer. |
| Partial dissolution | One unit of an IMRF employer becomes its own employer or joins with another IMRF employer. |
| Split dissolution | One employer completely dissolves and is annexed by two or more employers that may be new or already existing IMRF employers |
| Required Documents: | |
| School District(s) completely dissolved and annexed into existing school district(s) | Certificate of Dissolution—Annexing School District (Form 1.70) |
| Copy of the legal document that caused the annexation, e.g., legislation, referendum, or letter from legal authority authorizing the dissolution. | |
| School District(s) completely dissolved or partially dissolved or split and consolidated into new school district(s) | Certificate of Dissolution—New School Districts (Form 1.71) |
| Copy of the legislation, referendum or letter from legal authority authorizing dissolution. | |
| Unit(s) of government completely dissolved and annexed into existing unit(s) of government | Certificate of Dissolution—Annexing Unit of Government (Form 1.72) |
| Copy of the legislation, referendum or letter from legal authority authorizing dissolution. | |
| Unit(s) of government completely dissolved or partially dissolved or split and consolidated into new unit(s) of government | Certificate of Dissolution—New Governmental Unit (Form 1.73) |
| Copy of the legislation, referendum or letter from legal authority authorizing dissolution. | |
Change account IMRF uses for electronic deposit of health premiums deducted from retired members’ benefit payments
| Change Account for Electronic Payments from IMRF, Form 3.01 |
IMRF Online provides
a brief summary of IMRF benefits and the administration of those benefits.
IMRF members' and employers' rights and obligations are governed by Article
7 of the Illinois Pension Code.
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