INSTRUCTIONS: ALABAMA APPLICATION AND CERTIFICATION FOR OUT-OF-STATE SERVICE CREDIT (Form RSA 50B)

Alabama public employees enrolled in the state's retirement systems can use the form discussed in this article to apply for and receive credit for out-of-state service. This document can be obtained from the website maintained by the Retirement Systems of Alabama.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 1: Part I concerns the member. Enter your first name, middle name, last name and (if applicable) maiden name on the first blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 2: Enter your date of birth on the second blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 3: Enter your Social Security number on the third blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 4: Enter your home phone number on the fourth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 5: Enter your street address or P.O. box number on the fifth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 6: Enter your work phone number on the sixth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 7: Enter your city, state and zip code on the seventh blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 8: Enter your RSA account number, if known, on the eighth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 9: Enter the name of your out of state employer on the ninth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 10: Enter your total service on the tenth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 11: Write whether you were covered by a public retirement system or plan on the eleventh blank line. If yes, write the benefit on the twelfth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 12: Enter your signature on the thirteenth blank line.

Alabama Application And Certification For Out-Of-State Service Credit RSA 50B Step 13: Document your former out-of-state employers in Part II as directed. Part III should be completed by your former employer's retirement system.