SamCERA - Forms

 

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Printable PDF Forms

Choose a PDF form below. The form will open on your screen. Use the print menu on your computer to print the form. Mail your completed, signed form to SamCERA.

Address Change Form  
ARC Request Form  
Beneficiary Designation Form
 
Direct Deposit Form  
Disposition Form  
Enrollment Form (60 Day)  
Extra Help Form  
General Enrollment Form  
Plan 3 Upgrade Form  
Redeposit Form  
Safety Enrollment Form  
Switch to Contributory Plan Form  

Model Domestic Relations Order Model Forms
Model Domestic Relations Order
Model Order A
Model Domestic Relations Order
Model Order B
Model Domestic Relations Order
Model Order C
IRS Forms
Form W-4P (Federal Witholding Allowance Certificate For Pension or Annuity Payments)
Form DE 4P (California Witholding Allowance Certificate For Pension or Annuity Payments)

For more information on registering domestic partners withe the California Secretary of State, please click on the following link: http://ss.ca.gov/dpregistry/