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  
Beneficiary Designation Form
 
Direct Deposit Form  
Disposition Form  
Purchase Request Form  
Reciprocity Request Form  
Rollover Transfer Certification Form  
Transfer 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
Model Domestic Relations Order
Model Order D1
Model Domestic Relations Order
Model Order D2
     
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)
Employer Forms
Fact Sheet: New Rules Under PEPRA  
Fact Sheet: Hiring SamCERA Retirees  
Fact Sheet: Hiring SamCERA Retirees (SMCMVCD)  
Post-Employment Certification of Compliance (General Members)  
Post-Employment Certification of Compliance (Safety Members)  
Post-Employment Certification of Compliance (SMCMVCD)  
PEPRA Verification  
PEPRA Verification (SMCMVCD)  

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