Form Orp-Retire-1 - Application For Retirement And Initial Distribution Statement Template
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3ORP–RETIRE–1
State University System Optional Retirement Program (SUSORP)
Effective 11/15
Application for Retirement and Retirement Distribution
Division of Retirement – OAP/ORP Section
PO Box 9000
Tallahassee, Florida 32315-9000
Phone: 850-778-4696 Toll-free: 877-378-7677 FAX: 850-410-2030
Email:
A.
When to use Form ORP–RETIRE:
This form is an application for retirement under the SUSORP and to request authorization for retirement
distribution(s) from your SUSORP account. The distribution you are requesting includes required employer and
employee contributions, any voluntary employee contributions in your account, and earnings on these contributions.
A distribution includes, but is not limited to, a rollover to another retirement account, a direct payment to you,
receiving an annuity purchased through your provider company, or any combination of these options. Once you take
a distribution from your SUSORP account, you are considered a RETIREE and are subject to certain termination
requirements and reemployment limitations during the first 12 calendar months following your initial retirement
distribution date as provided in Subsection 121.091(9), F.S. As a RETIREE, you are not eligible to participate in any
state-administered retirement program in Florida if you return to Florida Retirement System (FRS)-covered
employment.
Do not use this form for contract exchanges of contributions between SUSORP-approved providers and products.
You will need to contact your provider company for those forms.
Do not use this form to redirect future contributions to a different provider. If you are not retiring, and wish to
direct future contributions to a different provider, please submit Form ORP-CHANGE.
Do not use this form if you are requesting a refund of only your voluntary employee contributions from your
SUSORP account. If you have been terminated for 3 calendar months, use Form ORP-REFUND for this purpose.
If you are requesting a Required Minimum Distribution, please use Form ORP-RMD.
B.
Eligibility for Distributions:
Under Florida law, you are not eligible to access your employer and/or required employee contributions and related
earnings in your SUSORP account until you terminate all employment relationships with all participating FRS
employers for three full calendar months. You may be eligible to receive, upon request to the division, up to ten
percent of your SUSORP account balance after termination for one full calendar month if the division determines
that you meet normal retirement date requirements as provided in Florida Statutes.
For the SUSORP, “Normal retirement date” means the date a member attains normal retirement by age, which is
determined as follows:
1. If initially enrolled before July 1, 2011:
a. The first day of the month the member attains age 62 (copy of birth certificate required); or
2. If initially enrolled on or after July 1, 2011:
a. The first day of the month the member attains age 65 (copy of birth certificate required).
If you wish to take a 10% distribution, please complete both pages of the ORP-RETIRE form.
NOTE: There may be tax penalties if you access the funds prior to age 59-1/2.
C.
Form Completion:
1. Complete Section I (Contact Information) and Section II (Member Certification) of the form. Your signature must
be notarized. If requesting up to ten percent after one month from termination, also complete page two.
2. Have your employer complete Section III (Employer Certification) of the form. Or you may also submit the form
with your notarized signature to the division and we will obtain the employer certification.
3. Submit the completed form to the Division of Retirement by fax, email, or U.S. Mail using the information provided at the
top of the form.
Upon receipt of the completed form, the division will determine your eligibility to receive a retirement distribution of your
employer and/or required employee contributions from your SUSORP account. The division will notify you if you are not
eligible.
If your service provider gives you a form that requests a signature from the Division of Retirement, add a note to the
company form that Form ORP-RETIRE will be sent to them by the division.
If you have any questions contact the Division of Retirement using the information at the top of this page or email
.
Rule 60U-1.012, F.A.C.
Instructional Page 1 of 1
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