Get Form 170s 2020-2025

Filling out the Form 170S online for authorizing direct deposit of a survivor's benefit can be simplified with a structured approach. This guide provides clear instructions for each section to ensure that your form is correctly completed and submitted.

Follow the steps to complete Form 170S online efficiently.

1. Press the ‘Get Form’ button to access the form and open it in the online editor.
2. Section A requires you to provide details about the Retirement Systems member. Fill in the last name, first name, middle initial, suffix, and member ID.
3. Section B is for your personal information. Input your first name, middle initial, last name, last four digits of your Social Security number, suffix, mailing address, city, state, zip, telephone number, and date of birth. If there are any changes to your contact information, check the appropriate box.
4. In Section C, select your retirement system by choosing one from the options provided, including Teachers' and State Employees' Retirement System, Legislative Retirement System, Local Governmental Employees' Retirement System, or Consolidated Judicial Retirement System.
5. Section D requires you to provide bank account information. Indicate the name of the bank, what type of account it is (checking or savings), and provide the bank's address.
6. Fill in your bank routing number and bank account number in Section E.
7. In Section F, certify your selections by signing and dating the form. Ensure you acknowledge that you authorize the Retirement Systems Division to make deposits and that you have completed the form properly.
8. The form must then be notarized. Ensure that the notary public completes their section appropriately before submission.
9. Once completed, save your changes, and if desired, download, print, or share the form as needed.

Complete your Form 170S online today to ensure timely processing of your survivor's benefit.