Form my|CalPERS0841 "Election of Optional Membership - Elective Officer" - California

What Is Form my|CalPERS0841?

This is a legal form that was released by the California Public Employees' Retirement System - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

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Download a printable version of Form my|CalPERS0841 by clicking the link below or browse more documents and templates provided by the California Public Employees' Retirement System.

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Download Form my|CalPERS0841 "Election of Optional Membership - Elective Officer" - California

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P.O. Box 942709 Sacramento, CA 94229-2709
888 CalPERS (or 888-225-7377)
TTY: (877) 249-7442 | Fax: (916) 795-4166
www.calpers.ca.gov
California Public Employees’ Retirement System
ELECTION OF OPTIONAL MEMBERSHIP - ELECTIVE OFFICER
The Public Employees’ Retirement Law (PERL) provides “optional” membership rights for certain
public officers and employees. California Government Code Section 20322 provides that an
"elective officer" is excluded from membership in CalPERS unless he or she files with the CalPERS
Board of Administration an election in writing to become a member.
"Elective officer" includes any officer of the Senate or Assembly who is elected by vote of the
members of either or both of the houses of the Legislature and an appointive officer of a city or
county occupying a fixed term of office, as well as officers of the state or contracting agencies
elected by the people. Exceptions are: (1) Effective July 1, 1994, elected or appointed officers of
a county superintendent of schools, school district, or community college district, or of a
contracting agency that is not a city or county, who serve on public commissions, boards,
councils, or similar legislative or administrative bodies, other than city councils or county boards
of supervisors, are excluded from membership with no right to elect optional membership unless
continuously holding the office since June 30, 1994; (2) Effective July 1, 1994, any person holding
the office of city attorney was removed from the elective officer definition and became subject
to non-elective, non- optional CalPERS membership qualifications unless continuously holding
the office since June 30, 1994; (3) Effective January 1, 1997, city and county elected or appointed
officers who serve on public commissions, boards, councils, or similar legislative or
administrative bodies, other than city councils or county boards of supervisors, are excluded
from membership with no right to elect optional membership unless they have continuously held
the office since December 31, 1996.
Government Code section 20039 provides that final compensation of a local elective or
appointed officer on a city council or board of supervisors accrued while in membership
pursuant to Section 20322, shall be based on the highest average annual compensation earnable
by the member during the period of employment in each elective or appointed office. This will
apply to elected or appointed city council or board of supervisors who have been elected or
appointed on or after July 1, 1994.
Please refer to the Public Employees' Retirement Law and the CalPERS Public Agency and Schools
Reference Guide and State Reference Guide for further information on elective officers.
my|CalPERS 0841
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P.O. Box 942709 Sacramento, CA 94229-2709
888 CalPERS (or 888-225-7377)
TTY: (877) 249-7442 | Fax: (916) 795-4166
www.calpers.ca.gov
California Public Employees’ Retirement System
ELECTION OF OPTIONAL MEMBERSHIP - ELECTIVE OFFICER
The Public Employees’ Retirement Law (PERL) provides “optional” membership rights for certain
public officers and employees. California Government Code Section 20322 provides that an
"elective officer" is excluded from membership in CalPERS unless he or she files with the CalPERS
Board of Administration an election in writing to become a member.
"Elective officer" includes any officer of the Senate or Assembly who is elected by vote of the
members of either or both of the houses of the Legislature and an appointive officer of a city or
county occupying a fixed term of office, as well as officers of the state or contracting agencies
elected by the people. Exceptions are: (1) Effective July 1, 1994, elected or appointed officers of
a county superintendent of schools, school district, or community college district, or of a
contracting agency that is not a city or county, who serve on public commissions, boards,
councils, or similar legislative or administrative bodies, other than city councils or county boards
of supervisors, are excluded from membership with no right to elect optional membership unless
continuously holding the office since June 30, 1994; (2) Effective July 1, 1994, any person holding
the office of city attorney was removed from the elective officer definition and became subject
to non-elective, non- optional CalPERS membership qualifications unless continuously holding
the office since June 30, 1994; (3) Effective January 1, 1997, city and county elected or appointed
officers who serve on public commissions, boards, councils, or similar legislative or
administrative bodies, other than city councils or county boards of supervisors, are excluded
from membership with no right to elect optional membership unless they have continuously held
the office since December 31, 1996.
Government Code section 20039 provides that final compensation of a local elective or
appointed officer on a city council or board of supervisors accrued while in membership
pursuant to Section 20322, shall be based on the highest average annual compensation earnable
by the member during the period of employment in each elective or appointed office. This will
apply to elected or appointed city council or board of supervisors who have been elected or
appointed on or after July 1, 1994.
Please refer to the Public Employees' Retirement Law and the CalPERS Public Agency and Schools
Reference Guide and State Reference Guide for further information on elective officers.
my|CalPERS 0841
Page 1 of 3
Elective Officers subject to this section should consider the following:
You may elect CalPERS membership at any time while you are an elective officer holding
the office as long as the office is not otherwise excluded by law or excluded by your
agency's contract.
Once elected, your membership remains in effect for all future service in this elective
officer position with the same employer unless there is a break in employment.
Your membership may be terminated only upon permanent separation from
employment covered by CalPERS and subsequent withdrawal of retirement
contributions.
If your election for optional membership in CalPERS will result in concurrent service with
employment credited in a private benefit plan or another public retirement system,
please contact that organization for information regarding the impact of such
concurrent service.
If your election will result in concurrent employment under CalPERS, please contact the
Employer Account Management Division at the above telephone number before
completing this election form.
While you are a CalPERS member, you may request costing information to purchase any
previous eligible service in your elected position at any time prior to retirement.
The form to request costing information for Optional Member Service is available on the
CalPERS website at www.calpers.ca.gov. The form is titled Request for Service Credit
Cost Information – Layoff, Prior Service, and Optional Member Service (PERS-MSD-372)
and is located in A Guide to Your CalPERS Service Credit Purchase Options (PUB 12).
We are here to assist you. Please visit our website www.calpers.ca.gov, or you may contact us toll
free at 888 CalPERS (or 888-225-7377).
Employer Account Management Division
my|CalPERS 0841
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Please complete and return this entire form to your Human Resources Office to establish your
membership in CalPERS.
I am an ELECTIVE OFFICER as defined in Government Code Section 20322, being a(n)
(position title)
with the
(agency)
, represented
by (agency contact)
, at
(agency telephone)
.
I was first elected to this position on
. My present term will expire on
20
. In accordance with the provisions of Government Code
Section 20322, I ELECT TO BECOME A MEMBER OF CALPERS. I request that this
election be filed with the CalPERS Board of Administration as my election to become
a member.
I understand this election is irrevocable as long as I remain in this position.
(Printed Name in Full)
(Signature)
(Date)
(CID or Social Security Number)
(Address)
(Daytime Telephone Number)
(City & State)
(ZIP Code)
Notice to Employer: The membership date for an optional member is the date CalPERS receives
and files the Election of Optional Membership form.
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