Forms
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- Administrative Forms
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- For PAC (Morrow) ONLY
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- Peach State Reserves Deferred Compensation Forms
- Retirement System Forms
- State Health and Flexible Benefits Plan Forms
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Form Title
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- 2023 Flexible Benefits Rate Sheet
- 2023 Flexible Benefits You Decide Guide
- 2023 Flexible Benefits-at-a-Glance
- 2023 State Health Benefit Plan Active Member Decision Guide
- 2023 State Health Benefit Plan Active Member Rates
- 2023 State Health Benefit Plan Retiree Decision Guide
- Affordable Care Act Model Notice
- All Peach State Reserves Deferred Compensation Information
- Assistant District Attorney Application
- Assistant District Attorney Appointment Order
- Assistant District Attorney Oath of Office
- BeWell SHBP Biometric Screening Form
- BeWell SHBP Biometric Screening Website
- Cell Phone Reimbursement Policy
- Certification for Serious Injury of a Current Servicemember
- Certification for Serious Injury or Illness of a Veteran for Military Caregiver Leave
- Certification of Health Care Provider for Employee’s Serious Health Condition
- Certification of Health Care Provider for Family Member’s Serious Health Condition
- Certification of Qualifying Exigency for Military Family Leave
- Chief Assistant District Attorney Appointment Order
- Chief Assistant District Attorney Oath of Office
- Child Labor Summary Sheet
- DA Investigator Appointment Order
- DA Investigator Oath of Office
- DA Victim Advocate Appointment Order
- Delegation of Authority – Absence Management
- Designation of Outstanding Wages
- Designation of Outstanding Wages
- DOL Separation Notice
- Drug Custody Form (see your office manager)
- E-Verify
- EEOC
- Employee Confidentiality Agreement
- Employee Information Sheet (PDF)
- Employee’s Report of Injury
- Employment Application
- Employment Eligibility Form (I-9)
- ERS Group Term Life Insurance Form (New Plan ONLY)
- ERS Handbook
- Family and Medical Leave Request Form
- Federal Minimum Wage
- Flexible Benefits Employee Orientation Video
- Flexible Benefits Enrollment Portal (All Flexible Benefits forms, including beneficiary forms must be filled out online or call 1-877-342-7339)
- FMLA
- Food Stamp Payment Request Form
- GA Third-Year Law Student Oath
- GA Third-Year Practice Application for Order of Admission
- GA Third-Year Practice Order
- GaBreeze Quick Reference Guide
- GDCP Application for Refund of Contributions
- GDCP New Hire Letter (hourly new hires only)
- GDCP New Hire Letter (hourly new hires only)
- Georgia Hotel and Motel Tax Exemption
- Georgia United Credit Union Benefits Brochure
- Georgia United Credit Union Membership Kit
- Georgia United Credit Union Payroll Deduction Form
- Georgia United Credit Union Website
- GSEPS 401K Enrollment Information
- GSEPS Handbook
- GSEPS Opt In Form
- Hourly Time Sheet (for Circuit Use ONLY)
- Hourly Time Sheet (for PAC Atlanta use ONLY)
- Important Changes to 401K and 457
- Incident Only Notice (When no immediate injury or no treatment needed beyond first aid)
- Investigator Application
- JQC Referral Letter Template
- JQC Referral Packet
- JRS Change or Designation of Beneficiaries
- JRS Handbook
- JRS Membership Application (For District Attorneys ONLY)
- Leave Adjustment Form
- Live Health Virtual Visit
- Loyalty Oath
- Monthly State Vehicle Reporting Form (for employees assigned a state vehicle)
- Motor Vehicle Assignment and Use Authorization
- Municipal/Probate Prosecutor Registration Form
- New Hire Checklist – Circuit Use only
- New Hire Forms Checklist
- New Hire Onboarding Paperwork
- OSHA
- Out of State Travel Authorization
- Paid Parental Leave Request Form
- Path 2 College 529 Application (Optional College Savings Plan)
- Payment & Reimbursement Request
- Payroll Deduction Authorization (Peace Officers’ Annuity and Benefit Fund of GA)
- Peachcare FAQ
- Personnel Action Form (PAF)
- Purchase Request Form
- Purchase Requisition Form (for Circuits)
- Reporting of Injuries
- Request for Exemption to the Budget Neutral Hiring Policy
- SG Victim Advocate Appointment Order
- SHBP Enrollment Portal
- SHBP Enrollment Portal Quick Reference Guide
- SHBP Enrollment Portal User Guide
- Special Assistant District Attorney Oath of Office
- Standard Disability Benefit Claim Form
- State Vehicle Insurance Card
- Statement of Limitation of Practice (for Part-Time Solicitors-General)
- Suggested Rights Statement
- Supervisor Reporting Instructions
- Travel Reimbursement Form (2019)
- Unemployment Insurance
- USERRA Poster
- Victim Impact Restitution Form
- Victim Impact Restitution Form
- Victim Impact Statement (revised 2010)
- W9
- WC Bill of Rights
- WC Bill of Rights (to be displayed in office)
- WC Fraud
- WC Fraud Notice (to be displayed in office)
- WC/MCO at a Glance (to be displayed in office)
- WC/MCO Panel (to be displayed in office)
- Witness Report of Injury
GDCP Application for Refund of Contributions
You can use your ERSGA online account to update your home address, make changes to your beneficiary designations, or to request a refund of your contributions and interest. Using your online account is fast, easy, and secure!
Requesting a Refund
If you are not able to apply for a refund online, please contact ERSGA for assistance. Our contact information can be found by selecting Contact under the About menu. You can call and speak to a customer care representative, or click Contact the Customer Care Group link on the right side of the Contact page.