Forms
Downloadable PDF forms
Below are the forms most commonly used by members and employers to request a service from KCERA. An incomplete form will delay your request, so please follow instructions carefully before submitting the document(s) to KCERA.
(To view the documents on this webpage, you will need Adobe Acrobat Reader installed on your computer. If you do not have the most recent version, you can download it for free by clicking here.)
Member Forms
Authorization For Release Of Member InformationBeneficiary Designation FormBeneficiary Designation-Survivor FormCertification of Prior County/District ServiceCertification of Prior Public ServiceCertification of Prior Public Service – MilitaryChange Request FormDirect Deposit StopDisposition PacketDRO SampleEmail Change FormPower of Attorney PacketPurchase of Service - FAQRetirement Application PacketRetirement Payment Authorization