Form 02-830 Application for Military Service Credit - Alaska

Form 02-830 is a Alaska Department of Administration form also known as the "Application For Military Service Credit". The latest edition of the form was released in October 1, 2018 and is available for digital filing.

Download an up-to-date Form 02-830 in PDF-format down below or look it up on the Alaska Department of Administration Forms website.

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TRS
Application for
FOR OFFICE USE ONLY
Military Service Credit
TEACHERS’ RETIREMENT SYSTEM
ALASKA DIVISION OF
Retirement
Benefits
and
Division of Retirement and Benefits
Juneau: (907) 465-4460
Toll-Free: (800) 821-2251
P.O. Box 110203
TDD: (907) 465-2805
alaska.gov/drb
Juneau, AK 99811-0203
Fax: (907) 465-3086
TO THE MEMBER:
To receive TRS credit for military service, you must: (1) complete this application and (2) provide legible copies of your separation forms
(DD or GG forms 214 or other documentation) verifying your beginning and ending dates of military service and your
honorable discharge.
If you need to obtain documentation of your military service, write to:
NPRC/MP National Personnel Records Center, Civilian Records Facility
1 Archives Drive
St. Louis, MO 63132
Be sure to include your military service and Social Security numbers, branch of service, and approximate dates of service.
MEMBER NAME (FIRST, MI, LAST)
RIN OR LAST 4 OF SSN
MAILING ADDRESS
CITY
STATE
ZIP
EMPLOYER
WORK TELEPHONE NUMBER
HOME TELEPHONE NUMBER
(
)
(
)
I wish to claim _____ years, _____ months and _____ days of military service (no more than five years may be claimed). I understand
that military service which has been credited in the Public Employees’ Retirement System (PERS) is not creditable in the TRS; and
that no more than ten (10) years total military and outside teaching service is creditable. However, if entry into the military service is
immediately preceded by the TRS membership service and discharge is followed by membership service within one year, the
ten-year limit does not apply.
I understand that compound interest as prescribed by regulation will be added to my military indebtedness until it is paid in full or I
retire, whichever occurs first.
SIGNATURE
DATE
FOR TRS USE ONLY – MILITARY SERVICE COMPUTATION
ENTRY INTO MILITARY SERVICE
SEPARATION FROM MILITARY SERVICE
CREDITABLE SERVICE
.
.
=
.
YEARS
.
.
=
.
YEARS
.
.
=
.
YEARS
.
YEARS
ADD .00274 FOR EACH SEGMENT (MORE THAN 1)
TOTAL YEARS OF CREDITABLE MILITARY SERVICE
(ROUNDED DOWN TO TENTHS)
.
YEARS
DATE
VERIFIED AND COMPUTED BY
CHECKED BY
02-830 (Rev. 10/18)
G:\Communications_Only\200 Products\206\TRS\02-830.indd
TRS
Application for
FOR OFFICE USE ONLY
Military Service Credit
TEACHERS’ RETIREMENT SYSTEM
ALASKA DIVISION OF
Retirement
Benefits
and
Division of Retirement and Benefits
Juneau: (907) 465-4460
Toll-Free: (800) 821-2251
P.O. Box 110203
TDD: (907) 465-2805
alaska.gov/drb
Juneau, AK 99811-0203
Fax: (907) 465-3086
TO THE MEMBER:
To receive TRS credit for military service, you must: (1) complete this application and (2) provide legible copies of your separation forms
(DD or GG forms 214 or other documentation) verifying your beginning and ending dates of military service and your
honorable discharge.
If you need to obtain documentation of your military service, write to:
NPRC/MP National Personnel Records Center, Civilian Records Facility
1 Archives Drive
St. Louis, MO 63132
Be sure to include your military service and Social Security numbers, branch of service, and approximate dates of service.
MEMBER NAME (FIRST, MI, LAST)
RIN OR LAST 4 OF SSN
MAILING ADDRESS
CITY
STATE
ZIP
EMPLOYER
WORK TELEPHONE NUMBER
HOME TELEPHONE NUMBER
(
)
(
)
I wish to claim _____ years, _____ months and _____ days of military service (no more than five years may be claimed). I understand
that military service which has been credited in the Public Employees’ Retirement System (PERS) is not creditable in the TRS; and
that no more than ten (10) years total military and outside teaching service is creditable. However, if entry into the military service is
immediately preceded by the TRS membership service and discharge is followed by membership service within one year, the
ten-year limit does not apply.
I understand that compound interest as prescribed by regulation will be added to my military indebtedness until it is paid in full or I
retire, whichever occurs first.
SIGNATURE
DATE
FOR TRS USE ONLY – MILITARY SERVICE COMPUTATION
ENTRY INTO MILITARY SERVICE
SEPARATION FROM MILITARY SERVICE
CREDITABLE SERVICE
.
.
=
.
YEARS
.
.
=
.
YEARS
.
.
=
.
YEARS
.
YEARS
ADD .00274 FOR EACH SEGMENT (MORE THAN 1)
TOTAL YEARS OF CREDITABLE MILITARY SERVICE
(ROUNDED DOWN TO TENTHS)
.
YEARS
DATE
VERIFIED AND COMPUTED BY
CHECKED BY
02-830 (Rev. 10/18)
G:\Communications_Only\200 Products\206\TRS\02-830.indd
FOR TRS USE ONLY – CALCULATION
SCHOOL YEAR JULY 1, ___________ TO JUNE 30, ___________ ANNUAL SALARY
$
CONTRIBUTION RATE
X
%
CONTRIBUTIONS DUE FOR ONE YEAR
$
TOTAL MILITARY SERVICE FROM SIDE 1
X
YEARS
TOTAL INDEBTEDNESS PRINCIPLE
$
INTEREST DATE
Interest accrues from date of hire or July 1, 1976, whichever is later. If military service is rendered following termination from TRS
employment, interest will accrue from date of rehire or July 1, 1976, whichever is later.
DATE
COMPUTED BY
02-830 (Rev. 10/18)
G:\Communications_Only\200 Products\206\TRS\02-830.indd

Download Form 02-830 Application for Military Service Credit - Alaska

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