Retired Teachers Forms

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Extremely dry conditions have Connecticut at an elevated level of fire risk:

- Governor Lamont declared a State of Emergency to help with any needed response. [Read more]
- DEEP has implemented a burn ban (outdoor grills, firepits, campfires, etc.) at all state parks, forests, and wildlife management areas. [Read more]

Retired Teacher Forms

Effective June 29, 2020 Our New Mailing Address is:

CT Teachers' Retirement Board
165 Capitol Avenue
Hartford CT 06106-1673
Address/Name Change Form
Application for Withdrawal of Supplemental and/or Voluntary (for new retirees)
Beneficiary Election for Disability Allowance
Certification of Residence Form
Change of Beneficiary Plan C Form
Change of Beneficiary Plan N Form
Connecticut Tax Withholding Change Form CT-W4P
Electronic Funds Transfer (EFT) Form
Federal Tax Withholding Change Form
Reporting the Death of a CTRB Member Form
Reporting the Death of a CTRB Member's Spouse, Dependent or Co-Participant Form
Request for a Duplicate IRS 1099R Tax Form

Connecticut Teachers' Retirement Board