Forms & Publications

Online submissions of forms are not available at this time.

Forms may be submitted via email, U.S. Mail, or dropped off in the StanCERA Lobby.

Most forms may be submitted electronically through DocuSign. To request a DocuSign version of a form, contact StanCERA at (209) 525-6393.

832 12th Street | Modesto, CA 95350 | retirement@stancera.org

Active/Deferred Members

Address Change Form – Deferred Members

Beneficiary Designation

Buy Back Calculation Request

Buy Back Request for AB2766

Name Change Form

Service Retirement Estimate Request

Retired Members

Address Change Form

Agreement for Direct Deposit – Submission by U.S. mail or in Person. For digital (DocuSign) submission, contact StanCERA.

Beneficiary for $5,000 Death Benefit

Final Benefit Payment Upon Death

Name Change Form

Tax Withholding Form – California State

Tax Withholding Form – Federal (W4-P)

Divorcing/Divorced Members

Tax Worksheets

Links to Simplified Method Worksheets for taxability calculation of your taxed contributions

IRS 2019 Publication 575 Pension and Annuity Income

Retired between July 2, 1986 – November 18, 1996
1099R Worksheet #1

Retired on or after November 19, 1996, with a spouse beneficiary continuance
1099R Worksheet #2

Retired on or after November 19, 1996, with no continuance
1099R Worksheet #3

Active employees are to update changes to name, address, telephone number, and marital status through employer. StanCERA imports updates directly from your employer records.

Member’s must forward supporting forms and documentation, for any updates, directly to StanCERA. Employers are not required to forward supporting documentation.

Need a form you don’t see on this page? Contact StanCERA staff for assistance. retirement@stancera.org or (209) 525-6393