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All LSERS Portable Document Format (pdf) forms can be downloaded and completed online.  You MUST have the Adobe Acrobat Reader (2.1 or higher) installed on your computer to view pdf documents. Click Here if you need to download Adobe Acrobat Reader. Print the completed form and send it to us by mail or fax.  

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CollapseForms in Numerical Order

1 Authorized Signatures and Employer Contacts (10/10) 
2 Enrollment Application/Employee Notification (6/09)
2AC Change of Address Authorization (6/09)
2R  Election to Retain Membership (6/09)
2SS  Statement Concerning Your Employment in a Job Not Covered by Social Security (6/09) 
3 Change of Beneficiary (2/12) 
4A  Contributions Report Transmittal (6/09)
4B  Contributions Correction Report (6/09) 
4C  Contribution Checks Transmittal (6/09) 
4P  Prior Year Correction of Earnings and Contributions (6/09)
W4P Withholding Certificate for Pension or Annuity Payments
4T  Employment Terminations (6/09)
5  Service Credit Verification (6/09)
5PT  Report on Part-time Service (4/04)
5WC  Report on Workers' Compensation (4/04)
7  Application for Refund of Member Contributions (1/11)
7D  Application for Refund of Contributions to Beneficiary (3/12)
8 Authorization for Direct Deposit (6/09)
9IO  Purchase of In-State, Out-of-State, Public, or Private School Employment (2/07)
9M Application for Purchase of Military Service (6/09)
9R  Application for Reciprocal Recognition of Service (4/04) 
9RO  Rollover/Trustee-to-Trustee Transfer Acceptance (2/06)
9RS  Application for Purchase of Refunded Service (2/07)
9SB  Application for Purchase of City or Parish School Board Employment (2/07)
9T Application for Transfer of Creditable Service (6/09)
10  Application for Service Retirement (3/12)
10-05  Application for Service Retirement under the Initial Benefit Retirement Plan (IBRP) (12/11)
10A  Employer Certification (5/11)
10DRC   After-DROP Notification (1/11) 
10DR  Application for Deferred Retirement Option Plan (DROP) (12/11)
11  Spousal Consent for DROP or IBRP Account (4/04) 
11D  DROP or IBRP Account Withdrawal Selection (12/11)
11E Spousal Consent for Selection of DROP or IBRP Withdrawal Method (4/04)
11I  DROP or IBRP Account - Spouse or Alternate Payee Lump Sum Withdrawal (2/12)
12  Application for Disability Retirement (6/10)
12B Disability Report by Supervisor (10/10)
12C Physician Report of Disabling Condition(non-psychiatric) (10/11)
12CP  Physician Report of Disabling Condition(psychiatric) (10/11)
12CR  Annual Physician Report of Disabling Condition (3/12)
12D  Disability Provisions Statement (4/04)
12E  Member Statement of Disabling Condition (4/04)
12F  Notification of Income from Other Sources (4/04)
13 Application for Survivor Benefit (10/11)
13H1  Eligibility Certification for Handicapped Survivor (4/04)
13H2 Physician Report of Handicap (11/11)
13M  Marriage Affidavit for Surviving Spouse (4/04)
13S1  School Information Statement (6/09)
13S2  Student's Marital Status Statement (4/04)
15  Re-employment of Retiree - Earnings Report (8/06)
15N  Retiree Return-to-Work Notification (2/07)
16  Request for Monthly Benefit Estimate (4/04)
17  Annual Cost of Living Option (10/09)
17A  Annual Cost of Living Option (10/09)
18 Member Authorization for Income Verification (1/12) 
36  Zero Posting Parameters (6/09)

CollapseMembers

Update your beneficiary information:  3
Change your address:  2AC
Member authorization for income verification:  18 
Request a monthly benefit estimate:  16 
Request an annual cost of living option estimate:  17
Request an invoice to repay refunded service credit:  9RS
Request a purchase of service credit:
    9IO  Purchase of In-State, Out-of-State, Public, or Private School Employment 
    9M Application for Purchase of Military Service
    9SB  Application for Purchase of City or Parish School Board Employment 
Request a transfer of service or reciprocal agreement from a public retirement system:
    9T    Application for Transfer of Creditable Service 
    9R Application for Reciprocal Recognition of Service 
Request a refund of your contributions:  7

CollapseRetirees

Change your federal tax withholding:  W4P 
Have your check sent directly to a financial institution:  8 
Change your address:  2AC 
Member authorization for income verification:  18 
Update your beneficiary information:  3

CollapseBenefit Application Process

 Apply for Service or Early Retirement:  10
 Apply for IBRP:  10-05
 Apply for DROP:  10DR
 Apply for Retirement after DROP:  10DRC
 Apply for Disability Retirement:  12
 Submit application for Survivor's Benefits:  13