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​Form Disclaimer

All forms on the KPPA website can be viewed within any browser. If you would like to fill out a form online, you will need to use any browser EXCEPT Microsoft Edge.

If you are looking for member forms, such as Form 6000, Notification of Retirement, or employment verification forms, please visit the Member Forms page.

Form 2011 - Hazardous Duty Certification H.P.-2
Form 2014 - Rejection of Nonhazardous Part-Time Participation
Form 4225 - Verification of Past Employment
Form 6481 - Employer Request for Post-Determination of Bona Fide Promotion or Career Advancement
Form 6486 - Authorization for Release of Retirement Account Information
From 6751 - Employer Certification Regarding Reemployment
Form 6752 - Employer Certification of Independent Contractor or Leased Employee
Form 6753 - Employer Certification of Volunteer
Form 6756 - Annual Employer Certification of Non-Contributing Service Providers
Form 6760 - County Police or Sheriff Appointment of Retired Police Officer
Form 6764 - Recertification of Retired Police Officer
Form 6766 - Appointment of Retired School Resource Officer
Form 6767 - Appointment of Kentucky State Police School Resource Officer
Form 6768 - Postsecondary Institution Appointment of Retired Police Officer
Form 6769 - Certification of Employed Police Officers Calendar Year 2015
Form 6770 - City Appointment of Retired Police Officer
Form 6774 - City Recertification of a Retired Police Officer
Form 6776 - Certification of Postsecondary Institution Employed Police Officers Calendar Year 2018
Form 6800 - Application for Duty Related/In Line of Duty Survivor Benefits
Form 7071 - Employer Administrator Account Creation Request
Form 7072 - Reporting/Balancing Employer Acknowledgement Form
Form 7075 - Employer Contact Information
Form 7727 - Actuarial Study for Quasi-Governmental Employer Cessation
Form 7730 - Application for Voluntary Cessation From CERS or KERS
Form 7851 - Data Use Agreement

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