Trooper Plan A: Forms
The West Virginia State Police Death, Disability and Retirement Fund (Plan A) Forms
- Application for Scholarship (opens in new window) (PDF document)
- Authorization to Release Information (opens in new window) (PDF document)
- Benefit Estimate Request (opens in new window) (PDF document)
- Combined Medical Power of Attorney and Living Will (opens in new window) (PDF document) (print on legal size paper)
- Confidential Records Order (opens in new window) (PDF document)
- Disability Recertification Policy (opens in new window) (PDF document)
- Less Than Honorable Service (opens in new window) (PDF document)
- Living Will (opens in new window) (PDF document) (print on legal size paper)
- Medical Power of Attorney (opens in new window) (PDF document) (print on legal size paper)
- Online Self-Service Get Started Guide (opens in new window) (PDF document)
- Qualified Domestic Relations Order (QDRO) (opens in new window) (PDF document)
- State of West Virginia Statutory Form Power of Attorney (opens in new window) (PDF document)