CalSTRS Permissive Membership Election Form and CalSTRS Member Handbook
If you are employed to perform creditable service in a position that is excluded from mandatory membership in the CalSTRS’ Defined Benefit (DB) Program, you may use this form to elect DB Program membership at any time while employed to perform creditable service.
Jump to Related FilesA permissive election of membership in the DB Program applies to all future creditable service performed for the same or another employer, including any non-member or CalSTRS Cash Balance Benefit (CB) Program service you are currently performing. You may be entitled to elect coverage by the CB Program or California Public Employees’ Retirement System (CalPERS) for future eligible service as allowed by law. Please work with your employer if you believe you are entitled to make one of these elections.
A permissive election of membership in the DB Program is irrevocable. Membership may only be cancelled if you terminate all employment to perform creditable service and refund your accumulated retirement contributions from the CalSTRS DB Program.
To Be Completed by the Employee
Provide the following information:
CalSTRS Client ID* or Social Security Number
- Last Name, First Name and Middle Initial
- Mailing Address**, City, State and Zip Code
- Date of Birth
- Email Address
- Telephone Number
*If you have already been employed to perform creditable service you will have a CalSTRS Client ID, even if you were not formerly a member. Please provide your CalSTRS Client ID, if you have one, in lieu of your Social Security Number.
**To establish residency for tax purposes, we ask that you provide a street address. Be sure to include any street, apartment or suite number. If your post office does not deliver mail to your street address, you may enter your box number instead. If you reside outside the United States, use the CITY – STATE – ZIP field to provide your foreign address. If you receive your mail in care of a third party, enter “c/o” followed by the third party’s name and address.
If you want to elect membership in the CalSTRS DB Program:
- Check the appropriate box
- Provide your requested membership date***
***You will begin contributing to the DB Program as of your membership date. Your membership date can be no earlier than the first day of the pay period in which your election is made, or your first day of employment, whichever is later. Work with your employer to select the most beneficial, valid membership date you are eligible for. Electing an invalid membership date will require a revision to your election form and may result in delayed contributions to CalSTRS.
If you do not want to elect membership in the CalSTRS DB Program at this time, check the appropriate box.
Sign the form and date your signature. Return the form to your employer.
To Be Completed by Employer
Provide the position hire date – the date in which the employee was hired to perform creditable service in the position they are making this election for. CalSTRS defers to the employer as to the date in which you consider an employee to be hired. Provide the position title – the title of the position the employee is performing creditable service in.
Verify the employee is eligible for the requested membership date.
Provide the following information:
- The employer (county or district) name
- County and district code
- Name and title of employer official completing the form
Sign the form and date your signature. Submit the form to CalSTRS and retain a copy.
This form should be submitted to CalSTRS by the employer. CalSTRS must receive this form within 60 days after the employee’s signature date and, if applicable, prior to the submission of contributions.
| Secure Employer Website | Send the completed form to the ES Forms Queue found in the Business Areas dropdown of the Recipient via SEW. |
|---|---|
| Submit this form via email to the esforms@calstrs.com mailbox unless otherwise instructed by your CalSTRS representative. If sending forms to the esforms@calstrs.com mailbox, please remove all Social Security numbers and only provide the Client ID where applicable. | |
| CalSTRS P.O. Box 15275, MS 17 Sacramento, CA 95851-0275 |
This form should be submitted to CalSTRS by the employer. CalSTRS must receive this form within 60 days after the employee’s signature date and, if applicable, prior to the submission of contributions.