Member forms
Make updates via myCalSTRS
No need to use paper forms—you can complete most transactions online using myCalSTRS. At myCalSTRS you can:
- Manage your beneficiaries
- Update direct deposit information
- Update tax withholding preferences
- Apply for a refund
Downloadable PDF forms - browse by category
For less common transactions that aren’t yet available through myCalSTRS, find the form that you need here by searching.
Many of our forms are now fillable — they are marked with an asterisk.
Most requested forms
Address Change Request (AS0786, rev. 07/19) *Cash Balance Income Tax Withholding Preference (CB584, rev. 06/23)Direct Deposit Authorization (AS1130, rev. 04/22) *Income Tax Withholding Preference Certificate (AD0908, rev. 12/22) *Request for Name Change (AS1040, rev. 05/19) *Retirement Progress Report Delivery Preference (AS2046, rev. 04/18) *
Apply for service retirement
Defined Benefit Program members
Service Retirement Application (SR0059, rev. 09/23)Express Benefit Report (Unused Sick Leave) (SR0554E, rev. 01/20)Direct Deposit Authorization (AS1130, rev. 04/22) *Cash Balance Benefit Program participants
Cash Balance Retirement Benefit Application Packet (CB586, rev. 04/22)Nonmember spouse
Nonmember Spouse Retirement Application (NM1258, rev. 06/11)Nonmember Spouse Defined Benefit Supplement (DBS) Application (NM1938, rev. 12/22)Transition to service retirement from a Coverage A disability benefit
Disability Allowance to Service Retirement Application (SR0234, rev. 02/19)Special circumstances: Use if needed when completing your service retirement application
Certification of a Special Needs Trust (SR1854, new 04/17)Compound Option Election (SR0363, rev. 01/19)DBS Application for Retired Members (DBS0890, rev. 01/24)Justification for Non-Signature of Spouse or Registered Domestic Partner (MS1125A, rev. 01/19)Reduced Benefit Election (SR1613, rev. 01/19)Cash Balance Benefit Application Change Request (CB1328, new 08/23)Employment Termination or Sick Leave Data Correction (SR0559, rev. 07/15)Retirement Application Change Request (SR1328, rev. 04/23)Apply for a refund
Defined Benefit Program members
Refund Application (RF1360, rev. 10/23)DBS Termination Benefit Distribution Election (RF1503, rev. 12/22)Cash Balance Benefit Program participants
Cash Balance Termination Benefit Application Packet (CB585, rev. 02/22)Nonmember spouse
Nonmember Spouse Refund Application (RF1356, rev. 12/22)Special circumstances: Use if needed when completing your refund application
Justification for Non-Signature of Spouse or Registered Domestic Partner (MS1125A, rev. 01/19)DBS Termination Benefit Distribution Election Change (RF1506, rev. 12/22)Apply for disability benefits
Defined Benefit Program member
Disability Benefits Application and Instructions (includes Service Retirement During Evaluation of a Disability Application) (DS0260, rev. 12/23)Direct Deposit Authorization (AS1130, rev. 04/22) *Cash Balance Benefit Program participant
Cash Balance Disability Benefit Application Packet (CB587, rev. 04/22)Special circumstances: Use if needed when completing your disability application
Certification of a Special Needs Trust (DS1854, new 04/23)Compound Option Election During Disability Retirement (DS1776, rev. 10/23)Justification for Non-Signature of Spouse or Registered Domestic Partner (MS1125A, rev. 01/19)Workers' Compensation Carrier Request for Information (DS1657, rev. 09/23)Reinstatement After Disability Benefits/Recurrence of Disability (DS0857, rev. 03/23)Disability Benefits Application Change Request (DS1328, rev. 01/23)Designate a beneficiary
Designate a recipient for the one-time lump sum death benefit
Recipient Designation (MS0002, rev. 09/22)Option Payee’s Beneficiary Designation (SB0816, rev. 10/23)Nonmember Spouse Account Holder Recipient Designation Form (NM2031, rev. 02/12)Designate a preretirement election of an option
Preretirement Election of an Option (SR0307 rev. 05/23)Preretirement Compound Option Election (SR0365, rev. 05/23)Special circumstances: Use if needed when designating a beneficiary
Justification for Non-Signature of Spouse or Registered Domestic Partner (MS1125A, rev. 01/19)Certification of a Special Needs Trust (SR1854, new 04/17)Cash Balance Postretirement Special Needs Trust Election (CB1855, new 04/17)Increase your benefit – purchase, consolidate, redeposit
Redeposit or purchase permissive service credit
Redeposit or Purchase of Permissive Service Credit (MS0287, rev. 12/22)Out-of-State or Foreign School Service Credit Certification (OSSC304, rev. 01/19)Verification for Employer-Approved Leaves (SC1553, rev. 07/10)Verification for California Public University Service (SC1732, rev. 07/22Roll over funds to your Cash Balance Benefit account
Cash Balance Rollover Certification (AR261, rev. 01/16)Consolidate prior Cash Balance service into your Defined Benefit Program account
Cash Balance Request to Consolidate Benefits Packet (CB263, rev. 11/03)Cash Balance Employment Certification (CB264a, rev. 06/04)Cash Balance Defined Benefit Employment Certification (CB264b, rev. 06/04)Manage my Pension2 account
Send all 403(b) plan, 457 plan and account maintenance forms to:
Fax (Include only one form per fax)
888-814-5862
Regular mail delivery
CalSTRS Pension2 Plan Administration
P.O. Box 389
Hartford, CT 06141
Via overnight delivery
CalSTRS Pension2 Plan Administration
One Orange Way
Windsor, CT 06095
403(b) plan
Enrollment FormEnrollment Form With Salary Reduction Agreement (Approved School Districts)Installment Request FormDistribution Request FormHardship Withdrawal Application457 plan
Enrollment FormEnrollment Form With Salary Reduction Agreement (Approved School Districts)Installment Request FormDistribution Request FormUnforeseen Emergency Withdrawal ApplicationSalary Deferral Agreement FormPlan Transfer In RequestAccount maintenance
Pension2 Change of Address FormPension2 Beneficiary Designation FormPension2 Beneficiary Distribution RequestPension2 Loan Request FormPension2 Rollover Contribution FormRoth Conversion FormContract Exchange/Plan Transfer InContract Exchange and Plan Transfer Withdrawal RequestUpdate or request tax withholding information
Elect to be a CalSTRS Defined Benefit Program member or Cash Balance participant
Other forms
Reinstate from retirement
Reinstatement After Retirement (SR0857, rev. 06/20)Cash Balance Reinstatement After Retirement (CB1102 rev. 07/21)Enroll in the Reduced Workload Program
Reduced Workload Program Eligibility Certification (ES1161, rev. 04/23)Request verification of benefits letter
Request for Verification of Benefits (AS1830, rev. 01/18)Request for Verification of Benefits for the Social Security Administration (AS1831, rev. 01/18)Enroll in the Medicare Premium Payment Program
Medicare Payment Authorization Packet (HB0986, rev. 09/23)Request community property estimate
Request for Community Property Statement and Estimate of Benefit (LGL722, rev. 08/10)Report earnings (for disability benefit recipients)
Earnings Limit Certification (A) (DS0727A, rev. 10/16)Earnings Limit Certification (B) (DS0727R, rev. 10/16)Update your gender identity
Gender Change Request (AS0671, rev. 12/21)
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