Get Calpers Member Reciprocal Self Certification Form

Completing the Calpers Member Reciprocal Self Certification Form is a crucial step for employees transitioning between reciprocal California public retirement systems. This guide provides a clear and supportive walkthrough of the online form filling process, ensuring that you accurately submit your information.

Follow the steps to successfully complete the form online.

1. Click ‘Get Form’ button to access the Calpers Member Reciprocal Self Certification Form online.
2. Provide your full name in the designated fields. Enter your last name, first name, and middle name as required.
3. Input your social security number or your CalPERS ID number in the appropriate field.
4. Indicate the name of your most recent reciprocal retirement system in the required section.
5. Fill in your permanent separation date from the most recent reciprocal retirement system.
6. State your first membership date in any prior California public retirement system that is subject to reciprocity.
7. Select the applicable statement regarding your prior membership in a reciprocal retirement system.
8. Read and acknowledge the certification statement, confirming that the provided information is true and correct.
9. Sign and date the form in the designated areas to validate your submission.
10. Once you have completed all sections, save your changes, and choose to download, print, or share the form as needed.

Complete your Calpers Member Reciprocal Self Certification Form online today to ensure a smooth transition in your retirement plans.