Retired Member Forms & Publications

Forms

2023 California Tax Withholding Certificate

2023 Federal Tax Withholding Certificate

Beneficiary Designation Form

Address Change Form

Direct Deposit Authorization Form

Domestic Relations Order (DRO) Model B (Retired Members) Form

Medicare Part B Reimbursement Form

Return to Active Membership Application

RPESJC Deduction Form

Special Power of Attorney Form

United Way Deduction Form

Publications

Domestic Relations Order (DRO)

Facts at a Glance

Medicare Part B Reimbursement Program

Retiree Statement Sample

Survivorship Booklet