COMMUNICATIONS
You can download 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 6/10
Retirement Plan D for General Members (ASD 541) PRINTED 6/09 PDF update 4-8-10
Retirement Plan E for General Members (ASD 543) PRINTED 6/09 PDF update 4-26-10
Retirement Plans A & B for Safety Members (ASD 544) PRINTED 6/09 PDF update 4-8-10
New Safety Member Workshop (OUT 422) PRINTED 9/02
New Member Guide Package (Includes Sworn Statement, Beneficiary form, Plan D and Plan E brochures) (ASD 683) PRINTED 3/08 • New Member Guide (brochure only) DOWNLOAD ONLY
• More Plan Transfer information
Prospective Transfer to Plan D (RSD 1511) PRINTED 11/04 DOWNLOAD ONLY
Review the Prospective Plan Transfer: Purchasing & Converting Plan E Service Credit Q&A book here.
Prospective Transfer to Plan E (RSD 1512) PRINTED 11/04 DOWNLOAD ONLY
Pre-Retirement Guide (OUT 414) PRINTED 2/08
• See the Pre-Retirement workshop schedule online
LACERA's Special Durable Power Of Attorney Q&A includes application form (LEG 401, LEG 402) PRINTED 6/08
• Special Durable Power of Attorney Form (LEG 402) PRINTED 6/08 DOWNLOAD ONLY
Survivorship Brochure (RSD 597) PRINTED 6/03
Direct Deposit includes application (ASD 611) PRINTED 1/09 • Application only (1/09) DOWNLOAD ONLY
• Additional Reciprocity information
Q&A: Purchasing Service Credit includes Service Credit Category List & application form (RSD 1589 & RSD 509) PRINTED 9/09
• Additional Purchasing Service Credit information
Q&A: Purchasing Additional Retirement Credit (ARC) (RSD 1540) PRINTED 8/09
• Additional ARC information
• Claims Against Third Party (DIS 117)
• Taxability of a LACERA Disability Retirement Allowance (RSD 1580)
• Employer Application for Disability Retirement (DIS 121)
NON-INTERACTIVE PRINT-ONLY VERSION: • Employer Application for Disability Retirement (DIS 121)
Disability Policies & Procedures (DIS 124) PRINTED 12/09
Procedures for Disability Retirement Hearings (DIS 112) PRINTED 9/06
Click here to read the individual forms included in the Survivor Package
Click here to read the individual forms and brochure included in the Employee Package
• Additional Disability Retirement information
Click here to read the individual forms and brochure included in the Employer Package
Forms with this icon are saveable interactive PDF documents. You may enter your data directly into the fields on your computer.
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, call 1-800-786-6464
Name Change (RSD 582) Make your change over the phone, call 1-800-786-6464
Beneficiary Designation (RSD 504) Make your change over the phone, call 1-800-786-6464
Beneficiary Designation For Ex-Spouse (RSD 578)
MAILED 4/10
MAILED 12/09
MAILED 1/10
2010-2011 ANNUAL HEALTH CARE PACKET: • 2010-2011 Annual Health Care Letter • Benefits Update • Benefits Guide • 2010-2011 Medical & Dental/Vision Premium Rates
The 2010 edition of the County Employees Retirement Law (CERL) of 1937 (The CERL PDF is of the entire law book and is a large file which may take a long time to download. For your convenience, we divided the law book into three separate PDF documents. For ease of use, the Table of Contents page is linked.) Part One: Sections 31450 - 31619 Part Two: Sections 31620 - 31755.3 Part Three: Sections 31760 - 31899.10
Disability Retirement Law Resource (Draft 2010) (6-3-10) A comprehensive review of both the related statutes and case law.
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 “READY TO ORDER” 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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7/12/10
