Municipal Government

Forms
IMRF Designation of Beneficiary Form 6.11
IMRF Form 5.10 Application for Separation Refund
Request for Rollover Approval for Early Retirement Incentive (ERI)
IMRF Form 7.12D for Health Insurance Deductions
IMRF Disability Benefits Application
W-4P Withholding Certificate for IMRF Monthly Annuity Payments
Illinois IMRF Pension Application
IMRF Pension Estimate Request
Employer Statement Disability Claim Form
IMRF Form 6.21 Election to Participate
IMRF Form 1199 Direct Deposit Application
IMRF Early Retirement Incentive Notice
Physician’s Statement – Disability Claim
Health Insurance Continuation Authorization Form
IMRF Form 6.02J Application for Military Service Credit
QILDRO Consent Form
IMRF Form BW-6B Non-Spouse Beneficiary Rollover Certification
IMRF Rollover Approval Form 6.01
IMRF Form 2.20 Authorized Agent Appointment
IMRF Death Benefit Application Form 5.30
Designation of Beneficiary for Annuitant $3,000 Death Benefit