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This form allows participants of the CalPERS Supplemental Income 457 Plan to request changes to their contribution amounts, suspend contributions, and update personal information such as marital status and name corrections. Participants must complete the form and submit it to their employer for processing.
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How to fill out participant change authorization form

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How to fill out participant change authorization form

01
Begin by downloading the participant change authorization form from the official website.
02
Fill in your personal details, including your name, address, and contact information.
03
Specify the participant type and include their identification details.
04
Clearly indicate the changes you want to authorize, such as name change, address update, or other modifications.
05
Sign and date the form at the designated area.
06
Review the entire form to ensure all information is accurate and complete.
07
Submit the completed form to the relevant authority, either in person or via email/fax as instructed.

Who needs participant change authorization form?

01
Participants who wish to update their information.
02
Guardians or legal representatives of participants requiring changes.
03
Organizations managing participants who need to maintain accurate records.
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The participant change authorization form is a document used to authorize or update changes regarding a participant's information in a program, plan, or service.
Participants in a program or plan who wish to make changes to their personal information or participation status are required to file the participant change authorization form.
To fill out the participant change authorization form, accurately provide the requested information, including personal details, the changes being requested, and any necessary signatures or dates.
The purpose of the participant change authorization form is to formally document any changes to a participant's information or status and ensure that the organization processes these changes correctly.
The form typically requires reporting personal details such as the participant's name, contact information, the specific changes being requested, and any relevant identification numbers.
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