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»  Fresno County Employees' Retirement Association

Forms

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Retiree Tax Withholding

  • Federal Withholding Certificate for Pension or Annuity Payments
Printable Version

  • State Withholding Certificate for Pension or Annuity Payments - California
Printable Version

  • State Withholding Request - Other States
Printable Version
Information Change and Update

  • Personal Information Waiver
Printable Version

  • Request for Change of Beneficiary
Printable Version

  • Request for Name and Address Change (Retired and Deferred Members Only)
Printable Version
Banking

  • Direct Deposit - Retired Only
Printable Version

  • Paper Check Disclaimer - Benefit Recipients
Printable Version

  • Stop Payment Request - Retired Only
Printable Version
Buybacks

  • Request For Service Credit Calculation
Printable Version

  • Application to Purchase Public Service with Release of Information
Printable Version
Disposition of Retirement Contributions

  • Disposition of Retirement Contributions
Printable Version

  • Disposition Form Instructions
Printable Version

  • IRS Safe Harbor 402(f) Notice
Printable Version
Estimate

  • Estimate Request For Retirement Benefits
Printable Version
Disability

  • Disability Retirement Flowchart
Printable Version

  • Disability Retirement Application
Printable Version
Miscellaneous

  • Claimant's Statement
Printable Version

  • Claim for Damages
Printable Version

  • Death Affidavit
Printable Version

  • Intent to Establish Membership for Elected Official
Printable Version

  • Limitations of Retirement Benefits (IRC415) Pre 1990
Printable Version

  • Limitations of Retirement Benefits (IRC415) Post 1990
Printable Version

  • Mailing Opt-Out Request
Printable Version

  • Non-Member Spouse Continuance Waiver (Deferred members only)
Printable Version

  • Redaction of Name for Safety Reasons
Printable Version

  • REFCO - Personal Information Waiver
Printable Version

  • Request Form (Generic)
Printable Version

  • Waiver of Membership (age 60 or older)
Printable Version


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County of Fresno is an Equal Employment Opportunity Employer