TR-0058 (Rev. 6/12) RDA-413
Waiver of
Retirement
Benefi ts
Tennessee Consolidated Retirement System
502 Deaderick Street
Nashville, Tennessee 37243-0201
1-800-770-8277 http://tcrs.tn.gov
Any retired employee or benefi ciary may suspend all or part of his/her monthly retirement allowance
received from the Tennessee Consolidated Retirement System (TCRS). Suspension of benefi ts is
considered a forfeiture of the amount suspended.
SECTION 1. MEMBER INFORMATION
Member ID Last 4 SSN XXX-XX- Date of Birth
Full Name
Mailing Address
City State Zip Code
Email Phone Number
Please select one:
I direct TCRS to stop my entire monthly retirement allowance
I direct TCRS to reduce my monthly retirement allowance to $_________________
Cost-of-Living Adjustments (COLA)
Any retired state employee or teacher who has been retired for at least 12 full months on July 1 of each
year is eligible to receive an adjustment in his/her retirement allowance. The adjustment depends on
the increase, if any, in the Consumer Price Index for the preceding calendar year.
If there is an increase in the Consumer Price Index between one-half of one percent and one percent
in any year and the State legislature approves, retired state employees will receive a one percent cost-
of-living adjustment. If there is an increase in the Consumer Price Index of one percent or more in any
year and the State legislature approves, retired state employees will receive an amount equal to the
increase in the Consumer Price Index, not to exceed three percent. Adjustments will appear on the
July 31 payment.
Note: Retired employees of political subdivisions are only eligible for COLAs if the local government
has passed a resolution providing COLAs.
Please select one:
Increase future payments to refl ect COLA
Do not adjust future payments for COLA
I understand this election constitutes a forfeiture of benefi ts and I may reinstate my full retirement
allowance at a later date by submitting written notice to TCRS.
Member’s Signature Date
