TCERA Logo

Forms

Beneficiary Form

This form is used for designating beneficiaries to a member's TCERA benefits in the event of their passing.

Acceptance Policy: Original form signed and accepted via Interoffice, Regular Post, In Person.

Form must be witnessed and signed by a party not named as a beneficiary.

(In Person I.D. is required if a TCERA staff member is witnessing the document)

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted

Estimate Request Form

This form is used for requesting retirement estimates of what a member's retirement may be at a future date. 

Acceptance Policy:  Original form signed and accepted via Regular Post, In Person, fax. E-Mail accepted if color scan of signed original is attached.

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted

Information Request Form

This form is used for requesting information regarding a member's TCERA account, such as a contribution balance, an income verification letter, or replacement 1099-R. 

Acceptance Policy: Original form signed and accepted via Regular Post, In Person, Fax. E-Mail accepted if color scan of signed original is attached.

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted

Direct Deposit Form

This form has new requirements for making any changes to your direct deposit. There are security questions required. This form is to update the instructions for depositing your pension check monthly. In order to update it in time TCERA asks we receive the completed form prior to the 15th day of the month.

Acceptance Policy: Original signed form preferred. Original form signed and accepted via Regular Post, In Person. E-Mail accepted if color scan of signed original is attached.  SECURITY QUESTIONS ON THE FORM MUST BE COMPLETED, unless brought in person to our office, with identification.

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted

Change of Address/Name Form

This form is for retired or deferred members only and is to inform TCERA of and address change or change in legal name. (Active Members must contact their department payroll clerk).

Acceptance Policy: Original signed form preferred. (a letter with complete address information and an original signature is also acceptable) Original form signed and accepted via Regular Post, In Person, Fax. E-Mail accepted if color scan of signed original is attached.

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted

Service Purchase Estimate Form

This form is for members who are interested in purchasing extra help or other qualifying breaks in service.

Acceptance Policy: Original form signed and accepted via Regular Post, In Person, Fax. E-Mail accepted if color scan of signed original is attached.

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted

Distribution Elections Form

This form is for members who have already terminated employment, do not wish to retire, and would like to determine what happens to their TCERA account. 

Acceptance Policy: Original signed form preferred. Original form signed and accepted via Regular Post, In Person. E-Mail accepted if color scan of signed original is attached.

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted

Distribution Election Form (NMFS)

This form is for a former spouse of a member who has received a portion of a member's retirement through a domestic relations order and would like to determine what happens to their portion of the TCERA account. 

Acceptance Policy: Original signed form preferred. Original form signed and accepted via Regular Post, In Person. E-Mail accepted if color scan of signed original is attached.

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted

Affidavit of Lost Warrant (Check) Form

This form is for payees who were expecting to receive a paper check and the check was either lost, stolen, or damaged and is in need of a replacement check.

Acceptance Policy: Original form signed and accepted via Regular Post, In Person, Fax. E-Mail accepted if color scan of signed original is attached.

 

If the warrant is more than $100, this affidavit must be notarized OR the payee must personally appear at TCERA’s office and sign the affidavit in the presence of a TCERA staff member.

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted

Federal Tax Withholding Form

This form is for updating the amount that is withheld for federal taxes from your monthly pension check.

Acceptance Policy: Original form signed and accepted via Regular Post, In Person, Fax. E-Mail accepted if color scan of signed original is attached.

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted

TCERA staff are not licensed tax experts and are not able to provide any tax advice.

CA State Tax Withholding Form

This form is for updating the amount that is withheld for CA state taxes from your monthly pension check.

Acceptance Policy: Original form signed and accepted via Regular Post, In Person, Fax. E-Mail accepted if color scan of signed original is attached.

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted

TCERA staff are not licensed tax experts and are not able to provide any tax advice.

TCERA Retiree Return to Work Application

This form is for members who have retired, but would like to return working for a TCERA sponsored employer. 

Acceptance Policy Original form signed and accepted via Regular Post, In Person, Fax. E-Mail accepted if color scan of signed original is attached.

Original (Wet) Signatures Only, No E-Signature/DocuSign Accepted