Employee Forms

Retirement Applications

Form		Description
Application for Immediate Monthly Benefit Pre-1996 Post-1995		Application for immediate retirement benefits. Note: There are two forms: one for employees hired before 1/1/1996 and one for employees hired on or after 1/1/1996 and before 7/1/2014. Application MUST be received within 60 days after termination.
Application for Lump-Sum Benefit PDF		Application for a lump-sum distribution of your retirement benefit(s). Application MUST be received within 60 days after termination.
Application for Deferred Benefit Pre-1996 Post-1995		Application for deferred retirement benefits with payments to begin at a later date. Note: There are two forms: one for employees hired before 1/1/1996 and one for employees hired on or after 1/1/1996 and before 7/1/2014. Application MUST be received within 60 days after termination.
Eligible Rollover Notice Not Roth PDF Roth PDF		Description of rollover rules related to any eligible distribution from TVARS
Benefits Summary for Terminating Employees PDF		For information on applying for retiree medical and dental insurance, see the Benefits Summary for Terminating Employees or contact the People First Solution Center. Applications MUST be received within 30 days after termination.

If eligible, you will also need to submit medical and dental insurance applications. Please see the healthcare benefits webpage for more information.

Employee Beneficiary Designations

You may need to change beneficiaries after marriage, divorce, death of current beneficiary, birth of a child, or children becoming financially independent. You may also want to contact the People First Solution Center at 888-275-8094 about changing your beneficiary for benefits such as Optional Life Insurance and Accidental Death & Dismemberment Insurance.

Form	Description
401(k) Plan	401(k) Beneficiary Designation Fidelity Investments handles beneficiary designations for the 401(k) Plan. Simply log on to NetBenefits at www.netbenefits.com/tva and click Profile, then Beneficiaries. All beneficiary designations with Fidelity are for your 401(k) Plan ONLY. Please complete form RS-2 to change your beneficiaries for the TVARS death-in-service benefit, if eligible.
Beneficiary Designation for Death-In-Service Benefit (RS-2) PDF	This form is only for employees who are participants in the Original Benefit Structure or who have a cash balance account. It applies to any pension benefits and Fixed and Variable Funds payable at your death, not including the 401(k) Plan.
Spousal Consent (RS-200) PDF	Spousal consent if you name someone other than your spouse as primary beneficiary (if hired after 1/1/1990).
Other TVA Beneficiaries	For changes to your other TVA beneficiaries, including FEGLI, Core, and Supplemental Life Insurance, go to PeopleGateway or contact the People First Solution Center. For unpaid compensation (i.e. last regular check, annual leave payment, etc.), use form SF 1152, available on InsideNet and send the completed form to disbursementservices@tva.gov.

Divorce

Document	Description
Procedures and Instructions	Domestic Relations Order procedures for filing.
DRO Model	Domestic Relations Order example and instructions.

Military

Document	Description
MLOA	TVARS Benefits related to MLOA.

Other Retirement Benefits

Document	Description
Level Income Plan (FAQ)	Description, eligibility, basis.
Supplemental Benefit (FAQ)	Description, eligibility, how it is calculated.
Disability Retirement (FAQ)	Overview of benefits and requirements of the disability retirement benefit.
Death Benefits (FAQ)	Overview of benefits available upon the death of an active employee.
Cost-of-Living Adjustments (FAQ)	Description, eligibility, how it is calculated

Retiree Forms

Form	Description
401(k) Plan	401(k) Beneficiary Designation Fidelity Investments handles beneficiary designations for the 401(k) Plan. Simply log on to NetBenefits at www.netbenefits.com/tva and click Profile, then Beneficiaries. All beneficiary designations with Fidelity are for your 401(k) Plan ONLY.
Beneficiary Designation for Lump-Sum Benefits After Retirement (RS-2A) PDF	Change beneficiaries for lump-sum benefits such as Option 1, Full Cash Refund, & Interest Only.
FEGLI Beneficiary Designation for Retirees (SF2823) PDF	Change beneficiary for Federal Employees’ Group Life Insurance. If you do not know your CSI number, contact TVARS. Retirees must submit form directly to:Office of Personnel Management Retirement Operations Center P.O. Box 45 Boyers, PA 16017-0045
Retiree Address Change or Income Tax Withholding Request PDF	Change amount withheld for Federal income taxes. Form must be submitted to BNY Mellon (see bottom of form).
Retiree Direct Deposit Request PDF	Change bank account used for direct deposit. Form must be submitted to BNY Mellon (see bottom of form).
Election Form for Deferred Retirees (RS-5D) Pre-1996 Post-1995	Election form for Deferred retirees to make changes during the deferral period or to begin payments.
Death notification	Contact TVARS
Survivor checklist	The purpose of this booklet is to assist you in identifying the steps you may need to take immediately following the loss of a loved one and in the months that follow.
Document locator	This document locator is designed to help you organize your important papers and records. It provides a convenient and concise way to summarize the location of vital documents.