South Carolina Department of Public Safety



Human Resource Forms - Benefits

SC Retirement Systems

Click on the above link for the following forms
  • Retirement Plan Enrollment Form 1100
  • Active Member Beneficiary Form 1102
  • State ORP Beneficiary Designation Form 1106
  • Request for Service Purchase Request 2101

Employee Insurance Program

Click on the above link for the following forms
  • Active Notice of Election Form
  • Certification Regarding Tobacco Use
  • COBRA Notice of Election Form
  • Dependent Social Security Number Form
  • 2011 MoneyPlus Enrollment Form
  • MoneyPlus Health and Dependent Day Care Reimbursement Claim Form
  • MoneyPlus Spending Accounts Change in Status Form
  • Student Certification Form
  • Incapacitated Child Certification Form
  • Life Insurance Statement of Health (MetLife)

Miscellaneous

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