559 457-0681 FCERA@FresnoCountyCA.gov
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Home / Forms

Forms

Information Change and Update

  • Name and Address Change Request
  • Beneficiary Designation Form

Retiree Tax Withholding and Banking

  • Direct Deposit Form
  • Federal Withholding Form
  • State Withholding Form – California
  • State Withholding Form – Other States
  • Stop Payment Request

Disposition of Retirement Contributions

  • Disposition of Retirement Contributions
  • Disposition Form Instructions
  • IRS Safe Harbor 402(f) Notice

Buybacks

  • Request For Service Credit Calculation
  • Application to Purchase Public Service

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Disability

  • Disability Retirement Flowchart
  • Disability Retirement Application

Miscellaneous

  • Claimant’s Statement
  • Claim for Damages
  • Death Affidavit
  • Intent to Establish Membership for Elected Official
  • Limitations of Retirement Benefits (IRC415) Pre 1990
  • Limitations of Retirement Benefits (IRC415) Post 1990
  • Mailing Opt-Out Request
  • Non-Member Spouse Continuance Waiver
  • Redaction of Name for Safety Reasons
  • REFCO Request for Address form
  • Request Form (Generic)
  • Waiver of Membership (age 60 or older)

Estimate

  • Estimate Request For Retirement Benefits
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CONTACT US

559 457-0681

FCERA@FresnoCountyCA.gov

7772 N Palm Ave,

Fresno, CA 93711

RETIREMENT BOARD

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