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).
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IMRF forms available online are in a Portable Document Format (PDF). These
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Software.
Forms
Index by Subject
Authorized
Agent Administration
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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
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Changing
information for a member
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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
(filed
with the member's retirement application)
Read
more about reversionary annuities.
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
May also use Notice
of Termination of IMRF participation, Form 6.41
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
May also use Notice
of Termination of IMRF participation, Form 6.41
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)
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Disability
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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
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Wage
Reporting - Current Year
In
the month paid
Submit via
Employer Access
May also use Monthly Deposit Summary, Form 3.10, Form
not available online
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
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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
May also use Employer's
Report of Adjustments to IMRF Earnings , Form 3.20
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
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Resolutions
-- Military Service Credit or Military Leave
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Miscellaneous
Resolutions and Certificates, and Suggested Forms for Resolutions
To
adopt the IMRF SLEP Program for Airport Police , Form 1.55
Resolution
-- Participation By Elected Officials In IMRF , Form 6.64
Resolution
-- Adoption of the 1,000 Hour Standard for IMRF Participation ,
Form 6.68
Certificate
of Sheriff's Law Enforcement Service , Form 6.71
Resolution
to resolution to include compensation paid under an Internal Revenue
Code Section 125 Plan as IMRF earnings , Form 6.72
Resolution
To Include Compensation Directed Into A Retirement Health Savings
Plan As IMRF Earnings , Form 6.73
Resolution
to Adopt Early Retirement Incentive , Form 6.77
Resolution
to Adopt Amortization Period For Imrf Early Retirement Incentive ,
Form 6.78
Resolution
to Authorize Pension Service Credit for Employees Previously Barred
by Age , Form 6.79
Suggested
Form of Resolution to Adopt Alternative Benefit Program for County
Officers , Form 6.80
Suggested
Form of Resolution to Revoke Alternative Benefit Program for County
Officers ,
Form 6.82
Suggested
Form of Resolution to Require Additional Member Contributions for
Past Service Converted to the Alternative Benefit Program for County
Officers , Form 6.83
Resolution
for Employer Pick-up (Payment) of Member Contributions Required for
Purchase of Service Under ERI , Form 6.85
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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
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