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Retirement Forms

Please complete the form(s) and send signed originals to the Retirement Office. Forms will be processed as soon as administratively possible. (All forms are in PDF format)

All forms should be sent to:
Knox County Retirement & Pension Board
City-County Building, Room 371
400 Main Street
Knoxville, TN 37902
Phone: (865) 215-2323
Fax:     (865) 215-2421


Asset Accumulation Plan

- In-Service Distribution
- Application for Rollover to Knox County
- Beneficiary Change Form
- Distribution/ Rollover
- Distribution/Rollover - Vested

Defined Benefit Plan

- Beneficiary Change Form

Life Insurance

- Life Insurance Beneficiary Form
- EOI Form
- EOI Instructions

Medical Expense Retirement Plan

- Enrollment and Change Form
- Hardship Request
- In-Service Distribution - MERP
- Payment Election Form for Retired Participants
- Payment Election Form for Terminated Participants
(Pre-retirement)

Retiree's Only

- ACH Debit Form for Medical and Dental Insurance
- Federal Income Tax Withholding
- State Income Tax Withholding
- Request to Cancel Medical or Dental Coverage
- Direct Deposit Form

Sheriff's Total Accumulation Retirement Plan

- Beneficiary Change Form
- Distribution/ Rollover
- Vested Distribution/Rollover

Uniformed Officers Pension Plan

- Refund Contributions w/ Release (over 5 yrs of service)
- Refund Contributions (under 5 yrs of service)
- Beneficiary Change Form
- Pre-retirement Option Election Form

Voluntary 457 Plan

- Enrollment/Change Form
- Stop Form
- Knox County 457 Hardship Form
- Distribution/ Rollover
- Vested Distribution/Rollover

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Retirement Services

City County Building
400 Main Street
Suite 371
Knoxville, TN 37902
Phone: 865-215-2323
Fax: 865-215-2421
Hours:
Monday - Friday
8:00 am - 4:30 pm
Department Email