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Division of School Financial Services PEERS Retirement Dismember ACTION REQUEST (Please PRINT or TYPE clearly)*Attach a \”Reciprocal Recertification Form\” for new appointments. This form is due
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01
Download the member-reciprocal-self-certification-form-calpers-1187pdf from the official CALPERS website.
02
Open the form using a PDF reader or editor.
03
Read the instructions carefully and gather all the required information.
04
Fill in your personal information in the designated fields, such as your name, address, and contact details.
05
Provide your current membership information, including your CALPERS ID number and employer's name.
06
Indicate if you are applying for a reciprocal retirement benefit and provide the necessary details.
07
If you have active service credits in other retirement systems, provide the required information.
08
Fill out the certification section by signing and dating the form.
09
Review the completed form to ensure all information is accurate and legible.
10
Save a copy of the filled out form for your records.
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Submit the member-reciprocal-self-certification-form-calpers-1187pdf as per the instructions provided by CALPERS.

Who needs member-reciprocal-self-certification-form-calpers-1187pdf?

01
Any CALPERS member who wishes to certify their reciprocity with other retirement systems in order to claim and transfer their service credits needs member-reciprocal-self-certification-form-calpers-1187pdf.
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The member-reciprocal-self-certification-form-calpers-1187pdf is a form used by members of CalPERS to certify their reciprocal service with other California public retirement systems.
Members of CalPERS who have service credit in other California public retirement systems are required to file the member-reciprocal-self-certification-form-calpers-1187pdf.
The member-reciprocal-self-certification-form-calpers-1187pdf must be filled out by providing personal information, details of reciprocal service, and certification of accuracy.
The purpose of the member-reciprocal-self-certification-form-calpers-1187pdf is to verify and document the reciprocal service of CalPERS members.
The member-reciprocal-self-certification-form-calpers-1187pdf requires information about the member's personal details, service credit in other California public retirement systems, and certification of accuracy.
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