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Get Membership Application - California State Retirees - Californiastateretirees

St Name Social Security No. First Name Middle Initial Number & Street Social Security No. City State Type of membership (check one) RETIRED MEMBERSHIP Available to state retirees only. See Dues Table. E-mail address BENEFICIARY MEMBERSHIP (Decedent Social Security No. ) Available only to bene ciaries of deceased CSEA employed or retired members. Dues are $1.00 per month. ASSOCIATE MEMBERSHIP Available only to persons not eligible for Retired or Bene ciary mem.

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