Ariz. Admin. Code § R2-8-133 - Survivor Benefit Applications
A. The definitions
in R2-8-126 apply to this Section.
B. The ASRS shall not distribute a survivor
benefit until a claimant notifies the ASRS of a member's death by telephone or
submission of a death certificate, unless the member elected a Joint and
Survivor Benefit Option upon retirement.
C. Upon notification of the death of a
member, the ASRS shall distribute the survivor benefits according to the most
recent, Acceptable Form that is On File with the ASRS that was received at
least one day prior to the date of the member's death, unless otherwise
provided by law.
D. The designated
beneficiary or other person specified in A.R.S. §
38-762(E) shall provide
the following:
1. An original certified death
certificate or a certified copy of a court order that establishes the member's
death;
2. If the claimant is not a
designated beneficiary, but is a person specified in A.R.S. §
38-762(E), a
copy of a document issued from a federal, state, local, sovereign, or medical
institution showing the claimant's relationship to the deceased
member;
3. A certified copy of the
court order of appointment as administrator, if applicable; and
4. Except if the deceased member was retired
and elected the joint and survivor option, complete and have notarized an
Application for Survivor Benefits, provided by the ASRS that includes:
a. The deceased member's full name,
b. The deceased member's Social Security
number or U.S. Tax Identification number,
c. The benefit the designated beneficiary or
other person specified in A.R.S. §
38-762(E) is electing;
d. If the designated beneficiary or other
person specified in A.R.S. §
38-762(E) is electing to roll over a benefit,
the following information:
i. The claimant's
full name;
ii. The name of the
institution to which the claimant is electing to roll over;
iii. The address of the institution to which
the claimant is electing to roll over;
iv. The full name of the authorized
representative of the institution to which the claimant is electing to roll
over;
v. The signature of the
authorized representative of the institution to which the claimant is electing
to roll over;
e. If the
beneficiary is electing to have any of the survivor benefits directly deposited
into a bank account, the following information:
i. Whether the bank account is a checking or
savings account;
ii. The name of
the banking institution to which the benefit is being sent;
iii. The routing number;
iv. The account number; and
f. The following information for
the designated beneficiary or other person specified in A.R.S. §
38-762(E):
i. Full name;
ii. Mailing address, if not On File with
ASRS;
iii. Date of birth, if
applicable; and
iv. Social Security
number or U.S. Tax Identification number, if not On File with ASRS.
g. The following statements of
understanding:
i. The designated beneficiary
or other person specified in A.R.S. §
38-762(E) has read and understands
the Special Tax Notice Regarding Plan Payments they received with this
application;
ii. The designated
beneficiary or other person specified in A.R.S. §
38-762(E) authorizes the
ASRS to make payments as indicated above and agree on behalf of themselves and
their heirs that such payments shall be a complete discharge of the claim and
shall constitute a release of the ASRS from any further obligation on account
of the benefit;
iii. The designated
beneficiary or other person specified in A.R.S. §
38-762(E) authorizes the
ASRS and the Banking Institution listed above to debit their account for the
purposes of correcting errors and returning any payments inadvertently made
after their death;
iv. Under
penalties of perjury, the designated beneficiary or other person specified in
A.R.S. §
38-762(E) certifies that:
(1)
The Social Security number or U.S. Tax Identification number shown on this
application is correct;
(2) They
are not subject to backup withholding because:
(a) They are exempt from backup withholding,
or
(b) They have not been notified
by the Internal Revenue Service that they are subject to backup withholding as
a result of a failure to report all interest or dividends, or
(c) The Internal Revenue Service has notified
them that they are no longer subject to backup withholding; and
(3) They are a legal resident of
the United States, unless they are an estate or trust.
v. The designated beneficiary or other person
specified in A.R.S. §
38-762(E) understands their right to a 30-day notice
period to consider a rollover or a cash distribution and they elect to waive
the notice period by their election for payment on this application;
vi. The designated beneficiary or other
person specified in A.R.S. §
38-762(E) understands if they elect to roll
over all or any portion of their distribution to another eligible retirement
plan, it is their responsibility to verify that the receiving plan will accept
the rollover and, if applicable, agree to separately account for the taxable
and nontaxable amounts rolled over and the related subsequent earnings on such
amounts;
vii. The designated
beneficiary or other person specified in A.R.S. §
38-762(E) understands if
they elect to roll over all or any portion of their distribution to an IRA
plan, it is their responsibility to verify that the receiving IRA institution
will accept the rollover and, if applicable, it is their responsibility to
separately account for taxable and nontaxable amounts;
viii. The designated beneficiary or other
person specified in A.R.S. §
38-762(E) understands if they elect to roll
over to another eligible retirement plan, any portion of the distribution not
designated for a rollover will be paid directly to them and any taxable amounts
will be subject to federal and state income tax withholding;
ix. The designated beneficiary or other
person specified in A.R.S. §
38-762(E) understands if they elect to roll
over to an inherited IRA plan, any portion of the distribution not designated
for a rollover will be paid directly to them and any taxable amounts will be
subject to federal and state income tax withholding.
xi. The designated beneficiary or other
person specified in A.R.S. §
38-762(E) understands if they elect to roll
over to an inherited IRA plan, they may be required to receive a minimum
distribution and they certify that the date of birth shown on this form is
correct.
5. For
a member who elected a Joint and Survivor Retirement Benefit Option, a
contingent annuitant shall submit a Joint and Survivor Certification form
containing:
a. The following information for
the member:
i. Full name;
ii. Social Security number or U.S. Tax
Identification number;
iii. Date of
death; and
b. The
following information for the beneficiary:
i.
Legal relationship to the member;
ii. Full name;
iii. Social Security number or United States
Tax Identification number, if not On File with ASRS;
iv. Mailing address, if not On File with
ASRS;
v. Date of birth, if not On
File with ASRS;
vi. If the
contingent annuitant is electing to have any of the survivor benefits directly
deposited into a bank account, the following information:
(1) Whether the bank account is a checking or
savings account;
(2) The name of
the banking institution to which the benefit is being sent;
(3) The routing number;
(4) The account number; and
c. The following
statements of understanding:
i. The contingent
annuitant has read and understands the Special Tax Notice Regarding Plan
Payments they received with the Joint and Survivor Certification
form;
ii. The contingent annuitant
authorizes the ASRS to make payments as indicated above and agree on behalf of
themselves and their heirs that such payments shall be a complete discharge of
the claim and shall constitute a release of the ASRS from any further
obligation on account of the benefit; and
iii. The contingent annuitant authorizes the
ASRS and the Banking Institution listed above to debit their account for the
purposes of correcting errors and returning any payments inadvertently made
after their death.
d. The
contingent annuitant's notarized signature.
E. Notwithstanding R2-8-132(H), if the
beneficiary or contingent annuitant is a minor as of the date of the member's
death, the beneficiary or contingent annuitant may submit a written request
with the information contained in R2-8-132(G)(1) through (4) within nine months
after the minor attains 18 years of age.
F. For a member who deceases prior to the
member's retirement date, if there is no designation of beneficiary or if the
designated beneficiary predeceases the member, the ASRS shall pay a survivor
benefit as specified in A.R.S. §
38-762(E).
G. The ASRS shall begin disbursing a survivor
benefit to a contingent annuitant according to A.R.S. §
38-760(B)(1) upon
notification and verification of the member's death by a third party.
H. The ASRS shall suspend a survivor benefit
for a contingent annuitant unless the contingent annuitant provides the
information in subsection (D) within two months of the ASRS disbursing a
survivor benefit.
I. If the member
is domiciled in Arizona, according to A.R.S. §
14-3971, and there is no
designated beneficiary, the ASRS shall distribute the balance of a member's
account to a claimant if the claimant submits an Affidavit for Collection of
Personal Property to ASRS with the following:
1. The claimant's name;
2. The claimant's Social Security number or
U.S. Tax Identification number;
3.
The claimant's mailing address;
4.
The member's name;
5. The member's
Social Security number or U.S. Tax Identification number;
6. The date of the member's death;
7. The state and county where the member
died;
8. Statements indicating:
a. According to A.R.S. §
14-3971(B)(2)(a), no application or petition for the appointment of a personal
representative is pending or has been granted in any jurisdiction and the value
of the member's entire estate, less liens and encumbrances, does not exceed the
amount in A.R.S. §
14-3971 as valued as of the date of the member's
death;
b. According to A.R.S.
§
14-3971(B)(2)(b), the personal representative has been discharged, or
more than a year has elapsed since a closing statement has been filed and the
value of the member's entire estate, less liens and encumbrances, does not
exceed the amount in A.R.S. §
14-3971 as valued as of the date the ASRS
receives the Affidavit for Collection of Personal Property;
c. The claimant is the successor of the
member and is entitled to the member's personal property because:
i. The claimant is named in the member's
will; or
ii. The member did not
have a will and the claimant is entitled to the member's personal property by
right of intestate succession according to A.R.S. §
14-2103;
d. If the claimant is entitled to
the member's personal property according to subsection (I)(8)(c)(i), then a
copy of the member's will;
e. If
the claimant is entitled to the member's personal property according to
subsection (I)(8)(c)(ii), then the relationship between the member and the
claimant and whether there are other surviving heirs;
f. If there are other surviving heirs, then
the name and relationship of each surviving heir;
g. A statement indicating the claimant is
making the Affidavit for Collection of Personal Property according to A.R.S.
§
14-3971 for the purpose of making a claim to the member's ASRS account;
and
h. The claimant's notarized
signature.
J.
If the member is not domiciled in Arizona and there is no designated
beneficiary, the ASRS shall distribute the balance of a member's account to a
claimant if the claimant submits legal documentation to claim the member's ASRS
account that complies with the statutory requirements of the state in which the
member was domiciled at the time of the member's death.
K. Notwithstanding any other provision, if
the amount of the survivor benefit as valued at the date of disbursement is
less than $10,000 per annum, the ASRS shall not distribute a survivor benefit
to a minor beneficiary unless the minor beneficiary's legal guardian submits
the following written information:
1. The
member's full name;
2. The member's
Social Security number or U.S. Tax Identification number;
3. The minor beneficiary's full
name;
4. The minor beneficiary's
Social Security number or U.S. Tax Identification number;
5. The full name of the minor beneficiary's
legal guardian;
6. The minor
beneficiary's legal guardian's address, if not On File with ASRS; and
7. The minor beneficiary's legal guardian's
signature certifying the minor beneficiary's legal guardian has care and
custody of the minor beneficiary.
L. Notwithstanding any other provision, if
the amount of the survivor benefit as valued at the date of disbursement is
$10,000 or more per annum, the ASRS shall not distribute a survivor benefit to
a minor beneficiary unless the minor beneficiary's conservator submits proof of
court-appointed fiduciary responsibility for the minor beneficiary.
M. The ASRS shall remit payment to the minor
beneficiary according to subsection (K) by sending the minor beneficiary's
conservator a check, if the document providing proof of the court-appointed
fiduciary responsibility requires payment to be made to a restricted or secure
account.
N. If a person claims that
a beneficiary or claimant is not entitled to a survivor benefit, then before
ASRS disburses a survivor benefit, the person may notify ASRS of the person's
intent to appeal the beneficiary's or claimant's right to a survivor
benefit.
O. Within 30 days, a
person who has notified ASRS of the person's intent to appeal a survivor
benefit disbursement according to subsection (N), shall submit an appeal to
ASRS according to 2 A.A.C. 8, Article 4.
P. If the ASRS receives documentation from,
or confirmed by, a law enforcement agency, that a beneficiary or claimant may
be guilty of the felonious and intentional killing of the member, the ASRS
shall not distribute any benefits to the beneficiary or claimant that may be
guilty of the felonious and intentional killing of the member until the matter
has been adjudicated.
Q. If the
member's estate has an appointed personal representative, the member's estate
shall submit a court document identifying the personal representative for the
member's estate before ASRS may distribute a survivor benefit.
R. If the member's estate is closed, the
person claiming a right to the member's ASRS account shall provide a court
document proving the estate is closed.
S. If the survivor receives a monthly annuity
and does not provide the direct deposit information according to subsection
(D)(4)(e) or (D)(5)(b)(vi), ASRS shall issue a debit benefit card.
T. If the survivor does not activate the
debit benefit card the ASRS issues to the survivor within 75 days, the ASRS
shall reclaim all the survivor benefits issued on the debit benefit card and
suspend the survivor's benefits until the survivor:
1. Activates the debit benefit card or
provides the direct deposit information according to subsection (D)(4)(e) or
(D)(5)(b)(vi); and
2. Returns the
notice of benefit suspension with the following information:
a. The survivor's Social Security number or
U.S. Tax Identification number;
b.
The survivor's address; and
c. The
survivor's notarized signature.
Notes
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