495—11.1 (97B) Application for benefits.
	   11.1(1) Form used. It is the responsibility of the member to notify IPERS of the intention to retire. This should be done 60 days before the expected retirement date. The application for monthly retirement benefits is obtainable from IPERS, 7401 Register Drive, P.O. Box 9117, Des Moines, Iowa 50306-9117. The printed application form shall be completed by each member applying for benefits and shall be mailed, sent by fax or brought in person to IPERS. An application that is incomplete or incorrectly completed will be returned to the member. To be considered complete, an application must include the following:
	      a.    	 Proof of date of birth for the member.
	      b.    	 Option selected, and
	       (1)  	 If Option 1 is selected, the death benefit amount.
	       (2)  	 If Option 4 or 6 is selected, the contingent annuitant’s name, social security number, proof of date of birth, and relationship to member. The member must designate the survivor benefit percentage, which shall be limited to one of the following:
	      1. 	  One hundred percent of the member’s benefit amount.
	      2. 	  Seventy-five percent of the member’s benefit amount.
	      3. 	  Fifty percent of the member’s benefit amount.
	      4. 	  Twenty-five percent of the member’s benefit amount.
	       (3)  	 If Option 1, 2, or 5 is selected, a list of beneficiaries.
	      c.    	 If the member has been terminated less than one year, or is applying for disability benefits, the employer certification page must be completed by the employer unless the employer has provided the termination date and date of the last paycheck on the monthly wage reports.
	      d.    	 Signature of member and spouse, both properly notarized unless witnessed by an authorized employee of the system.
	      e.    	 If the member has no spouse, “NONE” must be designated.
	      f.    	 If the member is applying for regular disability benefits, a copy of the award letter from the Social Security Administration or railroad retirement.
A retirement application is deemed to be valid and binding on the date the first payment is paid. Members shall not cancel their applications, change their option choice, or change an IPERS option containing contingent annuitant benefits after that date.
	   11.1(2) Proof required in connection with application. Proof of date of birth to be submitted with an application for benefits shall be in the form of a birth certificate, a U.S. passport, an infant baptismal certificate, a state identification card that is issued in compliance with the REAL ID Act of 2005, or a driver’s license that is issued in compliance with the REAL ID Act of 2005. If these records do not exist, the applicant shall submit two other documents or records which will verify the day, month and year of birth. A photographic identification record may be accepted even if now expired unless the passage of time has made it impossible to determine if the photographic identification record is that of the applicant. The following records or documents are among those deemed acceptable to IPERS as proof of date of birth:
	      a.    	 United States census record;
	      b.    	 Military record or identification card;
	      c.    	 Naturalization record;
	      d.    	 A marriage license showing age of applicant in years, months and days on date of issuance;
	      e.    	 A life insurance policy;
	      f.    	 Records in a school’s administrative office;
	      g.    	 An official document from the U.S. Citizenship and Immigration Services, such as a “green card,” containing such information;
	      h.    	 Driver’s license or Iowa nondriver identification card;
	      i.    	 Adoption papers;
	      j.    	 A family Bible record. A photocopy will be accepted with a notarized certification that the record appears to be genuine; or
	      k.    	 Any other document or record ten or more years old, or certification from the custodian of such records which verifies the day, month, and year of birth.
If the member, the member’s representative, or the member’s beneficiary is unable or unwilling to provide proof of birth, or in the case of death, proof of death, IPERS may rely on such resources as it has available, including but not limited to records from the Social Security Administration, Iowa division of records and statistics, IPERS’ own internal records, or reports derived from other public records, and other departmental or governmental records to which IPERS may have access.
IPERS is required to begin making payments to a member or beneficiary who has reached the required beginning date specified by Internal Revenue Code Section 401(a)(9). In order to begin making such payments and to protect IPERS’ status as a plan qualified under Internal Revenue Code Section 401(a), IPERS may rely on its internal records with regard to date of birth, if the member or beneficiary is unable or unwilling to provide the proofs required by this subrule within 30 days after written notification of IPERS’ intent to begin mandatory payments.
	   11.1(3) Benefits estimates. Prior to submitting an application for benefits, a member may request IPERS to prepare estimates of projected benefits under the various options as described under Iowa Code section 97B.51. A benefit estimate shall not bind IPERS to payment of the projected benefits under the various options specified in Iowa Code chapter 97B. A member cannot rely on the benefit estimate in making any retirement-related decision or taking any action with respect to the member’s account, nor shall IPERS assume any liability for such actions. An estimate will not include deductions for a QDRO or any other legal assignments or orders on a member’s account, unless specifically requested by the member. A member’s actual benefit can only be known and officially calculated when an eligible member applies for benefits.
	   11.1(4) Revocation of application. If IPERS determines an application for benefits is invalid for any reason, IPERS shall revoke, in whole or in pertinent part, the application for benefits and the recipient shall repay all payments made under the revoked application or all payments made pursuant to the revoked part of the application. The terms of repayment shall be subject to the provisions of 495—11.7(97B).
[ARC 8601B, IAB 3/10/10, effective 4/14/10; ARC 1348C, IAB 2/19/14, effective 3/26/14; ARC 1887C, IAB 2/18/15, effective 3/25/15; ARC 2402C, IAB 2/17/16, effective 3/23/16]