What if I entered the wrong SSN?

Notify HR and payroll immediately. Correcting a TIN or SSN typically requires submitting an amended record to payroll and, if applicable, corrected tax forms to the IRS to avoid backup withholding or reporting errors.

Can the picklist be signed electronically?

Yes. Under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, electronic signatures are legally valid when intent, consent, attribution, and retention are satisfied.

Is notarization ever required?

Some states or plan rules require notarized beneficiary designations; check state-specific rules. When notarization is required, remote online notarization (RON) may be permitted based on jurisdiction.

How do I correct a submitted picklist?

Submit a corrected picklist signed and dated with the correction date; HR should retain both versions and document the reason for change to preserve auditability.

How long must we keep signed picklists?

Retain per IRS and employment record rules—generally at least three years after filing or termination; longer retention may apply for HIPAA or state-specific requirements.

What causes signature verification failures?

Common causes include mismatched signer information, expired authentication links, or missing consent disclosures. Re-send with correct authentication or provide an alternative signing method.

Electronic Signature
Templates
Miscellaneous
Employee PERS Picklist

Employee PERS Picklist

This template is fully customizable. Edit the text, fill out the fields, and send it for signature. Give it a try!

Employee PERS Picklist Agreement and Enrollment Form

This Employee PERS Picklist Agreement and Enrollment Form (the "Agreement") is made and entered into as of Effective Date: by and between Employer Name: and Service Provider Name: .

WHEREAS

WHEREAS, Employer maintains a workforce of employees eligible for participation in a public employees' retirement system and seeks to implement a standardized picklist process for employee PERS enrollment elections and payroll deduction authorizations;

WHEREAS, Service Provider is engaged to design, administer and record employee picklist selections, provide secure transmission of election data to payroll, and maintain records in accordance with applicable confidentiality obligations;

WHEREAS, the parties desire to set forth the scope, payment, term and confidentiality terms governing the implementation and ongoing administration of the Employee PERS picklist process pursuant to the terms of this Agreement.

Scope of Work

Service Provider shall perform the following services in accordance with standards of professional care and applicable law:

Detailed Scope (describe tasks, deliverables, timelines)

Employee Enrollment Picklist

The following enrollment data shall be collected by Service Provider and retained in accordance with this Agreement. Employer authorizes the Service Provider to accept and record the selections supplied below for processing by Employer payroll.

Employee Name Employee ID

Position:

Department:

Hire Date:

Work Address

PERS Election (select one or more applicable options):

Enroll in PERS membership
Waive PERS membership (employee elects to opt out where permitted)
Reinstate prior PERS membership status

Contribution Rate or Amount

Pre-tax payroll deduction After-tax payroll deduction

Primary Beneficiary(ies)

Payroll Deduction Authorization

By completing this picklist, Employer authorizes Service Provider to record the above selections and to notify Employer payroll to implement deductions. Employee acknowledges responsibility for accuracy of submitted elections.

Employee Affirmation I affirm the selections above are accurate and authorize payroll deductions as indicated.

Employee Printed Name:

Payment Terms

Employer shall pay Service Provider for the services described in the Scope of Work in accordance with the terms set forth below. All fees are exclusive of any taxes for which Employer is responsible.

Service Fee Amount Payment Schedule Late Payment Fee

Term and Termination

This Agreement shall commence on Start Date: and continue until End Date: , unless earlier terminated in accordance with this Section.

Either party may terminate this Agreement for convenience upon written notice to the other party not less than prior to the effective date of termination. Either party may terminate immediately for material breach if the breaching party fails to cure within thirty (30) days after receipt of written notice of such breach.

Confidentiality

Each party shall maintain the confidentiality of Confidential Information of the other party and shall not disclose such information except as required by law or as necessary to perform its obligations under this Agreement. "Confidential Information" includes employee personal data, benefit elections, payroll data, and any other nonpublic information designated as confidential or that reasonably should be understood to be confidential.

Service Provider shall implement and maintain administrative, technical and physical safeguards appropriate to the sensitivity of employee data and shall promptly notify Employer of any unauthorized access or disclosure.

Governing Law

This Agreement shall be governed by and construed in accordance with the laws of the State of without regard to its conflict of laws principles.

Entire Agreement

This Agreement, including the Scope of Work and Enrollment Picklist data recorded hereunder, constitutes the entire agreement between the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous communications, proposals, and agreements, whether oral or written. Any amendment must be in writing and signed by authorized representatives of both parties.

Employer Representative (Print Name):

By:

Date:

Service Provider Representative (Print Name):

By:

Date:

What the Employee PERS Picklist Is and when it’s used

The Employee PERS Picklist is a standardized HR form used to record an employee’s selections and elections related to Public Employees’ Retirement System enrollment, contribution levels, beneficiary designations, and plan options. Employers use the picklist to capture consistent, auditable choices at hire or during open enrollment and to feed payroll, benefits administration, and retirement plan records. The document functions as both an employee instruction set and a data source for downstream systems, so clarity, accurate identifiers, and dated signatures are essential for reliable benefits administration and recordkeeping.

Why a clear Employee PERS Picklist matters

A precise picklist reduces processing errors, ensures correct pension enrollment, and creates an auditable record for compliance and payroll reconciliation. It helps employers meet documentation and reporting obligations while giving employees a clear record of their retirement elections.

Who completes and relies on the Employee PERS Picklist

Different teams interact with the picklist at distinct stages: employees select options, HR validates entries, and payroll applies elections to compensation records.

Employees — Complete personal data, choose contribution levels, and name beneficiaries; attest to accuracy before signing.
HR administrators — Verify eligibility, confirm plan tier, and route the completed picklist to payroll and benefits vendors.
Payroll and benefits teams — Import picklist selections into payroll, adjust withholding, and reconcile employer/employee contributions.

Keeping these roles distinct and documented reduces rework, supports audits, and shortens the time between election and pay-period effect.

Step-by-step: Filling out the Employee PERS Picklist

Follow these sequential steps to complete the picklist accurately, minimize downstream errors, and create a reliable audit trail for payroll and benefits processing.

01

Prepare: Gather employee ID, social security number, hire date, and plan options.
02

Complete: Select PERS tier, contribution percentage, and beneficiary information.
03

Verify: HR reviews entries, checks eligibility, and confirms required attachments.
04

Submit: Sign, date, and send the picklist to payroll and benefits administrators.

How the picklist moves through your workflow

A clear handoff sequence reduces processing delays and preserves an audit trail for each completed Employee PERS Picklist.

Upload: HR uploads the picklist template to the document system.
Assign Fields: Place required data fields, dropdowns, and signature blocks.
Send to Signer: Deliver via email link or secure portal to the employee.
Record: Save signed copy and export data to payroll and benefits systems.

Recommended digital workflow settings for the picklist

Configure your electronic workflow to capture identity, enforce required fields, and maintain an accessible audit trail for each picklist.

Field	Configuration
Authentication	Email link with optional SMS code for signer verification.
Conditional Fields	Show tier-specific options only when that tier is selected.
Notifications	Email alerts to HR and payroll when signed.
Retention Export	Automatic PDF export to records management after signing.

Technical requirements and integrations for eSubmission

Choose a platform that supports PDF and DOCX templates, audit trails, and common integrations with HR and payroll systems.

Integrations: Salesforce, NetSuite, Microsoft 365, Google Workspace supported
Formats: PDF, Word DOCX, and exportable CSV data
Authentication: Email, SMS code, or advanced signer authentication

Key timing rules and common deadlines

Align picklist deadlines with hiring timelines, payroll cutoffs, and plan enrollment windows to avoid missed elections or delayed contribution start dates.

Submission at Hire:

Provide picklist during onboarding or within employer-specified enrollment window.

Enrollment Window:

Typical window is 30 days from hire; verify with PERS administrator.

Pay Period Effect:

Effective date often applies at the next payroll cycle following submission.

Annual Changes:

Open enrollment changes usually have a defined annual deadline.

Corrections Deadline:

Report errors to payroll promptly to avoid retroactive adjustments.

Milestones from picklist issue to payroll application

Track these sequential milestones to ensure elections move from employee selection to payroll effect without gaps.

01

Issue Picklist

HR publishes and assigns the picklist to the employee for completion.

02

Employee Completion

Employee selects options, signs, and returns the picklist.

03

HR Verification

HR confirms eligibility and resolves inconsistencies.

04

Payroll Application

Payroll implements deductions on the scheduled pay date.

Common mistakes that cause delays or incorrect pension setup

Mismatched names or incorrect SSN entries cause identity verification failures and delay enrollment.
Selecting the wrong PERS tier or plan code can route contributions incorrectly and require retroactive corrections.
Incomplete beneficiary details prevent timely benefit payment and can force probate or administrative hold-ups.
Failing to sign or date the picklist makes the record invalid for payroll processing and benefits activation.

Security and compliance items to include with the picklist

Encryption: TLS 1.2/1.3 in transit, AES-256 at rest

Audit Trail: Timestamped events and signer metadata

Access Controls: Role-based permissions and SSO

HIPAA Readiness: BAA available where PHI applies

21 CFR Support: Compliance for regulated records

Certifications: SOC 2 Type II, ISO 27001

Short-term risks and compliance consequences

Incorrect TIN: Triggers 24% backup withholding

Late Filing: Penalties under IRC §6721 apply

I-9 Noncompliance: Fines $281–$2,789 per violation

Missing Signatures: Document may be invalid for payroll

Unauthorized Access: Data breach liabilities and fines

Beneficiary Errors: Delays in benefit payments

Real-world examples of online forms and eSign workflows

These examples show how organizations use digital signing and standardized forms to accelerate employee elections and preserve compliance records.

Tim Martin — Martin Properties

Many HR forms moved online to reduce processing time and lost paperwork.

Mobile and offline signing improved completion rates substantially.
He reported efficient, compliant execution across devices and faster turnaround, helping the organization avoid manual re-entry and reduce administrative backlog.

John Butler — Fertility Centers of Illinois

The team needed reliable signed records for clinical and benefits workflows.

API integrations streamlined data export to internal systems.
They praised a secure, auditable signing process that integrated with existing software, improving retrieval and compliance for patient and employee forms.

eSignature vendor comparison for handling Employee PERS Picklists

Compare core pricing and feature availability for common eSignature vendors; signNow is listed first per vendor-comparison conventions.

	signNow	DocuSign	Adobe Sign	PandaDoc	HelloSign
Starting Price	$8/user/mo	$15/user/mo	$14/user/mo	$19/user/mo	$15/user/mo
Free Trial	Yes, 7-day free trial	Yes	Yes	Yes	Yes
Bulk Send	Yes	Yes	Yes	Yes	Yes
Audit Trail	Yes	Yes	Yes	Yes	Yes
HIPAA Compliant	Yes	Yes	Yes	No	No
Envelope Cap	No envelope cap	100 envelopes/user/year	Varies by plan	Varies by plan	Varies by plan

FAQs and troubleshooting for the Employee PERS Picklist

Answers to common questions about missing fields, corrections, eSignature validity, and record retention when using the Employee PERS Picklist.

Need help? Contact support

What if I entered the wrong SSN?
Notify HR and payroll immediately. Correcting a TIN or SSN typically requires submitting an amended record to payroll and, if applicable, corrected tax forms to the IRS to avoid backup withholding or reporting errors.
Can the picklist be signed electronically?
Yes. Under the ESIGN Act (15 U.S.C. ch. 96) and UETA where adopted, electronic signatures are legally valid when intent, consent, attribution, and retention are satisfied.
Is notarization ever required?
Some states or plan rules require notarized beneficiary designations; check state-specific rules. When notarization is required, remote online notarization (RON) may be permitted based on jurisdiction.
How do I correct a submitted picklist?
Submit a corrected picklist signed and dated with the correction date; HR should retain both versions and document the reason for change to preserve auditability.
How long must we keep signed picklists?
Retain per IRS and employment record rules—generally at least three years after filing or termination; longer retention may apply for HIPAA or state-specific requirements.
What causes signature verification failures?
Common causes include mismatched signer information, expired authentication links, or missing consent disclosures. Re-send with correct authentication or provide an alternative signing method.

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