Service Retirement Application

Customer Name: JOHN DOE

Select your marital or RDP status below to indicate the Required Signatures necessary for your Service Retirement application.

Required Signatures

Make Your Selection
*Select all statements that apply to you.

	I have never been married or registered as a domestic partner.

	I am currently married or registered as a domestic partner to:
		Name: John A Doe	Edit
		Date of Birth: 02/03/1944
		Social Security Number: XXX-XX-8989
		Relationship: Spouse
		Gender: Male

	Will your Spouse / RDP sign this form? *Yes No (Electronically or hard copy)

	I have a prior relationship where I was married or registered as a domestic partner.

	Select one* option below to specify:

		I am now widowed. / My RDP has died.

		I am divorced or terminated a registered domestic partnership and my former spouse / partner was awarded a portion of my CalSTRS benefits.

		I am divorced or terminated a registered domestic partnership and my former spouse / partner was not awarded a portion of my CalSTRS benefits.