Retirement Systems Forms

The following forms are in PDF format.

  • Dental Form                                                                                   Retiree Dental Enrollment Form
  • Dental Rates                                                                                  Retiree Dental Rates     
  • Designation of Beneficiary Form                                       Designation of Beneficiary Form
  • Federal Withholding Worksheet                                       Retirement Office Worksheet Form
  • Retiree Change of Address Form                                       Retiree Change of Address Form
  • Retiree Direct Deposit Form                                                Retiree Direct Deposit Form
  • State Withholding Worksheet                                             Retirement Office Worksheet Form
  • W-4P                                                                                                    IRS Tax Withholding Form
  • W-4VT                                                                                                 Vermont Tax Withholding Form

Teachers Forms

State Forms

Municipal Forms

Contact Us

Office of the State Treasurer
109 State Street
Montpelier, Vermont 05609

Main Phone: (802) 828-2301
Toll Free: (800) 253-0191
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