Check List for Retirement Applications

Application (CO-898 revised 8/2015) - Original Only

Applicant's Signature ___ Agency Signature ___ Verify Date of Retirement ____

Type of Option matches form submitted ___

Verify Type of Retirement Checked off on application ___

Option Form - Original Only

A - 50% Spouse    B - 50% / 100%    C - 10 Yr / 20 Yr    D - Lifetime
(CO-899 Rev 7/15)    (CO-900 Rev 11/15)    (CO-901 Rev 11/15)    (CO-902 Rev 11/15)

The form was witnessed properly ___

The Witness is not the Annuitant and/or the Beneficiary ___

Certification of Marital Status (CO-1047 Rev. 9/15) - Original
Not Required if Electing Option A 50% Spouse or Option B Electing the Spouse

If married, verify receipt of marriage certificate ___

Verify that Parts I & III have been completed as follows:
Member's Option Election ___
Member's Signature ___
Spouse's Signature ___
Name of Annuitant
(if applicable) ___
Spouse's Initials ___
Authorized witness/if notary,
Expiration date required ___

If Single or Married less than one year, verify: ___
Completed Part I & II Authorized witness; if notary, expiration date required ___

Birth Documentation (one copy each)
Retiree Birth Certificate ___ If applicable, Annuitant Birth Certificate___

Choice of Health Services After Retirement (CO-744 Rev 7/15) - Original Only
Copy of Medicare Card
if retiree or spouse is 65 years or older

W4P (Original) ___             CT-W4P (Original) ___

Direct Deposit Form (CO-1068 Rev 7/2016) Original ___

Return to Retirement Services Division Memorandum 2016-03

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