Forms

Overview

Forms

At this time, we cannot accept electronic submission of forms due to the signature verification requirement. Verifying your signature protects the integrity of your personal account information.

Please mail completed forms to CCCERA at 1355 Willow Way, Suite 221, Concord, CA 94520. Please send original forms as we cannot accept copies. If you would like a form mailed to you, please call CCCERA at (925) 521-3960 or email info@cccera.org.

General information

Forms for Retired Members
Submit original documents only.

Retiree Change of Beneficiary Designation (Form 206)

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 Waiver (Form 303). (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) Form (Form 209)

Changes to your Electronic Funds Transfer (i.e., if you change banks or accounts) require this form.

Withholding Certificates for Pension Payments (Form 210)

General information

Forms for Active Members
Submit original documents only.

Welcome to CCCERA

New Member Enrollment Packet

Enrollment Affidavit (Form 101)

This form is filled out when a member accepts permanent employment with Contra Costa County or special district employers.

Beneficiary Designation Form (Form 102)

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 Waiver (Form 303). (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)).

Commands