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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.


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 November 22
401(a) Beneficiary April 22
401(a) In Service Withdrawal Age 59.5 or Older April 22
401(a) Incoming Direct Rollover November 22
401(a) Separation From Employment Withdrawal Request April 22
401(a) Death Claim February 22
457 Beneficiary April 22
457 In Service Withdrawal Age 59.5 or Older April 22
457 Incoming Transfer November 22
457 Paycheck Contribution Election April 22
457 Death Claim April 22
457 Separation From Employment Withdrawal Request April 22

Enrollment
Form Number Form Name Last Revision
1 Enrollment March 21
1A & 8 Beneficiary Designation - Death Benefits for Active Participants and Unmarried Vested Death Benefit August 21
Term-Non vested
Form Number Form Name Last Revision
2A Refunds - Payment Election July 21
Instructions Instructions for Form 2A - Refunds Payment Election May 20
Death
Form Number Form Name Last Revision
9 Application by Spouse June 21
3A Death Benefits - Non-Spouse Payment Election $10,000 Death Benefit November 22
3B Death Benefit - Spouse Payment Election $10,000 Death Benefit November 22
3C Death Benefit - Non-Designated Non-Spouse Payment Election $10,000 Death Benefit November 22
4A Death Benefits - Designated Non-Spouse Payment Election Single-Vested/Non-Vested Refund November 22
4B Death Benefit - Spouse Payment Election Non-Vested Refund November 22
4C Death Benefits - Non-Designated Non-Spouse Payment Election Single-Vested/Non-Vested Refund November 22
Instruction Instructions for Forms 3A, 3B, 3C, 4A, 4B & 4C - Death Benefits Payment Election April 19





Term vested
Form Number Form Name Last Revision
2V Termination Vested November 22
2B Retirement Application
Designation of Survivor
(Employees termed after 12/31/1999)
July 21
6 Retirement Application
(Employees termed before 1/1/2000)
June 16
EFT Electronic Funds Transfer July 19
Federal W4P Federal Withholding for Pension or Annuity Payments October 22
MO-W4P State Withholding for Pension or Annuity Payments October 22
2C Co-Annuitant for 10 Year Certain January 21








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