CalPERS Service Credit Request Form Instructions
This file contains detailed instructions and information on how to request service credit through CalPERS. It outlines the necessary steps, relevant sections, and certification requirements. Ideal for California public employees seeking to understand their service credit options.
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How do I fill this out?
To fill out this form, start by gathering all relevant employment information. Ensure you have your details like Social Security Number, CalPERS ID, and employer information ready. Follow each section carefully and provide accurate dates and information as requested.

How to fill out the CalPERS Service Credit Request Form Instructions?
1
Collect personal information and employment history.
2
Fill out the relevant sections with accurate dates.
3
Review the form for completeness and accuracy.
4
Sign the certification section.
5
Submit the form to CalPERS by the specified deadline.
Who needs the CalPERS Service Credit Request Form Instructions?
1
Public employees in California needing service credit.
2
Individuals preparing for retirement who wish to include extra service time.
3
HR departments ensuring employees submit accurate requests.
4
Teachers and educators seeking retirement credit for past service.
5
Independent contractors who rendered service to CalPERS-covered entities.
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What are the instructions for submitting this form?
To submit this form, mail it to CalPERS at P.O. Box 4000, Sacramento, CA 95812-4000. Ensure it is addressed to the Member Account Management Division, and include your name and CalPERS ID on every page. For inquiries, you may contact CalPERS at 888-225-7377.
What are the important dates for this form in 2024 and 2025?
Key deadlines and important dates for this form in 2024 include: March 1 for Spring pension application submissions and November 1 for end-of-year considerations. For 2025, similar deadlines are expected.

What is the purpose of this form?
The purpose of this form is to allow California public employees to formally request the purchase of service credit. Service credits are critical for enhancing retirement benefits, impacting calculations of pension payouts. Completing this form correctly ensures members meet criteria and deadlines to secure their requested credits.

Tell me about this form and its components and fields line-by-line.

- 1. Name of Member: Last name, first name, and middle initial of the applicant.
- 2. Social Security Number or CalPERS ID: Unique identifier for processing the request.
- 3. Member Mailing Address: Physical address where correspondence will be sent.
- 4. Daytime Phone: Contact number for the member.
- 5. Email Address: Contact email for digital communication.
- 6. Employment Information: Details of the employer, work periods, and employment status.
What happens if I fail to submit this form?
Failure to submit this form can lead to delays in processing your retirement benefits. It's crucial to ensure all sections are completed accurately to avoid complications. Incomplete submissions may necessitate resubmission, causing potential loss of service credits.
- Delayed Processing: Your request for service credit may take longer to process, affecting your retirement timeline.
- Loss of Credits: Incomplete forms may result in missed opportunities to purchase service credits.
- Legal Implications: Submitting incorrect information may have legal ramifications regarding your benefits.
How do I know when to use this form?

- 1. Before Retirement: Utilized by employees nearing retirement to maximize benefits.
- 2. Service Credit Purchase: Necessary for purchasing service time from previous roles.
- 3. HR Submission: Required by HR to certify eligible employee requests.
Frequently Asked Questions
What is this form used for?
This form is used to request service credit from CalPERS, allowing eligible public employees to purchase additional time for retirement benefits.
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What should I do if I make a mistake on the form?
You can easily correct any errors by editing the PDF on PrintFriendly before finalizing the document.
How do I ensure my submission is complete?
Make sure all sections are filled accurately and check that you have signed the certification before submitting.
Is there a deadline for submitting this form?
Yes, ensure you submit the form by your retirement date or other specified deadlines to avoid delays.
What if I need more assistance filling out the form?
You can refer to the official CalPERS website for publication guides and resources to assist with your submission.
How will I know if my form has been processed?
CalPERS will provide updates regarding your submission status via the contact details you provided on the form.
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