Retired Seattle Police Officers Association

Pension Office News | November 2017

LEOFF1 Seattle Police Pension Member:

We have mailed out your required Annual Reporting Forms today! Please look for them in the US Mail.  If you do not get your large white envelope with your documents, please contact us. We have asked RSPOA to Post the forms on their website as well.

For all Retired Officers:  
For those Retired Officers only, who are over 65 years old and on Medicare: You will also receive the 2017 Medicare Reimbursement Form. Do not complete this form if you are already submitting requests to our office. This form is for the Annual Medicare Reimbursement only. Expect processing time of approximately 4 to 6 weeks. NO REIMBURSEMENTS WILL BE PROCESSED UNTIL YOUR REPORTING FORMS ARE RECEIVED. This form is not required to be notarized.

For Surviving Spouses/Beneficiaries: 
You will receive only one form, the “Reporting Form”, which must be completed, notarized and returned to the Seattle Police Pension Office by January 31, 2017.  

Everyone will also receive the Emergency Contact Form. This form is not required to be notarized. Please complete this form and return it with your other document(s).

THESE ANNUAL FORMS ARE IMPORTANT.  Auditors look to these reports to validate public pension payments and medical benefits you may be receiving.  

Download the forms here:

5-Important Numbers

Instructions For All:
Please take a few minutes now to complete this vital paperwork and return it to your Seattle Police Pension Office by January 31, 2018!!  YOUR SIGNATURE(S) MUST BE NOTARIZED.  

Once completed and notarized, you can email, fax or mail your documents to the Pension Office:

Email:   The only way we can send an acknowledgement of our receipt is via the email transmission.

Fax: 206-386-9075

US Mail:  Police Pension Office, PO BOX 94729 Seattle, WA 98124-4729

We will be attending the monthly RSPOA meetings at the Nile and will have our notary stamps. So please bring your completed paperwork so we can notarize it for free and save you a few dollars. The meetings are held on the second Wednesday of each month.

Please be sure to keep a copy for your records! If we fail to receive your document(s) we will be contacting you for a copy.

If you have a Power of Attorney (POA) that person may complete these document(s)  for you as your POA; Police Pension must have a plain paper copy of your  Power of Attorney paperwork in your file, so please be sure to send us a copy with your documents.  

Should you have any questions, please call Stephanie at (206) 386-1287 option 3 or my email is  

Thank you for your prompt cooperation.  

Kind Regards,
Dan Oliver
Executive Secretary