INSTRUCTIONS: ALABAMA GENERAL STATEMENT OF SERVICE

When Alabama state employees are preparing to retire, one of the forms which must be filed in order to purchase services to be credited to their retirement account is a general statement of service. This document can be found on the website maintained by the Employees' Retirement System of Alabama.

Alabama General Statement Of Service Step 1: On the first blank line, enter your first, middle and last name.

Alabama General Statement Of Service Step 2: On the second blank line, enter your post office box number or your street address.

Alabama General Statement Of Service Step 3: On the third blank line, enter your city, state and zip code.

Alabama General Statement Of Service Step 4: On the fourth blank line, enter your Social Security number.

Alabama General Statement Of Service Step 5: Two statements are provided below. You should only check the box next to the statement applicable to you. The first statement should be checked if you have not established credit with any other public retirement service based on the service being claimed as a credit with the Employees' Retirement System of Alabama. By checking this statement, you also agree to notify the Employees' Retirement System of Alabama if you become entitled to credits or benefits for these services with any other public retirement plan when your entire, and that if you take these credits or benefits, your purchased service credit will be withdrawn and refunded to you.

Alabama General Statement Of Service Step 6: Check the box next to the second statement if you have established another public retirement system credit based on the service for which you are claiming credit with the Employees' Retirement System of Alabama.

Alabama General Statement Of Service Step 7: Provide your signature and the date in the blank lines where indicated.

Alabama General Statement Of Service Step 8: The form must then be certified by a licensed notary public. They will enter your state and county, the date on which you appear before them and your name. They will then sign the form, enter the date on which their commission expires, and affix their seal.

Alabama General Statement Of Service Step 9: File the form by mailing it to the address provided at the top of the form.