COMMUNICATIONS
You can read or order LACERA brochures, forms, and Retiree Health Care Information from this page. TIPS: How to View TIPS: How to Order
BROCHURES and APPLICATIONS SUMMARY PLAN DESCRIPTION BOOKS:
Retirement Plans A, B & C for General Members (ASD 545) PRINTED 6/09
Retirement Plan D for General Members (ASD 541) PRINTED 6/09
Retirement Plan E for General Members (ASD 543) PRINTED 6/09
Retirement Plans A & B for Safety Members (ASD 544) PRINTED 6/09
New Safety Member Workshop (OUT 422) PRINTED 9/02
New Member Guide Package (For General Members - includes Sworn Statement, Beneficiary form, Plan D and Plan E brochures) (ASD 683) PRINTED 3/08 New Member Guide (brochure only)
*New General Member Interactive Workshop Online *New General Member Workshop schedule online *New Member FAQs
*More Plan Transfer information
Prospective Transfer to Plan D (RSD 1511) PRINTED 11/04
Prospective Transfer to Plan E (RSD 1512) PRINTED 11/04
Pre-Retirement Guide (OUT 414) PRINTED 2/08
*See the Pre-Retirement workshop schedule online
LACERA's Special Durable Power Of Attorney Questions & Answers includes application form (LEG 401, LEG 402) PRINTED 6/08
Power of Attorney Form (LEG 402) PRINTED 6/08
Survivorship Brochure (RSD 597) PRINTED 6/03
Direct Deposit includes application (ASD 611) PRINTED 1/09 Application only (1/09) Make your change over the phone, 1-800-786-6464
*For more Reciprocity information
Purchasing Service Credit Questions & Answers includes Service Credit Category List & application form (RSD 1589 & RSD 509 PRINTED 9/09)
*For more Purchasing Service Credit information
Purchasing Additional Retirement Credit (ARC) Questions & Answers (RSD 1540 PRINTED 8/09)
*For more ARC information
Disability Retirement Plans A, B, C & D (DIS 108) PRINTED 3/05
Disability Policies & Procedures (DIS 124) PRINTED 7/05
Procedures for Disability Retirement Hearings (DIS 112) PRINTED 9/06
Click here to read the individual forms and brochure included in the Employee Package *More Disability Retirement information
Click here to read the individual forms and brochure included in the Employer Package
Forms with this icon are interactive PDF documents. You may enter your data directly into the fields on your computer. Upon completion of your form, print two copies, one to turn in and one to save for your records. NOTE: You will not be able to save your changes. (3/4/08)
Affidavit Public Safety Officer (PSO) Status and Election Form: Retired PSO $3,000 Health Care Tax Benefits
Federal & CA Tax Withholding Cert. For Pension/Annuity Payments (RSD 510) (Forms W-4P and DE-4P)
Address Change(RSD 583) Make your change over the phone, 1-800-786-6464
Name Change (RSD 582) Make your change over the phone, 1-800-786-6464
Beneficiary Designation (For Active & Retired Members) (RSD 504) Make your change over the phone, 1-800-786-6464
Beneficiary Designation For Ex-Spouse (RSD 578)
2009-2010 ANNUAL HEALTH CARE PACKET: 2009-2010 Annual Health Care Letter Benefits Update Benefits Guide 2009-2010 Medical & Dental/Vision Premium Rates
The 2009 edition of the County Employees Retirement Law (CERL) of 1937 (This is a PDF document of the entire County Employees Law with a linked table of contents page. The file is very large and may take a long time to download. For your convenience and ease of use, we have divided the law book into three PDF documents.) Part One: Sections 31450 - 31499.19 Part Two: Sections 31500 - 31706 Part Three: Sections 31720 - 31899.10
Disability Retirement Law Resource State Association of County Retirement Systems (read only)
The forms and brochures listed on this page are linked to PDF documents that you can read, print, or order. You may send the completed forms or applications to LACERA, 300 N. Lake Avenue Pasadena, CA 91101 or fax to 626-564-6155.
To order documents: 1) Scroll down to click on the box next to the item you want 2) Scroll down the page or click on “COMPLETE ORDER FORM NOW” and complete the mailing information 3) When you are finished, click on “Send Order Now” Your order is free of charge and will be processed by the next business day.
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10/13/09
