Print this form, sign and date it, and return it to PSERS.
Accounts: check all appropriate boxes for the monthly pension account(s) this form affects.
Routing number: it should be the first 9 digits of the number at the bottom left on your check.
Previous arrangements: this form supersedes all previous electronic transfer requests and revokes all prior payment arrangements the payee may have made with PSERS.
Changes: the payee agrees to notify PSERS sixty (60) days prior to the effective date of a change of the designated financial institution or account.
| Question | Answer |
|---|---|
| Form Name | PSRS-116 |
| Form Length | 1 page |
| Fillable? | Yes |
| Fillable fields | 17 |
| Avg. time to fill out | 3 min |
| Edition | 04/2020 |
| Issuing agency | Public School Employees' Retirement System |
| Matches the agency's file | Yes, checked October 3, 2026 |
| Other names | PSRS-116, PSRS116, PSERS direct deposit form, PSERS form, Authorization for Direct Deposit, Electronic Transfer of Monthly Benefit |
| Official source | PSRS-116 (Rev 04/2020), Public School Employees' Retirement System |
Psers Forms Form isn’t the one you’re looking for?