Forms

These are our most commonly used forms. Personal information entered on all electronic or paper forms is subject to the Washington Public Records Act, and may be subject to disclosure to a third-party requestor.  At the City of Seattle, we are committed to protecting your privacy and will ensure that any disclosures are done according to law.  To learn more about how this information is managed, please see our Privacy Statement.

Any form that requires notarization or attachments should be mailed to SCERS, 720 3rd Avenue, Suite 900, Seattle WA  98104.  Please note that active members should change their primary work phone number, home address, and personal email through Employee Self-Service (ESS).  Other changes such as name, marital status, gender, or work email must be made through their department. Home phone number changes can be made on the Change Form or through the Member Self-Service (MSS) Portal.

If you prefer to drop off the form in person rather than mailing, you may drop off your document to our offices during our service window hours from 9:00 am to 4:00 pm on Tuesdays, Wednesdays, and Thursdays.  Effective February 27, 2024, service window hours will be 8:30 am to 4:30 pm on Tuesdays, Wednesdays, and Thursdays.

Forms may be submitted as follows:                                                                                                                                    

 

Document Name Submit Via Adobe Sign  Email   Fax   Mail   Secure Message via MSS Portal  
Beneficiary Designation Form         X X
Benefit Estimate Request Form X X X X X
Change Form
X X X
Direct Deposit Authorization Form X X
Disability Retirement Application Form X X X
Exempt Employees - Membership Application X X X X
Plan 2 Notice and Election Form X X X X
Portability Claim Form X X X X X
Service Credit Purchase Request Form X X X X X

W-4P with instructions

X
X X
Withdrawal of Contributions - Beneficiary Application X
Withdrawal of Contributions - Member Application X

 

  • Fax to (206) 386-1506; please note that Disability Retirement Application Forms should be faxed to (206) 470-6767.
  • Mail to SCERS, 720 3rd Avenue, Suite 900, Seattle WA  98104
  • Send the document via secure message on your Member Self-Service account
  • Email to retirecity@seattle.gov.  To protect your personal information, the only forms that can be emailed are:  Membership Application for Exempt Employees; Plan 2 Notice and Election Form; Portability Claim Form; and Service Credit Purchase Request.

Please feel free to contact us at (206) 386-1293 if you have questions.

Retirement

Jeffrey S. Davis, Executive Director
Address: 720 3rd Ave, 9th Floor, Seattle, WA, 98104
Phone: (206) 386-1293
Fax: (206) 386-1506
retirecity@seattle.gov
Contact Us

The City of Seattle Employees' Retirement Office has two major functions: administration of retirement benefits and management of the assets of the Retirement Fund. Employee and employer contributions as well as investment earnings provide funding for the System.

The Mission of SCERS is to fulfill the promise made to our members by delivering the retirement benefits they have earned.