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Service Retirement Application

Customer Name: JOHN DOE

Your Defined Benefit (DB) with an Option Beneficiary Election

Review the information on file for your option beneficiary. Make any necessary changes below and select the Save button to continue.

Review Your Current Option Beneficiary Election

About Your Option Beneficiary

  Beneficiary Option:   50%  
  Beneficiary's Name:   John A Doe  
  Gender:   Male  
  Relationship to Member:   Spouse  
  Date of Birth:   03/20/1987  
  Social Security Number:   XXX-XX-7890  
  Member of CalSTRS:   No  


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:
 
Consider This
Changes to any beneficiary information listed above, except for Mailing Address and Primary Phone Number must be submitted to CalSTRS in hard copy by U.S. Postal Service, fax or hand-delivery to a local CalSTRS counseling office. external link

You must submit this Preretirement Election of an Option application containing these changes prior to your retirement date to be valid.


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