Forms Download

Welcome to the NPERS Forms Download page. Downloading and printing forms from this web site ensures you are using the most up-to-date version of the form.

All forms are in the Adobe Acrobat format. NPERS recommends using the Adobe Reader to properly view them. 3rd party viewers or web browser viewers may not properly view or print data from fillable fields. Download it here if you do not already have it.

NOTE: ENHANCED FORMS

Most of NPERS forms contain fillable fields allowing users the option to:

Enter information using their computer.

Print, sign, date, and notarize (if needed).

Then submit to our office.
Note: DCP forms must be submitted to your human resources or payroll department.

The Enhanced Form label indicates that a form has fillable fields.

Member Forms

Beneficiary Designation Enhanced Form	To designate or change your beneficiaries, complete this form, sign in front of a notary, and submit to NPERS.
For Annuities: Federal Income Tax Withholding Form Enhanced Form	NEW for 2023 Plan members who are receiving a PERIODIC monthly retirement benefit (annuity) may use this form to change their income tax withholding.
For Distributions OTHER THAN Annuities: Federal Income Tax Withholding Form Enhanced Form	NEW for 2023 Plan members who are receiving a NON-PERIODIC retirement payment may use this form to change their income tax withholding. NOTE: You DO NOT need to return a W-4R unless you want MORE than 20% federal income tax withheld.
All Distributions: Nebraska State Income Tax Withholding Form Enhanced Form	NEW for 2023 Plan members may use this form to change their Nebraska state income tax withholding for ANY TYPE of retirement payment (periodic or non-periodic).
Direct Deposit Enhanced Form	Plan members who are receiving a monthly retirement benefit may wish to have payments deposited directly into a designated bank account. Use this form to set up a new account or change an existing account. For a walkthrough of how to complete the Direct Deposit form click HERE.
Investment Election Form (Defined Contribution only) Enhanced Form	State and County members can submit this form to change future investment allocations or transfer existing funds.
Investment Election Form (DROP participants only) Enhanced Form	State Patrol DROP members can submit this form to change future investment allocations or transfer existing funds.
DCP Plan Enrollment/Change Enhanced Form	Members who wish to enroll in or make changes to their Deferred Compensation Plan, including adjusting contribution amounts, modifying investment allocations, or transferring funds, should complete this form and submit it to your agency payroll personnel for processing.
Application for Vesting Credit Enhanced Form	For plan members who are requesting vesting credit for prior participation in a Nebraska Governmental Plan.
Rollover to Financial Institution Enhanced Form	This form is required in order for NPERS to process a rollover. NPERS cannot process a rollover until we are in receipt of a completed, signed and notarized, Request for Distribution or Refund form.
School Refund Application Enhanced Form	School plan members submit this form to request distribution of their account. Refunds or rollovers will remove your service credit and do not include the employer contributions. For a walkthrough of how to complete the School Refund Application click HERE
Omaha School Refund Application Enhanced Form	Omaha School plan members submit this form to request distribution of their account. Refunds or rollovers will remove your service credit and do not include the employer contributions. For a walkthrough of how to complete the Omaha School Refund Application click HERE
Address & Name Change Form Enhanced Form	Terminated members can submit this form to update their address, or notify our office of name changes. If you are actively employed by the Nebraska School, Omaha School, State, County, Judges or State Patrol, these demographic changes must be submitted to your employer.
Patrol Member - Verification of Service Request Enhanced Form	Patrol plan members may submit this form to NPERS to request a tentative verification of service from NPERS up to one year but no less than 180 days prior to retirement or entering DROP.