1715 Abbey Road
Suite B
East Lansing, MI 48823
Tel: 517.336.7782
Fax: 517.336.8997

MSPTA Forms

Post and Unit Representative Proxy Form
Executive Board Proxy Form
Proposal Form
Transfer Frequently Asked Questions (Article 13)

Associate Membership Form
Retiree Update Subscription Form

District Financial Statement
Expense Voucher
Committee Meeting Fee Request Form

Deferred Retirement Option Plan (DROP)

DROP Brochure
DROP Frequently Asked Questions
State Police DROP Account Distribution Request
State Police DROP Beneficiary Designation
State Police DROP Early Termination Form
State Police DROP Election & Application Form

Grievance Forms

Grievance (PD-143)
Grievance Answer (PD-142)
Grievance Appeal (PD-144)

Human Resources

Leave of Absence Application (PD-8)
Applicant Resume (PD-12)
Supplemental Employment Application (PD-14)
Tuition Reimbursement Application (PD-80) [word / pdf]
Request for Hours from Physical Fitness Leave Bank (PD-186) [word / pdf]
Reimbursement Request for Duty-Related Loss/Damage to Personal Property (PD-187) [word / pdf]
Notification by Employee/Retiree of Qualifying Event (CS-1766)
Payroll Direct Deposit Authorization (Electronic Funds Transfer)

Management & Budget

Request for Moving (ADM-12)
Claim against the State of Michigan (Personal Loss under $1,000) (DMB-1104)

Michigan State Police Association (Hardship Fund)

What is the Michigan State Police Association?
Board of Directors
Trustees
Steps for Requesting Assistance
Employee Financial Assistance Questionnaire
Release of Information Form

Retirement Services

Office of Retirement Services Beneficiary Nomination Form
Defined Benefit Retirement Application
Domestic Relations Order for Retirees
Eligible Domestic Relations Orders
Insurance Application (Health-Vision-Dental)
Insurance Change Request
Military Service Credit Application
Name & Address Change
Pension Recipient's Federal Income Tax Withholding Form
Qualified Plan-to-Plan Transfer Certification
Retiree Health-Dental-Vision-Life Insurance Options
Retiree Life Insurance Beneficiary Designation Form
Retirement Direct Deposit Application Form
Retirement Guidelines for the State Police Retirement System
State Police Application for Retirement

Voluntary Insurance Plan

ReliaStar Request for Change of Beneficiary
ReliaStar Cancellation Form

Workers Compensation

How and When to Apply for Workers Compensation
Workers Compensation Report of Claim (CS-197) [word / pdf]
Request for Re-crediting of Duty-Related Sick Leave (PD-188) [word / pdf]

Miscellaneous

Training Record Request (TD-10) [word / pdf]
Memorandum (UD-40)
Application & License to Purchase a Pistol (RI-10)
Safety Inspection Certificate (RI-11)
Federal Employee Withholding Allowance Certificate (W-4)
Michigan Employee Withholding Exemption Certificate (W-4)