Pre Retirement Checklist Form

  1. Ready to Retire?
  2. You must be Age 55 (50 for protective) to take a retirement benefit.
    When do you want to retire?
    Your Name
  3. Submit Benefit Information Request Form to Employee Trust Funds (ETF).
  4. At least 8 - 12 months prior to retirement date, complete the Benefit Information Request Form ET-7301.

    If Military Service Credit - Submit Form DD214 to ETF along with the ET-7301
  5. Make an Appointment.
  6. Make appointment with one of the Benefits Specialist regarding Benefits and Leave Options at least 1-2 months prior to anticipated retirement date.
    Contact payrollandbenefits@uwgb.edu to make any appointment.
  7. Leave Options
    1. Vacation
    2. Vacation is pro-rated based on your retirement date. Any unused leave time will be paid out upon last day in pay status.

      Planning to extend your time in pay status by using your unused leave time (vacation, personal holiday, sabbatical/ALRA)?
           Yes No
    3. Personal Holiday/Legal Holiday/Comp Time
    4. Any unused leave will be paid out upon last day in pay status.
    5. Sabbatical (ALRA)
    6. Payout at time of retire OR Use while in pay status
    7. Sick Leave
    8. Convert to pay health insurance premium OR
      Escrow - complete Sick Leave Escrow Application ET-4305

      Are you interested in an estimate on how long your sick leave will pay for your Health Insurance?Yes No
  8. Insurance Information
    1. Health Insurance/Dental
    2. Do you carry the State Group Health Insurance? Yes No

      Does Spouse currently work for the State? Yes No
      Is Spouse Retired from the State? Yes No
      Spouse's Name:
    3. State Group Life (will continue upon retirement)
    4. ERA
    5. Stop at Retirement OR Take additional payments to cover entire year
  9. Inform Human Resources/Benefits of the address where your final paycheck and W-2 is to be sent.


  10. Provide written resignation notice to supervisor or Area Leader and send copy to Human Resources.
  11. Include last day working and, if applicable, indicate any leave you may be using. Provide last day in pay status. Submit as early as possible after final decision to retire is made.
  12. Returning to Work After Retirement.