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Total Rewards forms and guides

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Name/Description File type
Beneficiary designation form for active employees

Active employee Beneficiary Designation Form to be used for beneficiary designations for Basic Life, Supplemental Life, Accidental Death and Dismemberment, and pre-retirement death.

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Employee Contribution Agreement (for 401(a))

Form to designate employee contributions to the university’s 401(a) Supplemental Retirement Plan.

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Notice of Intent to Retire (NOI) form

Use this form to officially announce your plans to retire from the university. Submit this form to your department in time to allow the information to reach the University of Missouri System Retirement Program at least 90 days prior to your retirement date.

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Supplemental retirement 401(a) irrevocable election form

Form for enrolling in the 401(a) supplemental retirement plan.

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Direct Deposit for Retirees—Form 32B: Authorization and Order for Payroll Check Direct Deposit

The direct deposit form is located on the HR Forms webpage. Locate it in the list by the name (Direct Deposit) or the form number (32B).

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Retiree Change of Address Form

Retirees may use this form to change their mailing address with the University of Missouri System retirement office.

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Proof of relationship requirement

Proof of relationship requirements to confirm the individual or individuals to be covered are eligible under the specific definitions of the plans.

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Enrollment and Beneficiary Form: Qualified Plan (for 401(a))

Form from Fidelity for enrolling in the 401(a) Supplemental Retirement Plan and designating beneficiaries.

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University of Missouri Deferred Vested Benefits - Designation of Beneficiary for Death Benefit

Designate beneficiaries for the Retirement, Disability and Death (RDD) Benefit Plan’s Deferred Vested Benefit.

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University of Missouri Deferred Vested Benefits - Designation of Beneficiary for Guaranteed Period

Designate beneficiaries for the Retirement, Disability and Death (RDD) Benefit Plan’s Guaranteed Period Option.

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University of Missouri Retirement Benefits - Designation of Beneficiary for Guaranteed Period

Designate beneficiaries for retirement benefits under the Retirement, Disability and Death (RDD) Benefit Plan’s Guaranteed Period Option.

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Employee’s Illinois Withholding Allowance Certificate and Instructions (IL W-4)

You must complete this form so your employer can withhold the correct amount of Illinois Income Tax from your pay.

NOTE: You will be redirected to the Illinois Revenue website to access this form.

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Faculty Performance Shares Plan Option Exercise Request Notice

Form used to exercise the option to sell shares of Fidelity Investments Asset Manager 50%, to which an individual may be entitled under the terms and conditions of the University of Missouri Faculty Performance Shares Plan.

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Missouri Department of Revenue Withholding Certificate for Pension or Annuity Statements (MO W-4P)

This certificate is for voluntary withholding of Missouri State Income Tax from pension or annuity income only.

NOTE: You will be redirected to the Missouri Department of Revenue website to access this form.

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Statement of Tax Responsibility form

Form for formally requesting the university to not withhold Missouri income taxes from pay due to an employee performing services for the university outside of Missouri, or an employe being a retiree residing outside of Missouri.

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Witholding Certificate for Pension or Annuity Payments (IRS Form W-4P)

Form W-4P is for U.S. citizens, resident aliens, or their estates who are recipients of pensions, annuities (including commercial annuities), and certain other deferred compensation. Use Form W-4P to tell payers the correct amount of federal income tax to withhold from your payment(s).

NOTE: You will be redirected to the IRS website to access this form.

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401(a) Supplemental Retirement Plan Employer Contribution Nomination

Nomination form for the employing unit to contribute to a 401(a) Supplemental Retirement Plan.

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Request for Retirement or Vested Benefit Estimate

Use this form to request an estimate of your retirement or vested benefit estimate

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Request for Review of Prior Service

Complete and submit this form in order for the University of Missouri System Retirement Program to review your prior service with the university. To be eligible for any prior service, your previous employment must have been at least one year in length with an FTE of at least 75%.

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University of Missouri Retirement, Disability and Death Benefit Plan Division of Benefits Order

​Division of benefits order template to specify division of university pension benefits upon divorce.

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