Order by Mail

To order any of the forms and/or brochures shown below, check the box next to the desired item(s) and we’ll mail them to you at no cost.

When you’ve completed your order, click the Ready to Order button below Your Order Inventory, provide the requested information, and submit. Your order will be processed by the end of the next business day.

Download Forms Now

Click the Download PDF button next the form you desire.

To complete our PDF forms, either:

  • Download, print, complete by hand, and mail to LACERA, or
  • Download, input the requested information directly into the indicated spaces, save the file on your computer, mail the form to LACERA.

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Do not email forms to us; email is not secure.

Select from the Following Categories

Learn About Your Retirement Plan

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Manage Your Plans

  • (RSD2011) Printed 10/14

  • (RSD1542) Printed 8/09

  • (RSD1589) Printed 1/13

  • (RSD562) Printed 9/00

  • (RSD1539) Printed 3/08

Plan Your Retirement

Apply for Disability Retirement

Access Survivor and Beneficiary Information

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Your Order

To add items to your order, click the checkbox next to any items you wish to receive by mail.

You may order up to five copies of any item. Change an item’s quantity to “0” to remove it from your order.


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  1. General Plans A, B, C: Summary Plan Description Brochure
  2. General Plan D: Summary Plan Description Brochure
  3. General Plan E: Summary Plan Description Brochure
  4. General Plan G: Summary Plan Description Brochure
  5. Safety Plans A, B: Summary Plan Description Brochure
  6. Safety Plan C: Summary Plan Description Brochure
  7. General Plan G: New Hire Welcome Package
  8. Safety Plan C: New Hire Welcome Package
  9. Affidavit of Minor Student For Continuing Benefit
  10. Name Change Form
  11. Address Change Form
  12. Q&A: Special Durable Power of Attorney and Application Form
  13. Beneficiary Designation Form
  14. Beneficiary Designation for Ex-Spouse Form
  15. Community Property Brochure
  16. Purchasing Previous Service Credit Information & Application
  17. Q&A: Plan E Elective Cola
  18. Q&A: Purchasing Service Credit
  19. Withdrawal/Reciprocity Brochure
  20. Rollover/Transfer Certification Form
  21. Pre-Retirement Guide
  22. Introduction to Retirement: 7-Step Reference Card
  23. Request to Rescind or Change Retirement Date Form
  24. Disability Retirement Plans A, B, C, D Brochure
  25. Disability Policies & Procedures: Disability Applications Brochure
  26. Procedures for Disability Retirement Hearings Brochure
  27. Employee Disability Retirement Package
  28. Survivor (Service-Connected Death) Package
  29. Employer Disability Retirement Package
  30. Survivor & Death Benefits Information Card
  31. Q&A: Death & Continuing Benefits
  32. Survivor (Service-Connected Death) Package
  33. Direct Deposit Brochure and Application
  34. Federal & CA Income Tax Withholding on Retirement Income (W-4P, DE4P) Form
  35. Payday Planning Calendar
  36. Retired Public Safety Officer Affidavit Form: $3,000 Healthcare Tax Benefit
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