Get CalSTRS SR 0554E 2020-2024

Express Benefit Report Information and Instructions The Express Benefit Report form is used to request accumulated unused sick leave balance and employment termination information from your employer s during your last school year for whom you performed CalSTRS creditable activities. If the Express Benefit Report form is submitted before the last day of work vacation or approved leave and the member uses sick leave after submitting this form the district must submit a correction on the Employment Termination or Sick Leave Data Correction form to CalSTRS to ensure the member receives an accurate final benefit. For additional information about excess sick leave see the Express Benefit Report instructions. One-year final compensation I certify pursuant to the district bargaining agreement that the present-value payment for one-year final compensation will be made to CalSTRS within 30 days of receiving billing for the member who has fewer than 25 years of service credit. You must submit your Service Retirement Application to CalSTRS before you ll receive your CalSTRS retirement benefit. If your employer submits this form after you submit your retirement application it will not delay your initial benefit. Your full benefit will be calculated when the Express Benefit Report form is processed. You will receive a payment for any accumulated difference. Your last employer is required to submit an Express Benefit Report form to certify your employment termination and last day of work vacation or approved leave. your last employer can report unused sick leave. Credit for unused sick leave is included in the calculation of your retirement benefit. You must submit your Service Retirement Application to CalSTRS before you ll receive your CalSTRS retirement benefit. If you are reporting excess sick leave CalSTRS will send you a bill for the amount due for the unused excess sick leave days reported. A present-value calculation is used to determine the amount due. This applies only if you are reporting unused excess sick leave days. EXPRESS BENEFIT REPORT INFORMATION AND INSTRUCTIONS REV 01/15 PAGE 1 OF 2 Total Sick Leave Days Excess Sick Leave Days Total Sick Leave Days Contract Base Service Days final year To determine and legal holidays from the full-time equivalent FTE if they are included in the FTE. The base service days cannot be fewer than 175 days. An award letter with the updated information will be mailed to you. Contact your employer if there are discrepancies between your records and what your last employer reported to CalSTRS. Members please do not submit this form to CalSTRS. After completing sections 2 4 your employer will return SECTION 1 MEMBER INFORMATION TO BE COMPLETED BY MEMBER Enter your full name Social Security number date of birth mailing address telephone number position title and retirement date listed on your Service Retirement Application. Complete only section 1 of the Express Benefit Report form and give the form and these instructions to each of sections 2 4 and return the form directly to CalSTRS. Your last employer s must complete and certify the information in the remaining sections. CalSTRS may assess penalties for delinquent reports. SUBMITTING THE REPORT Mail to P. O. Box 15275 MS 65 Sacramento CA 95851-0275 Fax to 916-414-5964 or 916-414-5965 Overnight or hand deliver to If you are hand delivering or using a special mailing service such as UPS or FedEx send the form to CalSTRS Member Services 100 Waterfront Place West Sacramento CA 95605 QUESTIONS MEMBERS ONLY Email your questions using your myCalSTRS account or at CalSTRS.com/contactus or call 800-228-5453. If excess sick leave days were accumulated and unused complete the calculation given below to determine present value amount. Prior Year Present-Value Present Service Days Earnable Factor Value x PAGE 2 OF 2 EXPRESS BENEFIT REPORT INFORMATION AND INSTRUCTIONS REV 01/15 SR 0554E rev 01/15 California State Teachers Retirement System 800-228-5453 Members Complete only section 1 then submit this form to each of your employers during your last school year.