Consolidated Public Retirement Board Forms and Office Locations – Government Agency in West Virginia

All 18 forms

Form Title	Topics
2025 Calendar for Direct Deposit Dates
Authorization to Release Information
Combined Medical Power of Attorney and Living Will
Critical Need Substitute Bus Operator Affidavit
Critical Need Substitute Bus Operator Affidavit
Critical Need Substitute Teacher Affidavit
Critical Need Substitute Teacher Affidavit
DSRS Return to Covered Employment by Retired Member
DSRS Return to Covered Employment by Retired Member
Form to Change Federal Withholdings
Form to Change State Withholdings
Less Than Honorable Service
Living Will
Medical Power of Attorney
Retired Public Safety Officer Authorization for Insurance Premium Deduction (PSOA-2025)
Retired Public Safety Officer Insurance Carrier (ICA)
Retiree Return to Work with PERS Employer as Permanent Part-Time or Temporary Employee
Retiree Self-Service - Quick Guide

Consolidated Public Retirement Board