Stanislaus County Employees Retirement Association
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 StanCERA Forms

         

 
 
 
 
 
 
 
 

  

 

   Forms may be completed on-line and   On-line submission of forms not available.
   sent by mail or fax to:  

 

     
   StanCERA  
   P. O. Box 3150   

 

   Modesto, CA  95353-3150

   
     
   Fax: (209) 558-4976    
     
     
     

Active & Deferred Members

 

Retired Members

     
     
Link to Personnel Forms by Employer    Authorization for Automatic Deposit
     
Buy Back Calculation Request   Stop Direct Deposit
     
Buy Back Calculation Request: AB2766   Tax Withholdings - 2012 W4P
     
Beneficiary Designation - Instructions   Beneficiary for $5,000 Death Benefit
     
Service Retirement Estimate for Vested Members    
   

Service Retirement Packet  
   

Tax Worksheets:

Social Security Benefits Calculator 

   

 

Simplified Method Worksheets, for taxability calculation of your taxed contributions:

     1099R Worksheet #1
All Members   Retired between Jul. 2, 1986 - Nov.18, 1996.
   
Change of Address   1099R Worksheet #2
    Retired on or after Nov. 19, 1996 with a spouse beneficiary continuance.
Change of Name  
     1099R Worksheet #3
Request for Retirement Benefit Information   Retired on or after Nov. 19, 1996, with no continuance.
Due to Marital Dissolution  
IRS 2010 Publication 575                              
  Pension and Annuity Income
PERSONAL INFORMATION:  
Please inform your employer of a new address, phone number,    
name change, marriage or divorce in a timely manner. StanCERA  

(Click below to access IRS Withholding Calculator)

imports these changes from your employer's records.    
It is the member's responsibility to forward supporting forms and/or documentation for personal changes, as your employer is not required to do so. Need a form you don't see on this page? Call StanCERA at (209) 525-6393.