Forms

Benefit application

Form title Use this form to Product code

Age retirement claim form [PDF: 794 KB]

Claim your PSS benefits as an age retiree

SAR1

Associate preserved benefit (age benefit) claim form [PDF: 439 KB]

Claim your preserved benefit as an age retiree for associate members

PBA-ASS

Cessation of employment (resignation) form [PDF: 539 KB]

SR1

Early access to associate preserved super benefit form [PDF: 973 KB]

Apply for early access to your preserved benefit on the grounds of severe financial hardship if you are an Associate member

ACCESS-ASS-C

Early access to superannuation benefits form [PDF: 536 KB]

Apply for early access to your benefit on the grounds of severe financial hardship

ACCESS-C

Involuntary retirement (retrenchment/redundancy) claim form [PDF: 608 KB]

Claim your PSS benefit after receiving a redundancy package

SRR1

Orphan of a deceased member claim form [PDF: 460 KB]

Apply for deceased member benefits for an eligible child (not survived by spouse)

SOM1

Orphan of a deceased pensioner claim form [PDF: 391 KB]

Apply for deceased pensioner benefits for an eligible child (not survived by spouse)

SOP

Preserved benefit (age benefit) claim form [PDF: 508 KB]

Claim your preserved benefit as an age retiree

PBA

Preserved benefit (member contributions/transfer value) claim form [PDF: 474 KB]

PBC

PSS election to cease membership form [PDF: 763 KB]

EC-PSS

Retirement (SR) supplement election form [PDF: 648 KB]

Elect payment form for PSS entitlements to be paid out

SR

Review of student pension form [PDF: 274 KB]

Extend payment of student pension on behalf of an eligible child (or children) of a deceased PSS member who is engaged in full-time education

SC3

Spouse (or spouse and children) of a deceased member - Part 1 of 2 - Identification [PDF: 493 KB]

Identify spouse (or spouse and children) of deceased member to claim benefits

SSM1a

Spouse (or spouse and children) of a deceased member - Part 2 of 2 - Benefit options [PDF: 395 KB]

Claim benefits as spouse (or spouse and children) of deceased member

SSM1b

Spouse (or spouse and children) of deceased pensioner claim form [PDF: 1 MB]

Claim deceased pension benefits as an eligible spouse of a deceased pensioner

S2SP

Contributions and transfers

Form title Use this form to Product code

Application to transfer money into PSS [PDF: 619 KB]

Roll other super into your PSS account

SE5

CSS election to transfer to PSS form [PDF: 563 KB]

Transfer CSS holdings into PSS as a CSS member re-joining CSS

SE7

Leave without pay remittance advice form [PDF: 638 KB]

Arrange payment of super contributions from employer while on leave without pay

S637

Statement of compliance form [PDF: 103 KB]

Confirm PSS conformance with SIS standards

SC

Investments

Form title Use this form to Product code

Transfer (switch) to Cash Investment Option [PDF: 613 KB]

Switch your PSS holdings from Default Fund to Cash Investment Option

PCASH

Transfer (switch) to Default Fund [PDF: 612 KB]

Switch your PSS holdings from Cash Investment Option to Default Fund

PCASH-D

Invalidity

Form title Use this form to Product code

Application for issue of invalidity retirement certificate [PDF: 674 KB]

Determine if a seriously injured PSS member is unable to work again

SPC

Application for partial invalidity pension form [PDF: 214 KB]

Apply for a partial invalidity pension if you experience a significant reduction in your earning capacity

SPP

Approved invalidity retirement claim form [PDF: 819 KB]

Apply for released of your PSS benefit as a member incapacitated by injury

SIR1

Approved preserved benefit invalidity retirement claim form [PDF: 1 MB]

Apply for release of your preserved benefit as an incapacitated member unlikely to work again

PBI

Associate preserved benefit invalidity claim form [PDF: 1 MB]

Apply for release of your preserved benefit component as an associate member who has gained approval as a result of a terminal medical condition or incapacity

PBI-ASS

Early access on medical grounds application form [PDF: 741 KB]

Apply for early access to your preserved PSS benefit as an incapacitated member

ER-PSS

Invalidity pension estimate request form [PDF: 618 KB]

Receive an estimate for an invalidity pension as a member experiencing a significant reduction in earning capacity due to physical or mental incapacity

PIP

Medical examination report for invalidity retirement form [PDF: 756 KB]

Determine if a serious injury suffered by a PSS member has caused total and permanent incapacitation

SM2

Tax

Form title Use this form to Product code

Application to have pre-July 1983 excess contributions included in tax-free amount form [PDF: 656 KB]

Adjust your taxable pension portion (factoring in pre-July 11983 component) as a PSS pension recipient

P83

Contributions surcharge remittance advice form [PDF: 571 KB]

Pay off your superannuation surcharge debt via cheque

SUR1

Provide your tax file number form [PDF: 622 KB]

Provide your tax file number to PSS

TFN

Online services

Form title Use this form to Product code

Access number request and update your details [PDF: 725 KB]

Receive a new Access Number and/or update your personal details

PAAN1

Other

Form title Use this form to Product code

Application for PSS associate pension by former spouse [PDF: 683 KB]

Apply for share of pension income as former spouse of PSS pensioner

ASSOC-PENS

Application for superannuation information - Form 6 [PDF: 1024 KB]

Request information about a superannuation interest for the purposes of Family Law splitting

FORM6

Application for superannuation information - Form 6 - SMARTFORM [PDF: 922 KB]

Request information about a Superannuation interest for the purposes of Family Law splitting

FORM6

Application to re-join PSS form [PDF: 619 KB]

Apply to re-join PSS if you have preserved benefits and re-commenced work

SE4

Authority to release information to a third party form [PDF: 689 KB]

Grant a third party access to your personal PSS account information

AUTH

Confidential Medical and Personal Statement (CMAPS) form [PDF: 817 KB]

CMAPS

Estimate request (member use only) form [PDF: 590 KB]

Request an estimate of your current or future PSS entitlement

ESTI

Family law/property settlement – sample court order for super splitting (base amount) [PDF: 119 KB]

Re-allocate (in dollar terms) PSS holdings in accordance with super split order

90MT1a

Family law/property settlement – sample court order for super splitting (percentage split) [PDF: 119 KB]

Re-allocate (in percentage terms) PSS holdings in accordance with super split order

90MT1b

Family law/property settlement – separation declaration [PDF: 657 KB]

Notify PSS of new superannuation agreement or separation from your spouse

90MP

Increase or vary your insurance cover form [PDF: 693 KB]

Change your additional death and invalidity cover through your PSS super

SE6

Information about a non-member spouse - required by Regulation 72 [PDF: 811 KB]

Provide details of non-member spouse to PSS in relation to super splitting order

72NMS

Maintain additional insurance cover on LWOP form [PDF: 635 KB]

Elect to continue your additional death and invalidity cover while on leave without pay

SE8

Statutory declaration [PDF: 28 KB]