MFPRSI. Municipal Fire & Police Retirement System of Iowa

Active Member Forms

• Address/Name Change
• Alternate Payee Benefit application - MPO
• Annual Statement Request
• Authorized Leave Notice
• Beneficiary Designation
• Benefit Handbook
• Common Law Marriage Application
• Death Notification
• Disability Retirement Packet
• DROP Distribution Form
• DROP Enrollment & Beneficiary Form
• Medical Exam Fire
• Medical Exam Police
• Medical History F&P Questionnaire
• Medical Occupational Questionnaire - Fire
• Medical Occupational Questionnaire - Police
• Medical Protocol Checklist - F&P
• Purchase Service Credit Request Form
• Refund Application
• Sample Marital Property Order
• Service Retirement Application

Retiree / Beneficiary Forms

• 2021 Federal W-4P
• 2023 Iowa Tax Withholding Update
• 2024 Iowa W-4P
• Address/Name Change
• Alternate Payee Benefit application - MPO
• Benefit Handbook
• Children's Education Affidavit
• Death Notification
• Direct Deposit
• Duplicate 1099R Request
• Duplicate Deposit Notification Request
• Earnings Test Statement of Compliance
• Income Verification Request
• Representative Payee Application
• Sample Marital Property Order

Terminated Member Forms

• Beneficiary Designation
• Refund Application