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CalPERS Supplemental Income 457 Plan


Employee New Enrollment Form
For New Enrollments only.

Participant Change Authorization
Investment fund allocation changes must be made via Plan Information Line or Plan Website.

  • Increase or decrease your contribution amount
  • Suspend contributions
  • Change your name or address 

Beneficiary Designation Form
Designate beneficiary(ies)

457 (b) Deferred Compensation Enrollment Application

TRANSFERS / ROLLOVERS - (Updated: 07/27/16)

Rollover Form
Roll over monies from another type of plan [401(k), 403(b), IRA or 401(a)] from your previous employer

Inter-Plan Transfer Form
Transfers from a previous employer’s CalPERS Supplemental Income 457 Plan into the current employer’s CalPERS Supplemental Income Plan


DISTRIBUTIONS - (Updated 7/27/16)

Distribution Request Form  

  • Request distribution after separation/retirement
  • Change current distribution option
  • Alternate payee distribution per Qualified Domestic Relations Order

Death Distribution Form
For surviving spouse and/or beneficiary(ies) to request distributions (one form per beneficiary).

In-Service Withdrawal / Transfer Request Form

  • In-service transfer for CalPERS Service Credit purchase
  • In-service transfer for another Pension Plan Service Credit purchase
  • Small account withdrawal

Emergency Withdrawal Request Form
Withdrawal request due to an “unforeseeable emergency”

*Unforeseeable Emergency Withdrawal Process*

OTHER FORMS - (Updated: 7/27/16)