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Publications

Numeric List of ET- Forms and Brochures

The following list contains ET- forms for member use. If the form number you are seeking does not begin with ET-, we suggest you search for it by program or alphabetically.

Employer forms are not included in this list.

Many documents on this site are in Adobe Acrobat PDF format. Download a free version. Adobe Reader does not allow users to save completed fillable PDFs to their computer. Refer to the Adobe Web site for more information on fillable PDFs.


ET-1000s Forms

(ET-1137) Employer Options for Providing Increased Retirement Benefits

(ET-1311) Resolution to Increase Prior Creditable Service

(ET-1518) Medical Expense Account Continuation Election Form

ET-2000s Forms

(ET-2101) Wisconsin Public Employers Group Life Insurance Plan

(ET-2106) Income Continuation Insurance - State

(ET-2107d-12) It's Your Choice 2012 - State Employees, Annuitants and Continuants and Graduate Assistants - Decision Guide

(ET-2107d-11) It's Your Choice 2011 - State Employees, Annuitants and Continuants and Graduate Assistants - Decision Guide

(ET-2107d-10) It's Your Choice 2010 - State Employees, Annuitants and Continuants and Graduate Assistants - Decision Guide

(ET-2107r-12) It's Your Choice 2012 - State Employees, Annuitants and Continuants and Graduate Assistants - Reference Book

(ET-2107r-11) It's Your Choice 2011 - State Employees, Annuitants and Continuants and Graduate Assistants - Reference Book

(ET-2107r-10) It's Your Choice 2010 - State Employees, Annuitants and Continuants and Graduate Assistants - Reference Book

(ET-2112) Standard Plan - State Employees

(ET-2119) Your Benefit Handbook

(ET-2121) How Part-Time Employment Affects Your Benefits

(ET-2123) Additional Contributions

(ET-2124) Investment Earnings Distribution Report

(ET-2128d-12) It's Your Choice 2012 - Wisconsin Public Employees (Local Government Employees and Annuitants) - Decision Guide

(ET-2128d-11) It's Your Choice 2011 - Wisconsin Public Employees (Local Government Employees and Annuitants) - Decision Guide

(ET-2128d-10) It's Your Choice 2010 - Wisconsin Public Employees (Local Government Employees and Annuitants) - Decision Guide

(ET-2128r-12) It's Your Choice 2012 - Wisconsin Public Employees (Local Government Employees and Annuitants) - Reference Book

(ET-2128r-11) It's Your Choice 2011 - Wisconsin Public Employees (Local Government Employees and Annuitants) - Reference Book

(ET-2128r-10) It's Your Choice 2010 - Wisconsin Public Employees (Local Government Employees and Annuitants) - Reference Book

(ET-2129) Income Continuation Insurance - Local

(ET-2131) WPE Standard Plan Booklet

(ET-2157) Addendum-Traditional HMO-Standard PPP Program Option 3

(ET-2158) Addendum-Deductible HMO-Deductible Standard Plan Program Option 4

(ET-2159) Addendum-Deductible HMO-Deductible Standard PPP Program Option 5

(ET-2160) WPE Standard PPP Plan Booklet

(ET-2161) WPE Deductible Standard Plan Booklet

(ET-2162) WPE Deductible Standard PPP Plan Booklet

(ET-2163) WPE Deductible SMP Plan Booklet

(ET-2164) Group Life Insurance Plan Monthly Rates-2010-2011

(ET-2165) WPE SMP Plan Booklet

(ET-2166) Domestic Partner Benefits

(ET-2207) Buying Other Governmental Service

(ET-2301) Group Health Insurance Application/Change Form

(ET-2304) Life Insurance Application/Cancellation/Refusal

(ET-2305) Evidence of Insurability

(ET-2306) Conversion Information - Life Insurance

(ET-2307) Income Continuation Insurance Application-State

(ET-2313) Canceling Variable Participation

(ET-2320) Beneficiary Designation

(ET-2321) Beneficiary Designation (alternate form)

(ET-2325) Converting Your Group Life Insurance to Pay Health or Long-Term Care Insurance Premiums

(ET-2327) Living Benefits Brochure

( ET-2340) Automatic Premium Conversion Waiver/Revocation of Waiver

(ET-2356) Election to Participate in the Variable Trust Fund

(ET-2366) Income Continuation Insurance Application-Local

(ET-2371) Affidavit of Domestic Partners

(ET-2372) Affidavit of Termination of Domestic Partners

(ET-2405) ETF Insurance Complaint Form

(ET-2421) Request to Copy or Inspect Medical Information

(ET-2566) Maximum Voluntary Contributions Worksheet

(ET-2815) Name/Address Change

ET-3000s Forms

(ET-3101) Separation Benefits

ET-4000s Forms

(ET-4104) Group Life Insurance After You Terminate Employment

(ET-4106) Applying For Your Retirement Benefit

(ET-4107) Calculating Your Retirement Benefits

(ET-4112) Group Health Insurance

(ET-4113) State Medicare Plus

(ET-4116) Information for Retirees

(ET-4117) Choosing an Annuity Option

(ET-4121) Buying Creditable Service

(ET-4122) Military Service Credit

(ET-4125) Tax Liability on WRS Benefits

(ET-4132) Sick Leave Conversion Credit Brochure

(ET-4207) Retirement Estimate Request

(ET-4303) Waiver of Part-Time Elected Service

(ET-4305) Sick Leave Escrow Application

(ET-4307) Medicare Eligibility Statement

(ET-4310) Income Tax Withholding Election

Calculate and Print Your Income Tax Withholding Election (Retirees Only)

(ET-4317) Sick Leave Re-enrollment Application

(ET-4319) Retirement Annuity Option Change Application

(ET-4322) QDRO - Military Service Certification and Affidavit

(ET-4560) USERRA Certification

Federal USERRA Notice

(ET-4925) How Divorce Can Affect Your WRS Benefits

(ET-4926) QDRO - Order to Divide WRS Benefits

(ET-4930) How Participation in the Variable Trust Affects Your WRS Benefits

(ET-4935) QDRO - Foreign Jurisdiction Order to Divide WRS Benefits

(ET-4938) Appeal Form

(ET-4943) Administrative Appeal Process

(ET-4944) Limited Power-of-Attorney for Appeal

ET-5000s Forms

(ET-5103) s. 40.65 Duty Disability and Survivor Benefits

(ET-5107) Disability Benefits Folder

(ET-5108) Long-Term Disability Insurance Folder

ET-6000s Forms

(ET-6101) Death Benefits

(ET-6303) Notice of Death for Spouse or Dependent Child

ET-7000s Forms

(ET-7116) It's Your Benefit Newsletter

(ET-7282) Direct Deposit Authorization

(ET-7301) Benefit Information Request

(ET-7348) Telephone Message Center

(ET-7402) WRS News

(ET-7406) Authorization to Disclose Non-Medical Individual Personal Information

(ET-7414) Authorization to Disclose Medical Information

ET-8000s Forms

(ET-8501) Comprehensive Annual Financial Report

(ET-8900) Employee Reimbursement Accounts Fact Sheet

(ET-8902) Group Health Insurance Fact Sheet

(ET-8903) Group Life Insurance Fact Sheet

(ET-8904) Deferred Compensation Program Fact Sheet

(ET-8918) Income Continuation Insurance-State Fact Sheet

(ET-8929) Accumulated Sick Leave Credit Conversion Program (ASLCC) & Supplemental Health Insurance Fact Sheet

(ET-8931) Income Continuation Insurance-Local Fact Sheet

(ET-8933) Pharmacy Benefits Program Fact Sheet

(ET-8934) Ombudsperson Services Fact Sheet

(ET-8935) Ombudsperson Program Brochure

(ET-8940) Annuity Fact Sheet

(ET-8901) Wisconsin Retirement System Fact Sheet

ET-9000s Forms

(ET-9019) Local Annuitant Health Program - 2011