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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.


Term vested
Form Number Form Name Last Revision
2V Termination Vested December 20
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 July 19
Fed-W4P Federal Withholding for Pension or Annuity Payments January 21
MO-W4P Missouri Withholding for Pension or Annuity Payments November 13
2C Co-Annuitant for 10 Year Certain February 21





Enrollment
Form Number Form Name Last Revision
1 Enrollment March 21
1A Beneficiary Designation - Death Benefits for Active Participants January 20
8 Beneficiary Designation - Single Vested Death Benefit June 18
Term-Non vested
Form Number Form Name Last Revision
2A Refunds - Payment Election July 19
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 April 19
3B Death Benefit - Spouse Payment Election $10,000 Death Benefit April 19
3C Death Benefit - Non-Designated Non-Spouse Payment Election $10,000 Death Benefit April 19
4A Death Benefits - Designated Non-Spouse Payment Election Unmarried-Vested/Non-Vested Refund April 19
4B Death Benefit - Spouse Payment Election Non-Vested Refund April 19
4C Death Benefits - Non-Designated Non-Spouse Payment Election Unmarried-Vested/Non-Vested Refund April 19
Instruction Instructions for Forms 3A, 3B, 3C, 4A, 4B & 4C - Death Benefits Payment Election April 19





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 February 21
401(a) Beneficiary September 20
401(a) In Service Withdrawal Age 59.5 or Older January 21
401(a) Incoming Direct Rollover February 21
401(a) Separation From Employment Withdrawal Request January 21
401(a) Death Claim January 21
457 Beneficiary December 20
457 In Service Withdrawal Age 59.5 or Older January 21
457 Incoming Transfer February 21
457 Paycheck Contribution Election December 20
457 Death Claim January 21
457 Separation From Employment Withdrawal Request January 21
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