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Forms
Downloadable PDF forms
In the links below are the forms most commonly used by members and employers to request a service from KCERA. An incomplete form will delay your request, so please follow instructions carefully before submitting the document(s) to KCERA.
(To view the documents on this webpage, you will need Adobe Acrobat Reader installed on your computer. If you do not have the most recent version, you can download it for free by clicking here.)
Member Forms
Address Change Request FormAuthorization for Release of Member InformationBeneficiary Designation- Member FormBeneficiary Designation- Survivor FormBeneficiary Designation - Alternate Payee FormCalifornia Tax Withholding Form DE 4PCertification of Prior County/District ServiceCertification of Prior Public ServiceCertification of Prior Public Service - MilitaryDirect Deposit Change Request FormDirect Deposit StopDisposition PacketDRO SampleFederal Tax Withholding Form W-4PName Change Request FormPrior County-District Service Form with FAQPrior Public Service Form with FAQPrior Public Service Form W/Military with FAQPower of Attorney PacketPurchase of Service - FAQRetirement Application Packet
