Online Forms

These forms are available as Adobe Acrobat PDF files. These files can be viewed and printed using Adobe Acrobat Reader program. For a free copy of this software, visit the Adobe Web Site at www.adobe.com. Note: Be sure to select the "fit to page" option when printing if the form(s) you have selected does not print in its entirety.

Defined Contribution Savings Plans Forms

• 401(k) and 457 Plan Contract (for new enrollments)
• Investment Contract for 401(k) and 457 Plans (for transfers among investment options)
• Change in URS Records (for address, name, and marital status changes)
• Beneficiary Designation Form (for beneficiary designation changes)
  *You may now change your beneficiary designations through your Online Enrollment account. By doing so, this form is no longer required.
• 401(k) Withdrawal/Rollover Application (from URS 401(k) plan)
• 457 Withdrawal/Rollover Application (from URS 457 plan)
• Special Tax Notice Regarding Plan Payments
• Substitute W-4P Withholding Certificate for URS Savings Plans (tax withholding)
• 401(k) Hardship Withdrawal Application (for active members)
• 457 Emergency Withdrawal Application (for active members)
• Savings Plan Transfer/Direct Rollover To URS (rollovers to URS 401(k) or 457 plans)
• 401(k) and 457 Loan Information

Roth & Traditional IRA Forms

• URS IRA Enrollment Contract : Prior to enrolling in URS IRA accounts, click on the following links to view important information regarding IRA accounts:
  • Roth & Traditional IRAs Guidebook
  • URS Roth and Traditional IRA Disclosure Statement
  • URS IRA Enrollment Contract
• IRA Deposit Authorization form ( for direct contributions and 60-day rollovers)
• Savings Plan Transfer/Direct Rollover to URS (rollovers to URS IRAs)
• IRA Investment Contract form (for transfers among investment options)
• Substitute W-4P Withholding Certificate for URS Savings Plans (tax withholding)
• IRA Conversion form (to convert your URS Traditional IRA to a Roth IRA)
• Roth IRA Withdrawal/Transfer Application (rollovers from URS Roth IRA)
• Traditional IRA Withdrawal/Transfer Application (rollovers from URS Traditional IRA)

HRA Forms

• HRA Plan Agreement form (for new enrollments and benefits card registration)
• HRA Claim form (to apply for reimbursement)
• HRA Examples of Common Health Expenses

Defined Benefit Retirement Plans Forms

• Post-Retirement Employment Form (Used for re-employment on or after July 1, 2010)
• Direct Deposit Authorization
• Substitute W4-P for Retired Members only
• Change in URS Records (for address, name, and marital status changes)
• Beneficiary Designation Form (for beneficiary designation changes)

General Forms

• Property Locator
• Employment Application

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