Get Calpers Applicant Questionnaire

The CalPERS Applicant Questionnaire is a crucial step for entities seeking to participate in the California Public Employees’ Retirement System benefit programs. This guide offers clear instructions on how to fill out the form online, ensuring that your application is as complete and thorough as possible.

Follow the steps to complete your questionnaire with ease.

1. Click the ‘Get Form’ button to obtain the questionnaire. This will open the form for you to begin filling it out.
2. Provide your contact information in the designated fields. Ensure to include the official agency name, mailing address, street address, city, state, zip code, and county. Designate an authorized agency representative and provide their name, title, telephone number, and email.
3. Indicate the type of entity applying. Select from options such as Joint Powers Authority, Non-Profit Corporation, or other. If you select 'other', please describe the type of entity.
4. Respond to questions regarding past name changes of the agency. If applicable, list previous names in the provided section.
5. Specifically address previous contracts with CalPERS for health or retirement services by selecting 'yes' or 'no' for each service.
6. List the governing board or body members with their names, appointment dates, and current job titles. This information is essential for accountability.
7. Indicate whether the members of the governing board or body are elected or appointed, and provide details about who has the power to appoint them if they are appointed.
8. Explain any powers that other individuals or entities may have regarding the board, including voting or ownership interests.
9. Describe any applications to related entities or organizations, including references to governing documents as needed.
10. Confirm if any other government body has fiscal responsibility for the debts of the employer, and provide detailed information if applicable.
11. Provide a detailed description of all powers exercised and functions performed, with appropriate references to statutes or bylaws.
12. If created by a specific statute, cite it and provide details about the purposes and powers prescribed.
13. State if the government has any control over the employer's operations or property, and describe it in detail.
14. Indicate whether the employer currently has employees and specify the number of current and expected employees.
15. If employees perform services for related entities, provide a detailed description of these arrangements.
16. Identify if any other entity performs human resources or payroll functions for the employer, with detailed explanations.
17. Clarify if any of the employer's employees are participating in CalPERS through another entity and explain the arrangement.
18. Explain if the employer's employees are treated similarly to state employees in areas other than benefits.
19. Detail the grievance procedures and administrative appeals rights for employees.
20. Describe any funding sources expected to be received and their percentages of total funding.
21. Finalize the questionnaire with the employer certification. The authorized representative must sign and date the form, confirming all information is accurate and updates will be provided as necessary.
22. Once all fields are completed, save your changes. You can also download, print, or share the completed form as required.

Complete your CalPERS Applicant Questionnaire online today to ensure a smooth application process.