CCCERA Forms

CONTRA COSTA COUNTY
EMPLOYEES' RETIREMENT ASSOCIATION

Printable Forms

Active Members

Address Change: District or Deferred Member
If you are a County employee, you must change your address with your payroll clerk.

Estimate Request
This is not a request to retire, but a request to estimate your benefit amount to assist in planning your retirement. CCCERA does not accept estimate requests unless the member is within 5 years of retirement. Estimates beyond that time are not practical, since important data used in calculating estimated benefits (such as salary and years of service) are too variable beyond 5 years.

Records Disclosure Authorization
This form authorizes the release and/or use of your personal information (member records) to a person you designate. The Authorization must be on file with CCCERA to be in effect, and can be revoked at any time.

Retired Members

Address Change
This form notifies CCCERA of changes to your mailing address.

Beneficiary Change
Please note: If you are married or a State of California registered domestic partner, by law, your beneficiary is your spouse/domestic partner, unless you have a signed, notarized, spousal/domestic partner waiver. (California state law mandates that opposite sex domestic partners must be 62 years of age or older. See Section 3B of the Family Code (297)).

Electronic Funds Transfer (EFT)
Changes to your Electronic Funds Transfer (i.e., if you change banks or accounts) require this form. Click this link for the actual form. Click here for information about the form.

Federal and/or State Income Tax Withholding
Retired members have the right to change, start, or stop federal and/or state tax withholding from monthly benefit payments. A change can be made at any time by filing a new withholding authorization. Click this link for the form. Click here for information about the form.