The purpose of this rule development is to change this rule from the rule in which all Division forms are incorporated by reference to a listing of Division forms incorporated by reference throughout Chapter 60S-9, F.A.C.

 

DEPARTMENT OF MANAGEMENT SERVICES
Division of Retirement

RULE NO.: RULE TITLE:
60S-9.001: Approved Forms

PURPOSE AND EFFECT: The purpose of this rule development is to change this rule from the rule in which all Division forms are incorporated by reference to a listing of Division forms incorporated by reference throughout Chapter 60S-9, F.A.C.

SUMMARY: This rule has been revised to be a listing of all Division forms incorporated by reference throughout chapter 60S-9, F.A.C. rather than the rule where Division forms are incorporated by reference.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COST:

No State of Estimated Regulatory Cost was prepared. The agency has determined that this rule shall not have an effect on small businesses as defined by Section 288.703, Florida Statutes, nor on small counties or small cities as defined by Section 120.52, Florida Statutes.

Any person who wishes to provide information regarding the statement of estimated costs or to provide a proposal for a lower regulatory cost alternative must do so in writing within 21 days of this notice.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimate regulatory costs or if no SERC is required, the information expressly relied upon and described herein:

Not required because there are no adverse impacts on economic growth, business competitiveness or regulatory costs of more than $1M in the aggregate within five years of implementation.

RULEMAKING AUTHORITY: 121.031, 121.4501 FS.
LAW IMPLEMENTED: 1.01, 112.215, 112.361, 112.363, 120.55, 121.011, 121.015, 122.021, 121.031(2), 121.051, 121.0515, 121.053, 121.081, 121.091, 121.111, 121.115, 121.1122, 121.121, 121.125, 121.35, 121.4501, 121.591, 122.08, 122.09, 215.28, 238.05, 238.06, 238.07, 689.21, 1012.01 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW

DATE AND TIME: November 4, 2011, 10:00 a.m., ET

PLACE: Division of Retirement of the Department of Management Services, Director’s Conference Room, Suite 208, 1317 Winewood Blvd., Bldg. 8, Tallahassee, Florida 32399-1560

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Garry Green, Operations and Management Consultant Manager, Department of Management Services, Division of Retirement, 1317 Winewood Blvd., Bldg. 8, Tallahassee FL 32399-1560, [phone]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

60S-9.001 Approved Forms.

The following is a list of the forms utilized by the Division of Retirement in its dealings with the public, which are hereby incorporated by reference throughout Chapter 60S, F.A.C. into these rules. A copy of these forms may be obtained from the Division’s website (http://frs.myflorida.com) or by writing to the Division of Retirement, P. O. Box 9000, Tallahassee, Florida 32315-9000. You may also call the Division to request a copy of these forms by calling [phone]. If calling from outside the Tallahassee calling area, you may call the Division toll-free at [phone].

(1)(a) Bureau of Enrollment and Contributions.

 

FORM NO./REVISION DATE	TITLE/DESCRIPTION
1. BEN-001 (Rev. 6/04)	Florida Retirement System Pension Plan Beneficiary Designation Form Active Members Only – a one-page form.
2. FRS-400 (Rev. 4/00)	Florida Retirement System Application for Special Risk Membership Membership Law Enforcement/Correctional Officers – a one-page form.
3. FRS-401 (Rev. 7/99)	Florida Retirement System Special Risk Credit for Past Service – a one-page form.
4. FRS-402 (Rev. 10/01)	Florida Retirement System Application for Special Risk Equivalent Credit – a one-page form.
5. FRS-404 (Rev. 11/02)	Florida Retirement System Application for Special Risk Administrative Support Class – a one-page form.
6. FRS-405 (Rev. 10/03)	Florida Retirement System Application for Special Risk Membership Firefighters/Paramedics/EMTs – a one-page form.
7. ERQ-1 (Rev. 8/06)	Florida Retirement System Pension Plan Employment Relationship Questionaire for Retirees Within the 2nd – 12th Months – a five-page form.
8. BLE-1 (8/99)	Florida Retirement System Pension Plan Ballot for Member of an Existing Retirement System – a one-page form.
9. SMSD-1 (Rev. 8/00)	Florida Retirement System Senior Management Service Class Designated Position Form – a two-page document consisting of one-page of instruction and a one-page form.
10. FRS-410 (08/05)	Florida Retirement System Application for Special Risk Class Membership Forensic Discipline from October 2005 through June 2008 – a one-page form.
11. FRS-415	Florida Retirement System Application for Special Risk Class Membership for Forensic Discipline effective July 2008 – a one-page form.
11. FR-SUSORP (08/07)	Florida Retirement System Verification of State University Optional Retirement System Service (SUSORP) Service Dates – a one-page form.
(b) State Board of Administration – Enrollment and Election forms.
FORM NO./REVISION DATE	TITLE/DESCRIPTION
1. OCC-1 (Rev. 07/07)	Community College Optional Retirement Program (CCORP) Enrollment Form.
2. OCC-2 (Rev. 07/07)	Community College Optional Retirement Program (CCORP) Retirement Plan Conversion Form.
3. SMS-1 (Rev. 07/07)	State Senior Management Service Employees Retirement Plan Enrollment Form.
4. SMS-3 (Rev. 07/07)	Local Senior Management Service Employees Retirement Plan Enrollment Form.
5. EOC-1 (Rev. 07/07)	Elected Officers’ Class Retirement Plan Enrollment Form.
6. ELE-1 (Rev. 07/07)	GENERAL Retirement Plan Enrollment Form for Regular, Special Risk, and Special Risk Administrative Support Class Employees.
7. ELE-1-EZ (Rev. 07/07)	EZ Retirement Plan Enrollment Form for Regular, Special Risk, and Special Risk Administrative Support Class Employees.
8. ELE-2 (Rev. 07/07)	2nd Election Retirement Plan Enrollment Form.
9. ELE-2-EZ (Rev. 07/07)	2nd Election EZ Retirement Plan Enrollment Form.
10. ORP-16 (Rev. 7/07)	State University System Optional Retirement Program (SUSORP) Retirement Plan Enrollment Form.
11. CERT	Florida Retirement System (FRS) – Certification Form
11. SMS-4 (11/05)	Retirement Plan CONVERSION Form for Local Employer Senior Management Service Class (SMSC) Members.

 

(2) Bureau of Retirement Calculations.

 

FORM NO./REVISION DATE	TITLE/DESCRIPTION
(a) FR-9 (Rev. 6/04)	Florida Retirement System Pension Plan Information Request a one-page form.
(a)(b) FR-11 (Rev. 7/06)	Florida Retirement System Pension Plan Application for Service Retirement – a two-page document consisting of one page of instruction and a one-page form.
(b)(c) SR-11 (Rev. 9/07)	State and County Officers’ and Employees’ Retirement System Application for Service Retirement – a two-page document consisting of one page of instruction and a one-page form.
(c)(d) TR-11 (Rev. 9/07)	Teachers’ Retirement System Application for Service Retirement – a two-page document consisting of one page of instruction and a one-page form.
(d)(e) FR-28 (Rev. 6/04)	Division of Retirement Pension Plan Application to Purchase Retirement Credit for a Pension Plan Leave of Absence – a two-page document consisting of one page of information and a one-page form.
(e)(f) MF-1 (Rev. 7/06	Florida Retirement System Pension Plan Statement of Military Eligibility – a two-page document consisting of one-page of information and a one-page form.
(f)(g) TR-4 (Rev. 4/99)	Florida Retirement System Verification of Out-of-State Teaching Service – a two-page document consisting of one page of instruction and a one-page form.
(h) OSE-1 (Rev. 7/99)	Florida Retirement System Eligibility for In-State or Out-of-State Service – a one-page form.
(i) WC-1 (Rev. 7/99)	Florida Retirement System Certification of Workers’ Compensation – a one-page form.
(j) FC-1 (Rev. 7/04)	Florida Retirement System Pension Plan Salary Certification – a two-page document consisting of one page of instruction and a one-page form.
(g)(k) MF-2 (Rev. 7/06)	Florida Retirement System Pension Plan Statement of Military Eligibility to Purchase Military Service Under the Out-of-State Provisions – a two-page document consisting of one-page of information and one-page form.
(h)(l) FR-23 (Rev. 5/05)	Florida Retirement System Pension Plan Notification of Reemployment or Suspension of Retirement Benefits – a one-page form.
(i)(m) FR-23a (Rev. 5/05)	Florida Retirement System Pension Plan Application to Reactivate Retirement Benefits – a one-page form.
(j)(n) FR-30 (Rev. 7/04)	Florida Retirement System Pension Plan Verification for In-State or Out-of-State Service Credit – a three-page document consisting of one-page of instruction and a two-page form.
(k)(o) FR-30a (Rev. 7/04)	Florida Retirement System Pension Plan Out-of-State Employer Request – a one-page form.
(l)(p) FRS-11o (Rev. 7/06)	Florida Retirement System Pension Plan Option Selection for FRS Members – a one-page form.
(m)(q) FST-11o (Rev. 7/06)	Florida Retirement System Pension Plan Option Selection for TRS and SCOERS Members – a one-page form.
(n)(r) DP-ELE (Rev. 7/06)	Florida Retirement System Pension Plan Notice of Election to Participate in the Deferred Retirement Option Program (DROP) and Resignation of Employment – a two-page document with one-page of information and a one-page form.
(o)(s) DP-11 (Rev. 7/06)	Florida Retirement System Pension Plan Application for Service Retirement and the Deferred Retirement Option Program (DROP) – a two-page form consisting of one page of instruction and a one page form.
(p)(t) DT-11 (Rev. 7/06)	Teachers’ Retirement System Application for Service Retirement and the Deferred Retirement Option Program (DROP) – a two-page document consisting of two page of information and a one-page form.
(q)(u) DS-11 (Rev. 7/06)	State and County Officers’ and Employees’ Retirement System Application for Service Retirement and the Deferred Retirement Option Program (DROP) – a two-page document consisting of two page of instruction and a one-page form.
(r)(v) DP-EXT (Rev. 7/07)	Florida Retirement System Pension Plan Extension of Deferred Retirement Option Program (DROP) for Specified K-12 Instructional Personnel – a one page form.
(s)(w) PRO-1 (Rev. 10/07)	Florida Retirement System Pension Plan (401(a) Plan) Pretax Direct Rollover/Transfer Form – a one-page form.
(t)(x) HIS-IP (7/04)	Florida Retirement System (FRS) Application for Health Insurance Subsidy for Investment Plan Members – a two-page document consisting of one-page of instruction and a one-page form.
(u) (y) HIS IP-2 (7/04)	Florida Retirement System Health Insurance Subsidy Certification for Investment Plan Members – a one-page form.
(v)(z) SA-1 (5/00)	Division of Retirement Spousal Acknowledgement – a one-page form.

 

(3) Bureau of Benefit Payments.

 

FORM NO./REVISION DATE (a) FR-13 (Rev. 7/06)	TITLE/DESCRIPTION Florida Retirement System Pension Plan Application for Disability Retirement – a four-page document consisting of two pages of instruction and a two-page form.
(b) FR-13a (Rev. 7/06)	Florida Retirement System Statement of Disability by Employer – a two-page form.
(c) FR-13b (Rev. 6/06)	Florida Retirement System Physician’s Report of Disability a two-page form.
(d) TR-13 (Rev. 10/86)	Teachers’ Retirement System of Florida Application for Disability Retirement – a one-page form.
(e) TR-13a (Rev. 10/86)	Teachers’ Retirement System of Florida Member’s Statement of Disability – a one-page form.
(f) TR-13b (Rev. 10/86)	Teachers’ Retirement System of Florida Physician’s Report of Disability – a one-page form.
(g) SR-13 (Rev. 9/71)	State and County Officers’ and Employees’ Retirement System Application for Disability Retirement – a one-page form.
(h) SR-13a (Rev. 9/71)	State and County Officers’ and Employees’ Retirement System Member’s Statement of Disability – a one-page form.
(i) SR-13b (Rev. 9/71)	State and County Officers’ and Employees’ Retirement System Physician’s Report of Disability – a one-page form.
(j) FR-13e (Rev. 7/06)	Florida Retirement System Retiree’s Report of Continuing Disability – a two-page form.
(k) FR-13f (Rev. 7/06)	Florida Retirement System Physician’s Report of Reexamination – a two-page form.
(l) TR-13e (Rev. 2/88)	Teachers’ Retirement System Retiree’s Report of Continuing Disability – a four page form.
(m) TR-13f (Rev. 7/81)	Teachers’ Retirement System Physician’s Report of Reexamination – a four-page form.
(n) SR-13e (10/86)	State and County Officers’ and Employees’ Retirement System Retiree’s Report of Continuing Disability – a four-page form.
(o) SR-13f (Rev. 7/81)	State and County Officers’ and Employees’ Retirement System Physician’s Report of Reexamination – a four-page form.
(p) FRS-M81 (Rev. 7/01)	Florida Retirement System Pension Plan Request for Refund – a one page form.
(q) HIS-1 (Rev. 7/05)	Florida Retirement System Pension Plan Health Insurance Subsidy Certification Form – a two-page document consisting of one page of instruction and a one-page form.
(r) FST-12 (Rev. 12/02)	Florida Retirement System Pension Plan Beneficiary Designation Form (Retired Members Only) – a one-page form.
(s) JA-1 (Rev. 12/02)	Florida Retirement System Pension Plan Change of Joint Annuitant Form (Retired Members Only) – a one-page form.
(t) AAPS (Rev. 8/00)	Florida Retirement System Pension Plan Affidavit Attesting to Payee Status – a one-page form.
(u) FST-11b (Rev. 12/02)	Florida Retirement System Pension Plan Application of Beneficiary for Monthly Retirement Benefits – a one-page form.
(v) FST-11g (Rev. 12/02)	Florida Retirement System Pension Plan Application of Beneficiary for Benefit Payment – a one-page form.
(w) TR-11c (Rev. 12/02)	Teachers’ Retirement System Application for Survivor Benefits – a two-page document consisting of one - page of information and a one-page form.
(x) SRF-2 (Rev. 7/99)	Florida Retirement System Pension Plan Student Report Form – a one-page form.
(y) SRF-3 (Rev. 7/99)	Florida Retirement System Pension Plan Authorization for Release of Information – a one-page form.
(z) SVF-1 (Rev. 7/99)	Florida Retirement System Pension Plan Student Verification of Enrollment by Institution – a one-page form.
(z)(aa) SVF-2 (Rev. 7/99)	Florida Retirement System Pension Plan Affidavit Attesting to Eligibility – a one-page form.
(aa)(bb) DIS-1 (Rev. 4/06)	Florida Retirement System Pension Plan Disclaimer of Benefits – a two-page document consisting of one-page of instruction and a one-page form.
(bb) (cc) JA-NUL (Rev. 7/99)	Florida Retirement System Pension Plan Joint Annuitant Nullification Form – a one-page form.
(cc)(dd) FR-30b (Rev. 7/99)	Florida Retirement System Pension Plan Verification for In-State or Out-of-State Service Credit – a two-page form.
(dd)(ee) DP-TERM (Rev. 6/06)	Florida Retirement System Pension Plan Deferred Retirement Option Program (DROP) Termination Notification – a one-page form.
(ee)(ff) DP-PAYT (Rev. 3/03)	Florida Retirement System Pension Plan Deferred Retirement Option Program (DROP) Selected Payout Method – a one-page form.
(ff) (gg) DP-JOINT (Rev. 9/99)	Florida Retirement System Pension Plan Deferred Retirement Option Program (DROP) Joint Annuitant Verification – a one-page form.
(hh) Rollover (Rev. 7/01)	Florida Retirement System Pension Plan Direct Rollover Election Form – a one-page form.
(gg)(ii) DP-12 (Rev. 2/06)	Florida Retirement System Pension Plan Beneficiary Designation Form for the Alternate Payee of a DROP Participant – a one-page form.
(hh)(jj) SB-13b (Rev. 3/01)	Florida Retirement System Pension Plan Physician’s Report – a two-page form.
(ii)(kk) FST-11so2 (Rev. 12/02)	Florida Retirement System Pension Plan Application for Survivor Benefits – a one-page form.
(jj)(ll) DP-TEOC (9/01)	Florida Retirement System Pension Plan Deferred Retirement Option Program (DROP) Elected Officers’ Termination Notification – a one-page form.
(mm) DROLL (1/02)	Florida Retirement System Pension Plan Beneficiary Direct Rollover Election Form – a one-page form.
(kk)(nn) DIS-2 (Rev. 4/06)	Florida Retirement System Pension Plan Disclaimer of Benefits – a two-page document consisting of one page of instruction and a one-page form.
(ll)(oo) DIS-3 (Rev. 4/06)	Florida Retirement System Pension Plan Disclaimer of Benefits – a two-page document consisting of one page of instruction and a one-page form.
(mm)(pp) DP-VOID (4/03)	Florida Retirement System Pension Plan Deferred Retirement Option Program (DROP) Void Form – a one-page form.
(nn)(qq) SRA-1 Rev. (Rev. 12/04)	Florida Retirement System Pension Plan Service Retirement Agreement – a one-page form.
(oo)(rr) PR-13 (Rev. 7/06)	Florida Retirement System Investment Plan Application for Disability Retirement – a four-page form consisting of two pages of instruction and a two-page form.
(pp)(ss) PR-11o (7/04)	Florida Retirement System Investment Plan Option Selection for FRS Members – a one-page form.
(qq)(tt) DP-TEOC-2	Florida Retirement System Pension Plan Deferred Retirement Option Program (DROP) Elected Officer DROP Termination Notification – a one-page form.
(rr)(uu) DP-TEOC-3	Florida Retirement System Pension Plan Deferred Retirement Option Program (DROP) Elected Officer Employment Termination Notification – a one-page form.
(ss) SA-2	Florida Retirement System Investment Plan Spousal Acknowledgment Form for Disability Retirement – a one-page form.

 

(4) Administration.

FORM NO./REVISION DATE	TITLE
SAPS (Rev. 10/02)	Florida Retirement System Statement Attesting to Payee Status – a one-page form.

 

Rulemaking Authority 121.031 FS. Law Implemented 1.01, 112.215, 112.361, 112.363, 120.55, 121.011, 121.015, 122.021, 121.031(2), 121.051, 121.0515, 121.053, 121.081, 121.091, 121.111, 121.115, 121.1122, 121.121, 121.125, 121.35, 121.4501, 121.591, 122.08, 122.09, 215.28, 238.05, 238.06, 238.07, 689.21, 1012.01 FS. History– New 9-9-82, Amended 2-6-84, 11-6-84, 4-17-85, Formerly 22B-9.01, Amended 6-4-86, 12-5-90, Formerly 22B-9.001, Amended 1-4-93, 1-18-94, 4-26-94, 1-10-95, 11-2-95, 12-28-95, 3-12-96, 12-16-97, 10-14-98, 4-26-99, 1-24-00, 12-19-00, 2-6-01, 3-18-02, 10-23-05, 9-18-07, 5-22-08,________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Sarabeth Snuggs, Director, Division of Retirement

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: John P Miles, Secretary, Department of Management Services

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: July 20, 2011

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: June 18, 2010, Vol. 36/24