Form my|CalPERS0843 "Election of Optional Membership - Part-Time Employee" - California

What Is Form my|CalPERS0843?

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.

Form Details:

  • The latest edition provided by the California Public Employees' Retirement System;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form my|CalPERS0843 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|CalPERS0843 "Election of Optional Membership - Part-Time Employee" - California

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P.O. Box 942715 Sacramento, CA 94229-2715
888 CalPERS (or 888-225-7377)
TTY: (877) 249-7442 | Fax: (800) 959-6545
www.calpers.ca.gov
_____________________________________________________________________________________
California Public Employees' Retirement System
ELECTION OF OPTIONAL MEMBERSHIP - PART-TIME EMPLOYEE
The Public Employees’ Retirement Law (PERL) provides “optional” membership rights for
certain part-time employees. Those eligible part-time employees are excluded from
membership unless and until a written election for membership is filed with CalPERS.
The Government Code Section 20325 provides that a county superintendent of schools, a
school district, a community college district, or a contracting agency, whose respective
resolution or contract contains an election to be subject to this section, may offer to its part-
time employees whose service is less than the minimum service prescribed by paragraph (2) of
subdivision (a) of section 20305 the option to elect at any time to become a member by filing
an election with the California Public Employees' Retirement System (CalPERS) Board of
Administration to become a member. For further information please refer to section 20325.
Part-Time Employees subject to this section should consider the following:
• You may elect CalPERS membership at any time while you are in the compensated part-
time position.
• Once you elect membership, your membership remains in effect for all future service in
the part-time position 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 CalPERS membership will result in service concurrent with different
employment credited in a private benefit plan or another 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, contact the
Employer Account Management Division before completing this election form.
• While you are a CalPERS member, you may request costing information to purchase any
previous eligible service in the part-time position at any time prior to your retirement.
• For further information on service credit purchases, please view A Guide to Your
CalPERS Service Credit Purchase Options (PUB 12) on the CalPERS website at
www.calpers.ca.gov.
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 0843
Page 1 of 2
P.O. Box 942715 Sacramento, CA 94229-2715
888 CalPERS (or 888-225-7377)
TTY: (877) 249-7442 | Fax: (800) 959-6545
www.calpers.ca.gov
_____________________________________________________________________________________
California Public Employees' Retirement System
ELECTION OF OPTIONAL MEMBERSHIP - PART-TIME EMPLOYEE
The Public Employees’ Retirement Law (PERL) provides “optional” membership rights for
certain part-time employees. Those eligible part-time employees are excluded from
membership unless and until a written election for membership is filed with CalPERS.
The Government Code Section 20325 provides that a county superintendent of schools, a
school district, a community college district, or a contracting agency, whose respective
resolution or contract contains an election to be subject to this section, may offer to its part-
time employees whose service is less than the minimum service prescribed by paragraph (2) of
subdivision (a) of section 20305 the option to elect at any time to become a member by filing
an election with the California Public Employees' Retirement System (CalPERS) Board of
Administration to become a member. For further information please refer to section 20325.
Part-Time Employees subject to this section should consider the following:
• You may elect CalPERS membership at any time while you are in the compensated part-
time position.
• Once you elect membership, your membership remains in effect for all future service in
the part-time position 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 CalPERS membership will result in service concurrent with different
employment credited in a private benefit plan or another 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, contact the
Employer Account Management Division before completing this election form.
• While you are a CalPERS member, you may request costing information to purchase any
previous eligible service in the part-time position at any time prior to your retirement.
• For further information on service credit purchases, please view A Guide to Your
CalPERS Service Credit Purchase Options (PUB 12) on the CalPERS website at
www.calpers.ca.gov.
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 0843
Page 1 of 2
Please complete and return this entire form to your Human Resources Office if you wish to
establish membership in CalPERS.
I am a "part-time employee" as defined in Government Code Section 20325 with
(agency) ________
_________________________
, represented by
(agency contact) _____
______________________
, at
(agency telephone) _
___________________________
.
In accordance with the provisions of Government Code Section 20325, 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 a part-time employee as defined
in Government Code 20325.
(Printed Name in Full)
(Signature)
(Date)
(CalPERS ID or Social Security
(Address)
Number)
(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.
my|CalPERS 0843
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