Forms
Find the Helpful Forms You Need
Click the links below to access and download frequently required forms. Please note that forms related to direct deposits (specifically, Form 5 and Form 5Q) must be requested by calling our office.
Completed forms can be returned via email to: Forms@firepension.ok.gov
Form 1: Application for Retirement Pension
Form 2: Application of Firefighter for Disability Pension
Form 3: Application for Surviving Spouse for Pension
Form 4: Application of Child for Pension
Form 5: Authorization for Direct Deposit (Call Office for Form)
Form 6: Request for Federal Income Tax Withholding
*Request for State Income Tax Withholding*
Form 7: Application for Participation in Oklahoma Firefighters Deferred Option Plan
Form 7a: Application for Participation Under the Back Drop Provision
Form 8: Notice of Termination From Fire Department
Form 9: Minimum Physical Performance Test/Agility
Form 11: Designation of Recipient for $5,000 Death Benefits
Form 11B: Designation of Recipient for Deferred Benefits (Plan B)
Form 12: Application for Refund of Contribution
*Safe Harbor Special Tax Notice*
Form 13: Employee Entrance Application
Form 16B: Authorization for Change in Deductions
Form 16C: Appointment of New Official
Form 18: Vested Benefit Application
Form 19: Application for Death Benefit
Form 19A: Death Benefit Tax Form
Form 19B: Qualified Disclaimer
Form 20: Deferred Option Plan – “Plan B” Withdrawal Form
*Safe Harbor Special Tax Notice*
Form 20R: Deferred Option Plan – “Plan B Rollover” Election Form
*Safe Harbor Special Tax Notice*
Form20B: Deferred Option Plan – “Plan B” Beneficiary Election Form
*Safe Harbor Special Tax Notice*
Form 21: Letter of Student Status
Form 22: Waiver of All or a Portion of Monthly Benefits (formerly Waiver of Retirement Benefits)
Form 23: Health Election Change Form for the Pension Protection Act of 2006
Form 24: Affidavit Verifying Lawful Presence in the United States
QDRO Forms (Ex-Spouse)
Form 5Q: Authorization for Direct Deposit (QDRO) (Call Office for Form)
Form 6Q: Request for Federal Income Tax Withholding
*Request for State Income Tax Withholding*
Form 12Q: Application for Refund of Contribution (QDRO)
*Safe Harbor Special Tax Notice*