KPERS-13 Withdrawal Form: Five Parts, Cash or Rollover, Mailing

The KPERS-13 withdrawal form is how a former Kansas public employee claims a refund of their personal retirement contributions after leaving a job covered by the Kansas Public Employees Retirement System. You cannot sign it until at least 31 days after your last day of covered employment, it has to be mailed on paper with original notarized signatures, and KPERS typically pays out four to six weeks after receiving both your completed application and your former employer’s final payroll report.¹ Signing is permanent: you give up all service credit and any future pension tied to those years.

Before You Can Sign

Kansas law requires a full separation of at least 30 days from every KPERS-participating employer before a refund can be paid.² KPERS counts this as 31 calendar days from your last day on the payroll, and you cannot date the application any earlier than that 31st day.³

You also have to be free of any current or promised job with a KPERS-affiliated employer, whether the position itself is covered or not. Your signature on the form certifies both. Accept a new covered job during the waiting period and you rejoin the system, which cancels your right to withdraw.³ If you are contesting your termination through an administrative or legal proceeding, you cannot apply until that proceeding ends.

Download the current KPERS-13 booklet from the KPERS website under “Forms By Number” or from the “Leaving Employment” page.⁴ Print it. KPERS will not accept the form by email or fax; only a mailed original with wet-ink signatures and notary seals will do.³

Filling Out the Five Parts

Part A: Member Information

Enter your Social Security number, full legal name, phone number, mailing address, and email. Check the retirement system you belonged to: KPERS, KP&F, or Judges. Check more than one if you participated in more than one.³

Part B: Payment Information

Part B is the payment election, and it drives the tax outcome. The form splits your account into a taxable portion and a nontaxable portion (your after-tax cost basis, if any has been recorded). For each portion, pick one of three destinations:

Direct payment to you, sent to your bank or mailed as a check. Federal tax withholding of 20% is applied automatically to the taxable portion.
Full direct rollover into a traditional IRA, Roth IRA, 401(a), 403(b), or governmental 457(b) plan. No federal tax is withheld.
Split payment, with a percentage going to a rollover account and the rest paid directly to you. The percentages have to total 100%.

If any portion is rolling over, fill in the receiving institution’s name, mailing address, account number, and plan type. Verify these against a statement from the receiving institution. A wrong account number or address can delay the transfer and can accidentally convert a rollover into a taxable distribution.³

Part C: Direct Deposit Information

If any part of your payment is coming directly to you, this section is how you get it electronically. Provide your bank’s name, city and state, routing number, and account number, and check whether the account is checking or savings. Leave Part C blank and KPERS mails a paper check to the address in Part A.

Part D: Member Statement and Signature

Mark your marital status, then sign and date. Your signature has to be notarized in front of the notary; KPERS will not process a form without a seal on Part D. Banks and UPS Store locations commonly notarize, often free for account holders. By signing, you certify that you have no current or promised job with a KPERS-affiliated employer, and you acknowledge that you irrevocably forfeit all service credit and rights to disability, retirement, and survivor benefits.³

Part E: Spousal Consent

Part E applies only if you are both married and vested (five years of service in KPERS 1, 2, or 3).¹ In that case, your spouse must consent to the withdrawal, and your spouse’s signature also has to be notarized. If your spouse refuses, KPERS notifies them directly and gives 90 days to consent or let it stand; at the end of that period, KPERS pays the withdrawal regardless.⁵ Not married, or not yet vested? Skip Part E.

Choosing Cash or Rollover

The election in Part B has real dollar consequences, so it’s worth pausing on before you notarize.

A direct payment triggers a mandatory 20% federal withholding on the taxable portion. You cannot opt out.⁶ If you want more than 20% withheld, attach an IRS Form W-4R. If 20% is fine, you don’t need to submit anything extra.³ The 20% is only a prepayment against your actual liability, which depends on your total income for the year.

If you are under age 59½ and take a direct payment, the IRS generally adds a 10% early-distribution penalty on top of ordinary income tax.⁷ Two exceptions come up often for KPERS members: separating from your KPERS employer during or after the year you turned 55 removes the penalty, and qualified public safety employees under KP&F get the exemption starting at age 50 or after 25 years of service, whichever comes first.⁸

A direct rollover avoids the 20% withholding and the 10% penalty because no distribution occurs; the money moves institution to institution. KPERS lump sums, including interest, are generally exempt from Kansas state income tax, even when rolled into an IRA that holds other retirement funds.⁹ If you live in another state, check its rules separately.

One backstop if you elect a direct payment and change your mind: you have 60 days from receipt to deposit the funds into an IRA or other eligible plan, and the IRS will treat it as a rollover.¹⁰ To roll over the full original amount, you’d need to replace the 20% KPERS already withheld out of your own pocket. Anything not rolled over inside 60 days is taxable, and the 10% early penalty may apply if you’re under 59½.

One thing the refund won’t include: employer contributions. Those stay in the KPERS trust and are not paid out to individual members, whether you’re in KPERS 1, 2, or the KPERS 3 cash balance plan.¹¹¹

Where to Mail It and How Long It Takes

Mail the completed, notarized original to:

KPERS
611 S. Kansas Ave., Suite 100
Topeka, KS 66603¹²

Processing doesn’t start until KPERS has the physical form in hand.³ Two other pieces then have to line up. Your former employer must send KPERS a final payroll report showing your last day and the contributions withheld from your final paychecks, which KPERS reconciles against its own records. And you must receive the IRS Special Tax Notice (the 402(f) notice) at least 30 days before distribution. You can waive that 30-day wait by making an affirmative election on the form indicating you’ve reviewed the notice and want to proceed.¹³

Once the application and final payroll data are both in, expect payment within four to six weeks.¹ The delays that come up most often are avoidable: a missing notary seal, blank rollover fields on Part B, or a vested married member who left Part E unsigned.

Before You Send It, Know What You’re Giving Up

The certification you sign in Part D is unambiguous. You “irrevocably forfeit all service and any right to disability, retirement and any other benefits you may be entitled to as a Retirement System member.”³ The withdrawal booklet does not describe any mechanism to buy that service credit back later. If you return to Kansas public employment after withdrawing, you begin as a new member at zero years.

Leaving the money in KPERS instead preserves your position. A vested member who returns to covered employment resumes right where they left off, and even a non-vested member who returns within five years keeps their prior service credit.³ Especially if you’re vested or close to it, the pension you’d forfeit can be worth far more over time than the lump sum in your hand.

1
Kansas Public Employees Retirement System. Leaving Employment and Withdrawals
2
Kansas Office of Revisor of Statutes. Kansas Code 74-4917 – Termination of Employment; Payment of Accumulated Contributions
3
Kansas Public Employees Retirement System. KPERS-13 Application for Withdrawal Booklet
4
Kansas Public Employees Retirement System. Forms By Number
5
Kansas State Legislature. Kansas Code 74-4917b – Termination of Employment; Payment of Accumulated Contributions; Spousal Consent
6
Internal Revenue Service. Pensions and Annuity Withholding
7
Internal Revenue Service. Hardships, Early Withdrawals and Loans
8
Internal Revenue Service. Topic No. 558 – Additional Tax on Early Distributions From Retirement Plans
9
Kansas Public Employees Retirement System. Important Tax Information
10
Internal Revenue Service. Rollovers of Retirement Plan and IRA Distributions
11
Kansas Public Employees Retirement System. Retirement System Plan Comparison
12
Kansas Public Employees Retirement System. Contact / Visit Us
13
Internal Revenue Service. Notice 2002-3 – Safe Harbor Explanation for Certain Qualified Plan Distributions