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Click ‘Get Form’ to open it in the editor.
Begin by filling out Section 1 - Personal Information. Enter your Social Security Number, name, address, and contact details. Ensure accuracy, especially for your date of birth and Social Security Number.
Proceed to Section 2 - Current Employment Information. Provide your job title and the start date of your current elected service if applicable.
In Section 3 - Prior Service Information, answer the questions regarding previous public employment in Ohio. If applicable, list any employers and provide details about prior service contributions.
Complete Section 4 - Employee Certification by signing the form. Remember not to print or type your signature.
Finally, ensure that Section 5 - Employer Certification is filled out by your employer before mailing the completed form to OPERS.
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Forms | Oklahoma Public Employees Retirement System
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Dec 5, 2025 This form must be submitted to OPERS within the first month (30 days) after a students employment. It must be approved by OPERS and returned to the employer.Read more
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