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CA PERS-BSD-369-S 2017 free printable template

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Service Retirement Election Application 888 Callers (or 8882257377) TTY: (877) 2497442 Please do not mail or deliver your application to Callers more than 120 days before your retirement date. For
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Start by downloading the CA PERS-BSD-369-S form from the official website.
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Read the instructions carefully to understand the purpose of the form.
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Fill in your personal information, including your name, address, and contact details.
04
Provide your employee identification number or Social Security number, if required.
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Enter the details of your employment, such as your job title and department.
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Specify the reason for filling out the form, following the guidelines provided.
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Who needs CA PERS-BSD-369-S?

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Employees of California public agencies who are enrolled in the California Public Employees' Retirement System (PERS) may need to fill out the CA PERS-BSD-369-S form.
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Individuals seeking benefits or changes related to their retirement status are also required to submit this form.
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CA PERS-BSD-369-S is a form used by employers to report information to the California Public Employees' Retirement System (CalPERS) regarding their employees' membership and service records.
Employers who have employees enrolled in the CalPERS pension system are required to file CA PERS-BSD-369-S to report relevant data.
To fill out CA PERS-BSD-369-S, employers need to provide accurate information regarding employee details, employment status, and periods of service, following the instructions specific to the form.
The purpose of CA PERS-BSD-369-S is to ensure that CalPERS has accurate and up-to-date information regarding employee service and membership for retirement benefit calculations.
The form requires reporting information such as employee names, identification numbers, positions, service dates, and any leave taken that may affect retirement calculations.
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