TR-0471
(Rev.
8/18
)
RDA-413
Tennessee Consolidated Retirement System
502 Deaderick Street
Nashville, Tennessee 37243-0201
1-800-922-7772 RetireReadyTN.gov
Any person who has optional membership including part-time state employees, part-time teachers, or
part-time higher education employees on or after July 1, 2016 and who otherwise would be covered
under the Hybrid Plan must, upon initial date of hire, file an irrevocable election to become or not to
become a participant in the Hybrid Plan.
Pursuant to T.C.A., Section 8-34-101, “part-time employee” means any person employed by the state or a
political subdivision who renders less than a full day of service per working day or less than a full week of
service per working week. Any employee falling into either of the above categories shall be considered part-
time unless the law otherwise provides. “Part-time employee” does not include employees who are students,
seasonal or temporary employees under twenty-five (25) years of age, temporary employees in institutions of
higher education, or substitute teachers, unless such substitutes are under contract and scheduled to work the
same time as a regular teacher. “Part-time employee” includes any interim teacher who is employed on a
temporary basis to teach for a regular teacher who is on unpaid leave.
For more information regarding TCRS retirement benefits and plan provisions, please contact your employer
or visit our website at RetireReadyTN.gov.
SECTION 1. MEMBER INFORMATION
Member ID
SSN
Date of Birth
Full Name Gender
Male Female
Mailing Address
City State Zip Code
Email Phone Number
Employer Date of Employment
Pursuant to T.C.A., Section 8-36-903(c), I must elect whether to participate in TCRS or fi le an irrevocable
election to not become a participant in the Hybrid Plan.
I have read the foregoing and have elected to participate in TCRS. I understand that this election may not
be changed.
I have read the foregoing and have elected not to participate in TCRS. I understand that this election may
not be changed.
Member’s Signature: ___________________________________ Date: ____________________
Employers may submit this form via email to TCRS.CustomerSupport@tn.gov.
ELECTION TO PARTICIPATE
FOR STATE EMPLOYEES,
TEACHERS, AND HIGHER
EDUCATION EMPLOYEES WITH
OPTIONAL MEMBERSHIP
