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Preretirement Election of an Option

Customer Name: JOHN DOE

Add an Option Beneficiary

Complete the form below by filling out About Your Option Beneficiary and Your Option Beneficiary’s Contact Information. Once you have filled out the form below, select the Next button to continue.

Add Your Option Beneficiary’s Information

About Your Option Beneficiary

Beneficiary Option:   100%
*First Name:  
Middle Initial:  
* Last Name:  
* Gender:  
* Relationship to Member:  
* Date of Birth:   calendar
* Social Security Number:  
Member of CalSTRS:  


Your Option Beneficiary’s Contact Information

* USA or International Address:   USA International
* Street Address:  
Apartment/Condo/Suite #:  
* City:  
* State:  
* Zip Code:   -
Primary Phone Number:   () - Ext.
Alternate Phone Number:   () - Ext.
Fax Number:  
* E-Mail Address:  
* Confirm E-Mail Address:  


*Required fields to continue.
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