This form is mainly used to change your address, beneficiary, or marital status.

This form is also required when submitting the Service Retirement application. If you wish to designate more than three beneficiaries, please use the Supplemental Beneficiary Designation Form below and submit it with your Member’s Affidavit.

Note: Active Members should update their address with their employer who will report the new information to SCERS. 

Return the completed form in person or by mail to SCERS; or request a digital (DocuSign) version by calling us at (916) 874-9119 or emailing sacretire@saccounty.gov. SCERS will not accept this form by fax or email.

Member's Affidavit

Supplemental Beneficiary Designation Form