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This document is used in California to authorize the use of the Automated Clearing House (ACH) method for making electronic payments.
This Form is used for the election of optional membership for California National Guard members in the California Defense Mobilization Committee (DMC).
This Form is used for the distribution of funds from the Judges' Retirement System (JRS) Extended Service Incentive Program (ESIP) Required Minimum Distribution (RMD) in California.
This Form is used for employers in California to request an estimate for disability allowance for their employees.
This form is used for the First Tier Future Election Package in California. It provides information and instructions for future elections.
This Form is used for enrolling in the Health Benefits Plan for retirees and survivors in California. It provides instructions for completing the enrollment process.
This Form is used for enrolling in a health benefits plan for active employees in California. It provides instructions on how to complete Form HBD-12.
This document describes the circumstances under which someone in California may be ineligible for Medicare certification.
This form is used for providing survivor and beneficiary information for the Judges' Retirement System in California.
This form is used for judges in California who are applying for service retirement.
This form is used for submitting a medical report to apply for the CalPERS Disabled Dependent Benefit in California.
This form is used for reporting a disability in the state of California. It is typically completed by a physician to provide information about an individual's disability and its impact on their ability to work or perform daily activities. The report is often required for various disability benefits or accommodations.
This form is used for designating a beneficiary to receive a lump sum payment after retirement for nonmembers in California.
This form is used for designating a lump-sum beneficiary to receive retirement benefits after the employee's retirement in California.
This document is used for applicants who are applying to a public agency in California. It is a questionnaire that collects information about the applicant.
This form is used for reporting the separation for death of an employee and requesting payroll information in the state of California.
This document is used to request information about the cost of service credit for the Alternate Retirement Program in California.
This form is used for the CalPERS Disabled Dependent Health Benefit in California. It is a member questionnaire for individuals who are seeking this benefit.
This form is used for individuals in California who want to request permission to work while receiving disability or industrial disability retirement benefits.
This form is used for collecting information from applicants interested in attending schools in California. It helps schools gather details about the applicant's background, interests, and academic qualifications.
This form is used for service verification purposes in the state of California. It is used to validate an individual's employment or income in order to verify their eligibility for certain services or benefits.
This document is used for making tax withholding elections in the state of California.
This Form is used for reporting the quarterly business activity in California.
This document is used in California to provide a sworn statement of income.