Arizona Administrative Code › Title 2 - ADMINISTRATION › Chapter 8 - STATE RETIREMENT SYSTEM BOARD › Article 1 - RETIREMENT SYSTEM › Section R2-8-133 - Survivor Benefit Applications

Current through Register Vol. 30, No. 28, July 12, 2024
A. The definitions
				in R2-8-126 apply to this Section.
B. The ASRS shall not distribute a survivor
				benefit until a claimant notifies the ASRS of a member's death by telephone or
				submission of a death certificate, unless the member elected a Joint and
				Survivor Benefit Option upon retirement.
C. Upon notification of the death of a
				member, the ASRS shall distribute the survivor benefits according to the most
				recent, Acceptable Form that is On File with the ASRS that was received at
				least one day prior to the date of the member's death, unless otherwise
				provided by law.
D. The designated
				beneficiary or other person specified in A.R.S. §
									38-762(E)  shall provide
				the following:
1. An original certified death
				certificate or a certified copy of a court order that establishes the member's
				death;
2. If the claimant is not a
				designated beneficiary, but is a person specified in A.R.S. §
										38-762(E), a
				copy of a document issued from a federal, state, local, sovereign, or medical
				institution showing the claimant's relationship to the deceased
				member;
3. A certified copy of the
				court order of appointment as administrator, if applicable; and
4. Except if the deceased member was retired
				and elected the joint and survivor option, complete and have notarized an
				Application for Survivor Benefits, provided by the ASRS that includes:
a. The deceased member's full name,
b. The deceased member's Social Security
				number or U.S. Tax Identification number,
c. The benefit the designated beneficiary or
				other person specified in A.R.S. §
											38-762(E)  is electing;
d. If the designated beneficiary or other
				person specified in A.R.S. §
											38-762(E)  is electing to roll over a benefit,
				the following information:
i. The claimant's
				full name;
ii. The name of the
				institution to which the claimant is electing to roll over;
iii. The address of the institution to which
				the claimant is electing to roll over;
iv. The full name of the authorized
				representative of the institution to which the claimant is electing to roll
				over;
v. The signature of the
				authorized representative of the institution to which the claimant is electing
				to roll over;
e. If the
				beneficiary is electing to have any of the survivor benefits directly deposited
				into a bank account, the following information:
i. Whether the bank account is a checking or
				savings account;
ii. The name of
				the banking institution to which the benefit is being sent;
iii. The routing number;
iv. The account number; and
f. The following information for
				the designated beneficiary or other person specified in A.R.S. §
											38-762(E):
i. Full name;
ii. Mailing address, if not On File with
				ASRS;
iii. Date of birth, if
				applicable; and
iv. Social Security
				number or U.S. Tax Identification number, if not On File with ASRS.
g. The following statements of
				understanding:
i. The designated beneficiary
				or other person specified in A.R.S. §
												38-762(E)  has read and understands
				the Special Tax Notice Regarding Plan Payments they received with this
				application;
ii. The designated
				beneficiary or other person specified in A.R.S. §
												38-762(E)  authorizes the
				ASRS to make payments as indicated above and agree on behalf of themselves and
				their heirs that such payments shall be a complete discharge of the claim and
				shall constitute a release of the ASRS from any further obligation on account
				of the benefit;
iii. The designated
				beneficiary or other person specified in A.R.S. §
												38-762(E)  authorizes the
				ASRS and the Banking Institution listed above to debit their account for the
				purposes of correcting errors and returning any payments inadvertently made
				after their death;
iv. Under
				penalties of perjury, the designated beneficiary or other person specified in
				A.R.S. §
												38-762(E)  certifies that:
(1)
				The Social Security number or U.S. Tax Identification number shown on this
				application is correct;
(2) They
				are not subject to backup withholding because:
(a) They are exempt from backup withholding,
				or
(b) They have not been notified
				by the Internal Revenue Service that they are subject to backup withholding as
				a result of a failure to report all interest or dividends, or
(c) The Internal Revenue Service has notified
				them that they are no longer subject to backup withholding; and
(3) They are a legal resident of
				the United States, unless they are an estate or trust.
v. The designated beneficiary or other person
				specified in A.R.S. §
												38-762(E)  understands their right to a 30-day notice
				period to consider a rollover or a cash distribution and they elect to waive
				the notice period by their election for payment on this application;
vi. The designated beneficiary or other
				person specified in A.R.S. §
												38-762(E)  understands if they elect to roll
				over all or any portion of their distribution to another eligible retirement
				plan, it is their responsibility to verify that the receiving plan will accept
				the rollover and, if applicable, agree to separately account for the taxable
				and nontaxable amounts rolled over and the related subsequent earnings on such
				amounts;
vii. The designated
				beneficiary or other person specified in A.R.S. §
												38-762(E)  understands if
				they elect to roll over all or any portion of their distribution to an IRA
				plan, it is their responsibility to verify that the receiving IRA institution
				will accept the rollover and, if applicable, it is their responsibility to
				separately account for taxable and nontaxable amounts;
viii. The designated beneficiary or other
				person specified in A.R.S. §
												38-762(E)  understands if they elect to roll
				over to another eligible retirement plan, any portion of the distribution not
				designated for a rollover will be paid directly to them and any taxable amounts
				will be subject to federal and state income tax withholding;
ix. The designated beneficiary or other
				person specified in A.R.S. §
												38-762(E)  understands if they elect to roll
				over to an inherited IRA plan, any portion of the distribution not designated
				for a rollover will be paid directly to them and any taxable amounts will be
				subject to federal and state income tax withholding.
xi. The designated beneficiary or other
				person specified in A.R.S. §
												38-762(E)  understands if they elect to roll
				over to an inherited IRA plan, they may be required to receive a minimum
				distribution and they certify that the date of birth shown on this form is
				correct.
5. For
				a member who elected a Joint and Survivor Retirement Benefit Option, a
				contingent annuitant shall submit a Joint and Survivor Certification form
				containing:
a. The following information for
				the member:
i. Full name;
ii. Social Security number or U.S. Tax
				Identification number;
iii. Date of
				death; and
b. The
				following information for the beneficiary:
i.
				Legal relationship to the member;
ii. Full name;
iii. Social Security number or United States
				Tax Identification number, if not On File with ASRS;
iv. Mailing address, if not On File with
				ASRS;
v. Date of birth, if not On
				File with ASRS;
vi. If the
				contingent annuitant is electing to have any of the survivor benefits directly
				deposited into a bank account, the following information:
(1) Whether the bank account is a checking or
				savings account;
(2) The name of
				the banking institution to which the benefit is being sent;
(3) The routing number;
(4) The account number; and
c. The following
				statements of understanding:
i. The contingent
				annuitant has read and understands the Special Tax Notice Regarding Plan
				Payments they received with the Joint and Survivor Certification
				form;
ii. The contingent annuitant
				authorizes the ASRS to make payments as indicated above and agree on behalf of
				themselves and their heirs that such payments shall be a complete discharge of
				the claim and shall constitute a release of the ASRS from any further
				obligation on account of the benefit; and
iii. The contingent annuitant authorizes the
				ASRS and the Banking Institution listed above to debit their account for the
				purposes of correcting errors and returning any payments inadvertently made
				after their death.
d. The
				contingent annuitant's notarized signature.