Retirement forms

Welcome to the Retirement Forms section of the York County Controller’s Office. Here you’ll find forms for active and vested employees in the County’s retirement plan.

The Member Data and Designation of Beneficiary form is for active and vested employees. It designates the beneficiary of the lump sum retirement balance or, for members with more than 10 years of service, the recipient of the total Death benefit.

The Death Benefit as Monthly Life Pension to Beneficiary - Option Two - D is for active employees with more than 10 years of service only. This form can be filled out instead of the Member Data and Designation of Beneficiary if the active employee prefers the primary beneficiary receive a monthly benefit instead of a lump sum death benefit in the event the active member’s death.

Request for a Change in Member's Contribution Rate - This is for active employees only. It is used to increase or decrease an active employees contribution into the retirement plan. Employees can contribute up to 15 percent of their earnings into the plan, with the county matching up to 5 percent. Only the first 5 percent of an employee’s contribution is pre-tax.

The Request For Vesting form is for employees vested in the pension plan who have left service. It authorizes the county to vest  retirement funds until you are eligible to receive a deferred normal pension upon reaching superannuation retirement age (age 60).

Request for Refund of Accumulated Deductions When Individuals is Entitled to Vest and Authorization for DistributionThis form is for employees who have completed five years of service and are fully vested in the pension plan. It authorizes the county to refund your retirement funds.  Refund is payable to the employee less applicable federal taxes, or can be rolled over into an IRA.  Employees who choose this option forfeit their “vested pension.”

Request for Refund of Accumulated Deductions and Authorization For Distribution: This form is for employees who leave county service before they have vested in the pensions plan (five years of service). This form authorizes distribution of an employee's contribution toward the plan. The refund is payable to the employee less applicable federal taxes, or can be rolled over into an IRA.