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Forms and Publications Download Page

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FORMS

2009 ADMS Correction Form

Available

(40K)

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2010 Medical Plan Open Enrollment Form

Available

(400K)

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2010 Dental Plan Open Enrollment Form

Available

(70K)

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2010 Vision Plan Open Enrollment Form

Available

(278K)

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Active or Deferred Member Beneficiary Designation Form Available
(75K)
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Address and Name Change Form for Retired Member/Payee Available
(36K)
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Affidavit of Domestic Partnership
Tell Me More
Available
(166K)
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Agreement and Order for Division of Retirement Benefits -- Separate Accounts Available
(32K)
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Agreement and Order for Division of Retirement Benefits --   Shared Accounts Available
(28K)
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Application For Disability Retirement (Sample Only)
Tell Me more
Available
(333K)
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Application for Service Retirement

Tell Me More

Available

(50K)

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Aquilino Tier I Restoration Application
Tell Me More
Available
(184K)
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Authorization for Release of Information and Documents Available
(52K)
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Bi-Weekly Transmittal Form

(Participating Employer Use Only)

Available

(180K)

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Community Property Estimate Request Form

Available

(170K)

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Confidentiality Policy

Available

(82K)

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Declaration of Qualification for Registration as Domestic Partners Available
(136K)
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Direct Deposit Form Available
(260K)
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HIPAA Authorization Form

Tell Me More

Available

( 78K)

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HIPAA Cancellation Form

Tell Me More

Available

( 78K)

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IRS Form W-9

Available

( 273K)

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MBRP Application Form
Tell Me More
Available
(48K)
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Membership Status Change Form

Tell Me More

Available

(230K)

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New Member Enrollment Questionnaire Available
(400K)
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Notice of Claim Available
(47K)
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Power of Attorney Available
(56K)
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Purchase/Redeposit Request Form
Tell Me More
Available
(163K)
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Request for Joinder Packet Available
(69K)
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Retirement Estimate Request Form Available
(36K)
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Retired Member Beneficiary Designation Form
Available
(191K)
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Social Security - Request for Earnings and Benefit Estimate Statement Available
(28K)
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Survivor Continuance Recipient's Designation of Beneficiaries Form Available
(20K)
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Tax Withholding Designation Form (State of California / EDD)

Tell Me More

Available

(3K)

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Tax Withholding Designation Form (IRS Federal Form W4-P)

Tell Me More

Available

(3K)

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Termination Election of Membership Request Form

Available

(314K)

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Termination of Domestic Partnership
Tell Me More
Available
(3K)
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Verification of Enrollment Status Available
(42K)
Download It!

 

PUBLICATIONS

2010 Retiree Health Fair Brochure Available
(5 MB)
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2010 Notice of Election Available
(98 KB)
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2010 COLA Announcement Available
(1.4 MB)
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ACERA Presentation Information Available
(292 K)
Download It!
2010 Active Member Seminars Schedule Available
(292 K)
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2010 Retiree Seminars Schedule Available
(874 K)
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2010 Retired Member Benefits Handbook Available
(665 K)
Download It!
2009 Participating Employers Handbook Available
(3.6 MB)
Download It!
2010 Enrollment and Health Plan Brochure Available
(882 K)
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2009 ACERA Health Fair Save The Date Postcard Available
(101 K)
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2009 ACERA Health Fair Brochure Available
(9.2 MB)
Download It!
Monthly Investment Performance Report (July 2010)
Available
(120K)
Download It!
ACERA Directed Brokerage Policy

Available

(120K)

Download It!

Disability Retirement Handbook

Available

(288K)

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ACERA Disability Retirement Procedures

Available

(464K)

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ACERA Member Handbook

Available

(1 MB)

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Divorce and ACERA Benefits Memo Available
(100K)
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Understanding ACERA Retiree Death Benefits Available
(130K)
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ACERA Legal Manual Available
(600K)
Download It!
ACERA Newsletter, Spring/Summer 2010

Available

(323 KB)

Download It!

ACERA Newsletter, Winter 2010

Available

(791 KB)

Download It!

ACERA Newsletter, Spring 2009

Available

(1 MB)

Download It!

ACERA Newsletter, Summer 2009

Available

(330 KB)

Download It!

ACERA Newsletter, Fall 2009

Available

(828 KB)

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ACERA Newsletter, Winter 2009

Available

(1 MB)

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ACERA Pre-Retirement Seminar Presentation

More Retirement Seminar Information...

Available

(932 K)

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ACERA Mid-Career Seminar Presentation
More Retirement Seminar Information...
Available
(884K)
Download It!
Plan Year 2010 Dental, Vision and Non-Medicare Medical Plan Rates Available
(67K)
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Plan Year 2010 Medicare Supplement and Medicare Risk Plan Premiums Available
(38K)
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Medicare Part D Prescription Drug Coverage Flyer

Available
(412K)
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Comprehensive Annual Financial Report

For years ending 2008-2009

Available
(6.9MB)
Download It!

Popular Annual Financial Report

For years ending 2008-2009

Available
(3.8MB)
Download It!

Comprehensive Annual Financial Report

For years ending 2007-2008

Available
(5.3MB)
Download It!

Popular Annual Financial Report

For years ending 2007-2008

Available
(2.3MB)
Download It!

Comprehensive Annual Financial Report

For years ending 2006-2007

Available
(4.81 MB)
Download It!

Popular Annual Financial Report

For years ending 2006-2007

Available
(2.86 MB)
Download It!

Comprehensive Annual Financial Report

For years ending 2005-2006

Available
(3.97MB)
Download It!

Popular Annual Financial Report

For years ending 2005-2006

Available
(1.07K)
Download It!

Comprehensive Annual Financial Report

For years ending 2004-2005

Available
(2.75MB)
Download It!

Popular Annual Financial Report

For years ending 2004-2005

Available
(541K)
Download It!
Comprehensive Annual Financial Report
For the years ending 2003-2004*
Available
(849K)
Download It!
Comprehensive Annual Financial Report
For the years ending 2002-2003*
Available
(1.0MB)
Download It!
Comprehensive Annual Financial Report
For the years ending 2001-2002*
Available
(1.5MB)
Download It!
 

*Information may have been updated or changed on this website since first publication.  The download version is original and unchanged from date of publication

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