Forms for Retired Members
Submit original documents only.
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. Only original forms will be accepted (no copies).
Mail completed forms to:
1200 Concord Avenue, Suite 300
Concord, CA 94520
If you would like a form mailed to you, please call CCCERA or email firstname.lastname@example.org.
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, . (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)).
Changes to your Electronic Funds Transfer (i.e., if you change banks or accounts) require this form.
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.
Use this form to suspend your retirement and reinstate as an active CCCERA member under Gov. Code Section 31680.4.
This form notifies CCCERA of changes to your mailing address.
This form notifies CCCERA of a name change to apply to your account.
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.