Employee New Enrollment Form
For New Enrollments only.

Participant Change Authorization
Investment fund allocation changes must be made via Plan Information Line or Plan Website.

• Increase or decrease your contribution amount
• Suspend contributions
• Change your name or address 

Beneficiary Designation Form
Designate beneficiary(ies)
 

457 Account Transfer Form
Transfer balance from another 457 Plan Provider offered by your previous or current Employer into your current CalPERS Supplemental Income 457 Plan

Rollover Form
Roll over monies from another type of plan [401(k), 403(b), IRA or 401(a)] from your previous employer

Direct Rollover Request Form (optional)
Form used to request a rollover from your 401(k), 403(b), IRA or 401(a) provider if they do not provide you one

Inter-Plan Transfer Form
Transfers from a previous employer’s CalPERS Supplemental Income 457 Plan into the current employer’s CalPERS Supplemental Income Plan
 

Distribution Request Form  

• Request distribution after separation/retirement
• Change current distribution option
• Alternate payee distribution per Qualified Domestic Relations Order

Death Distribution Form For surviving spouse and/or beneficiary(ies) to request distributions (one form per beneficiary).

In-Service Withdrawal / Transfer Request Form

• In-service transfer for CalPERS Service Credit purchase
• In-service transfer for another Pension Plan Service Credit purchase
• Small account withdrawal

Rollover Request Form For CalPERS Service Credit Purchase
Rollover all or part of your account to purchase CalPERS service credits after you have permanently separated from your employer

Emergency Withdrawal Request Form
Withdrawal request due to an “unforeseeable emergency”
 

Application For Electronic Direct Deposit

Designation Of Normal Retirement Age/Catch-up Work

Three-Year Special 457(b) Catch-up Worksheet (For Current Employer Only)