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Retirement Forms

While you're here, click on the tabs above to find information and resources about retirement.

457 Deferred Compensation Plan Enrollment Form    
Participation Agreement and Service Request
(Pay Center: 6, Agency Code UA
PDF Enroll Online
Phased Retirement Agreement    
Phased Retirement Program Agreement Template and Age Discrimination in Employment Act Disclosure PDF  
Retiree Medical Forms    
2023 Group Participant Medicare Part D Enrollment Form - ADOA PDF Additional Information
2023 Retiree Health Benefits Enrollment Form - ADOA PDF Additional Information
Retiree Accumulated Sick Leave Forms (Submit to Human Resources via secure document upload https://hr.arizona.edu/submit-documents)
Retiree Accumulated Sick Leave (RASL) Form (GAO-SL-50) PDF                                 Additional Information
Employee's Arizona Withholding Election (Submit with RASL form) PDF Additional Information
Retiree Accumulated Sick Leave Checklist for University Employees
   (Submit with RASL form)
PDF Additional Information
Retiree Accumulated Sick Leave Federal Taxes
   (Submit with RASL form)
PDF Additional Information
Retiree Accumulated Sick Leave Nationwide - Deferral Notification Form
   (Submit with RASL form - if applicable)
PDF Additional Information