CERF Participant Forms

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CERF Forms

Submit all completed forms to your County Clerk. Contact your County Clerk or the CERF Administrative Office if you have any questions about the pension plan forms.


Enrollment
Form Number Form Name Last Revision
1 Enrollment November 16
1A Beneficiary Designation - $10,000 Death Benefit/Non-Vested Refund of Contributions July 17
8 Beneficiary Designation - Single Vested Death Benefit June 18
Term-Non vested
2A Refunds - Payment Election August 17
Instructions Instructions for Form 2A - Refunds Payment Election November 08
Death
Form Number Form Name Last Revision
9 Application by Spouse November 15
3A Death Benefits - Non-Spouse Payment Election $10,000 Death Benefit September 12
3B Death Benefit - Spouse Payment Election $10,000 Death Benefit September 12
3C Death Benefit - Non-Designated Non-Spouse Payment Election $10,000 Death Benefit September 12
4A Death Benefits - Non-Spouse Payment Election Single-Vested/Non-Vested Refund September 12
4B Death Benefit - Spouse Payment Election Non-Vested Refund September 12
4C Death Benefits - Non-Designated Non-Spouse Payment Election Single-Vested/Non-Vested Refund April 13
Instruction Instructions for Forms 3A, 3B, 3C, 4A, 4B & 4C - Death Benefits Payment Election August 12


Term vested
Form Number Form Name Last Revision
2V Termination Vested Jun 18
2B Retirement Application
Designation of Survivor
(Employees termed after 12/31/1999)
June 17
6 Retirement Application
(Employees termed before 1/1/2000)
June 16
EFT Electronic Funds Transfer December 16
Fed-W4P Federal Withholding for Pension or Annuity Payments March 18
MO-W4P Missouri Withholding for Pension or Annuity Payments November 13
2C Co-Annuitant for 10 Year Certain March 09

Submit all completed forms to your County Clerk. Contact the Empower Retirement Office at 1-877-895-1394 if you have any questions about the savings plan forms.

Form Name Last Revision
Savings Plan Enrollment Apr 18
401(a) Beneficiary Mar 18
401(a) In Service Withdrawal Age 59.5 or Older Mar 18
401(a) Incoming Direct Rollover Mar 18
401(a) Separation From Employment Withdrawal Request May 18
401(a) Death Claim May 18
457 Beneficiary Mar 18
457 In Service Withdrawal Age 70.5 Mar 18
457 Incoming Transfer Mar 18
457 Paycheck Contribution Election May 18
457 Death Claim May 18
457 Separation From Employment Withdrawal Request May 18
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