LAGERS Forms

Membership Form

Every full time employee must complete when hired.  Send to LAGERS immediately after completion.

Application for Payments due a Former Member

A former member's application for a refund of employee contributions or a lump sum payment (if eligible).

Request for Refund of Employee's Contributions by Beneficiary

A former member's beneficiary applying for a refund of the member's contributions.

Change of Name / Beneficiary before Retirement

Member choosing to change his or her name and/or beneficiary prior to retirement.

Direct Deposit (EFT) Authorization

Used when a member chooses to have his/her retirement benefit or lump sum payment deposited directly into a designated bank account.

Application for Retirement

Used to apply for normal, early, deferred, or disability retirement. Must be received no less than 30 days before retirement effective date.

Application for Survivor's Retirement

Used by beneficiary of deceased member.

Application for Survivor's Retirement, Death during Deferral

Used by beneficiary of deceased former vested member.

Application for Temporary Duty Disability Service Credit (WC)

Must be completed for an employee to receive LAGERS service credit while out on worker's compensation.

Application for Purchase of Military Service

Members may purchase up to 4 years of military service to be converted to LAGERS service credit.

Federal Withholding Form for Pension Annuity Payments

For retirees choosing the amount withheld from a retirement benefit for federal taxes.

Missouri Withholding Form for Pension Annuity Payments

For retirees choosing the amount withheld from a retirement benefit for Missouri income taxes.

IMPORTANT:  Your benefit is likely not to be taxable in Missouri if you have moved out of the state.  LAGERS will only withhold Missouri income taxes and will not withhold or forward withholdings to any other state.  Please contact the Missouri Department of Revenue if you have questions about the taxability of your LAGERS benefit.

57 Pages

Includes all forms as well as instructions for the monthly administration of LAGERS.