CERT Rev 07/2024 19-11.009 F.A.C. Page 1 of 2
FRS Employment Certification Form
This form is not an offer of employment and completion of this form does not constitute enrollment in a retirement program under the
Florida Retirement System (FRS). If you are hired, information about your retirement plan options may be mailed to your address on file.
1
Enter
Your Info
PLEASE
PRINT
_________________________________________________
NAME
__________________________________
SOCIAL SECURITY NUMBER
CURRENT AGENCY NAME
PREVIOUS AGENCY NAME
2
Confirm
Prior
Member-
ship
Have you ever been a member of a State of Florida-administered retirement plan?
No, I have never been a member of a State of Florida-administered retirement plan.
If No, skip to section 4.
Yes, I have been a member of a State of Florida-administered retirement plan.
If Yes, indicate which plan(s) you are or were a member of, then proceed to section 3.
FRS Pension Plan (including DROP)
FRS Investment Plan
Senior Management Service Optional Annuity
Program (SMSOAP)
State Community College System Optional
Retirement Program (SCCSORP)
State University System Optional Retirement
Program (SUSORP)
Other _______________________________
If you answered YES above but have never made a retirement plan election (including default) between the FRS Pension
Plan and the FRS Investment Plan, you will have a choice period established for you with a designated deadline. See page
2 for additional information on making a choice.
3
Confirm
Retiree
Status
Are you retired from a State of Florida-administered plan? You are considered retired if:
- You have received any benefits (other than a withdrawal of your employee contributions) under the FRS
Pension Plan, including DROP.
- You have taken any distribution (including a rollover) from the FRS Investment Plan, or other state-
administered retirement programs offered by state universities (SUSORP), state community colleges
(SCCSORP), state government for senior managers (SMSOAP), or local governments for senior managers.
No, I am not retired from a State of Florida-administered plan. I understand that if it is later
determined I am retired, both my employer and I might be liable for repaying retirement benefits I have
received if I am reemployed by or provide services to an FRS-covered employer through any paid or
unpaid arrangement as described below. Refer to Page 2 for additional information.
Yes, I am retired from a State of Florida-administered plan, and I understand I must
satisfy any termination requirement prior to returning to FRS employment.
If Yes, enter your FRS Pension Plan retirement effective date, DROP termination date, or date you
received your first distribution from the FRS Investment Plan, SUSORP, SCCSORP, SMSOAP, or
other plan.
DATE _______________________________
4
Sign
Here
By signing below, I acknowledge that I have read and understand the information on pages 1 and 2 of this form,
and I certify all supplied information to be true and correct.
___________________________________________________ ________________________
SIGNATURE DATE
Questions? Call the MyFRS Financial Guidance Line at 1-866-446-9377, Option 2 (TRS 711) or visit MyFRS.com.
This completed form, including page 2, should be retained in the employee’s personnel file. Do not send this form to the FRS, unless requested.
CERT Rev 07/2024 19-11.009 F.A.C. Page 2 of 2
Review the Following Important Information Carefully
Section 2 – Confirm prior membership
If you answered NO - Not Previously Enrolled in the FRS
A New Hire Kit will be mailed to your address on file with your employer within 30 to 60 days after your hire date.
• You are responsible for ensuring your retirement plan election is received by the Plan Choice Administrator on or before 4:00
p.m. ET on the last business day of the 8
th
month following your month of hire.
• If you do not submit an election choice, the Investment Plan will be considered your initial election by default. Exception: If you
are enrolled in the Special Risk Class, the Pension Plan will be considered your initial default election.
If you answered YES - Previously Enrolled in the FRS
• If you were previously enrolled in the FRS, made an active election or defaulted into the FRS Pension Plan or FRS Investment
Plan, and separated employment without retiring you will not receive a new choice window. You will continue to participate in
the plan you were enrolled in at the time of separation and continue to accrue service credit under that plan.
• If you were previously enrolled in the FRS and did not make an election between the FRS Pension Plan and FRS Investment
Plan during your previous enrollment in the FRS, you will receive a choice window with a designated choice deadline. This
would include those who have never had an opportunity to make a retirement plan election, members with Pension Plan service
prior to July 1, 2002, and who return to FRS employment today, and new hires on or after July 1, 2002 who had an election
period established previously but separated employment before making an election or defaulting.
o You are responsible for ensuring your election is received by the Plan Choice Administrator on or before 4:00
p.m. ET on the last business day of the 8
th
month following your month of hire.
o If you do not submit an election, the Investment Plan will be considered your initial election by default. Exception:
If you are enrolled in the Special Risk Class, the Pension Plan will be considered your initial default election.
o If you elect or default to the Investment Plan, any accrued value you may have in the Pension Plan will be
transferred to your Investment Plan account as your opening account balance and is subject to the vesting
requirements of the Pension Plan. The initial transfer amount is an estimate, and your account will be reconciled
within 60 days of the transfer using your actual FRS membership record pursuant to Florida law. You direct that
all future employer and employee contributions be deposited in your Investment Plan account.
Section 3 – Confirm Retiree Status
If you are a Pension Plan retiree, you understand:
• If you are reemployed within six calendar months of retirement in any type of position with an FRS employer, your
retirement and DROP status (if applicable) may be voided. If voided, all retirement and DROP benefits you received must
be repaid, and you must reapply for retirement to receive future benefits.
If you are an Investment Plan, SUSORP, SCCSORP, or SMSOAP retiree, you understand:
• If you are reemployed within the first six calendar months of retirement in any type of position with an FRS employer,
any benefits you received must be repaid, or you must terminate employment.
• Any type of position includes, but is not limited to, regularly established, full-time, part-time, OPS, temporary, seasonal, substitute
teachers, adjunct professors, etc. Also, any paid or unpaid positions with an FRS employer, service arrangements with an FRS
employer, employment by or through a third-party providing service to an FRS employer, or positions pre-arranged before retirement
to provide services after retirement to any FRS employer, are prohibited.
• Florida law requires a return of all overpaid Pension Plan benefit payments or Investment Plan distributions received by a member
who has violated the FRS termination or reemployment provisions. Similar provisions apply to overpaid SUSORP, SCCSORP, or
other state-administered plan distributions – contact that plan’s administrator for details.
• Retirees may provide volunteer services with an FRS employer without violating the termination requirements or reemployment
limitations (must comply with Section 121.091(15), Florida Statutes).
• Effective July 1, 2017, retirees of the Investment Plan, SUSORP, SMSOAP, SCCSORP are eligible for renewed membership in the
Investment Plan, SUSORP, SMSOAP, SCCSORP. You must be employed in an FRS-covered position on or after July 1, 2017 in
order to have renewed membership. Renewed members may not use a second election to change to the Pension Plan.
This completed form, including page 2, should be retained in the employee’s personnel file. Do not send this form to the FRS, unless requested.
