Retirement Forms - LA Clerks of Court Association

Active Member Forms

Membership Application

Benefit Forfeiture Form

Request for Change Form

Request for Refund

Request for Benefit Estimate

Parish Reporting Forms

Contribution Rate Letter
2021-2022

Contribution Rate letter
2020 - 2021

Contribution Report
2021-2022

Contribution Report
2020-2021

Retirement Change in Status Form

DROP Forms

DROP Information Sheet

Application for Regular Retirement/DROP/Post DROP

Retirement Forms

Retiree Packet
Includes forms below

Application for Regular Retirement/DROP/Post DROP

Direct Deposit Form

2021 W-4P Tax Form

Fill out forms below only if member completed DROP and Retiring:

Retiree Packet including SDP Forms
Includes forms below

DROP Distribution Form
Fill out only if completed DROP

Self Directed Plan (SDP) Forms
Self Directed Plan (SDP) Forms

Direct Deposit Form

2021 W-4P Tax Form

Fill out forms below only if member completed DROP and Returning to Work:

Certification DROP Return to Work Form

Self Directed Plan (SDP) Forms
Self Directed Plan (SDP) Forms

Other Retirement Forms

Disability Application Form

Transfer In Application Form

Request for Buy Back Service Credit

QDRO (Sample) Clerks Retirement