Forms

The following forms (PDF format) are available for download using Adobe Acrobat.

NEW HIRE RETIREMENT FORMS - FOR EMPLOYEES HIRED ON OR AFTER JULY 1, 2019 Employees' Retirement System Plan E Beneficiary Designation Police Officers Retirement System Plan C Beneficiary Designation Uniformed Retirement System Plan F Beneficiary Designation

 

GENERAL FORMS for ACTIVE EMPLOYEES

• Opt Out of Defined Retirement
• Account Balance Request
• Beneficiary Change Form
• Beneficiary Change Form - for POLICE OFFICERS
• Research Request Form
• Preparing for Retirement
• Event of My Death

QDRO

• QDRO Guidelines

ESTIMATE REQUESTS

• General County Employee
• School Employee

DEFERRED VESTED RETIREMENT APPLICATIONS

• Employee Deferred Vested Retirement Application
• Police Officers Deferred Vested Retirement Application
• Uniformed Deferred Vested Retirement Application

NORMAL/EARLY RETIREMENT APPLICATION/PACKAGES

• SCHOOL Employee Normal/Early Retirement Package
• Employee Normal/Early Service Retirement Application   How To  / Español
• Police Officers Normal/Early Retirement Package
• Uniformed Normal/Early Service Retirement Package  How To
   

JOINT & LAST SURVIVOR OPTION AT NORMAL RETIREMENT ELIGIBILITY DATE
- This form is only for members who reached early or normal retirement eligibility.

• Employee Joint and Last Survivor Bridging Option 
• Police Officers Joint and Last Survivor Bridging Option 
• Uniformed Joint and Last Survivor Bridging Option 
   

DROP ENTRY FORMS/PACKAGES

• SCHOOL Employee DROP Entry Package
• Employee DROP Entry Form  How To
• Police Officer Entry
• Uniform DROP Entry
   

DROP EXIT FORMS/PACKAGES

• School DROP Exit Package
• Employee DROP EXIT Form
• Police Officer DROP EXIT Package
• Uniformed DROP EXIT Package
   

REFUNDS

• Acknowledgement of Employment Termination (Refund Application/Deferred Vested)
• If you are leaving or have already left Fairfax County employment, you should review the Options for Terminating/Separating Employment. Members who are vested should review the Deferred Vested Retirement section of the Retirement Handbook
• Please read this Special Tax Notice before downloading any refund forms
• Spouse Refund/Benefit Request Employees' and Uniformed Systems
   

LINKS TO TAX FORMS

• Federal Tax Forms
• Virginia Tax Forms
   

FORMS for RETIREES

• Change of Address for GENERAL COUNTY Retirees
• Change of Address for SCHOOL Retirees
• Direct Deposit  How To   /  Español
• Secondary Direct Deposit
• Event of My Death
• Life Insurance Beneficiary Change
• Retirement Income Verification
• Stop and Reissue Payment Request
• Tax Form - Federal Withholding (W-4P)
• Tax Form - VA Withholding (VA-4P)