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It requires signatures certifying eligibility and authorization for deposits and related debits, and explains requirements for handling requests outside U.S. territorial jurisdiction. 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In order to receive important information about benefits, payees should keep CalPERS informed of any address changes.  \nA separate form must be completed for each type of retirement benefit to be sent by direct deposit.  \n\n| Name (First Name, Middle Initial, Last Name) |  | Social Security Number or CalPERS ID |\n| --- | --- | --- |\n| Address |  | Daytime Phone |\n| City\u003Cbr>Section 2: Information About Your Account |  | State ZIP Code |\n| Select the account type for your direct deposit.\u003Cbr> Checking  Savings  Joint (If so complete Section 3)  Trust Account*\u003Cbr>Please use tape to attach your voided, pre-printed personalized check. (Do not staple or paperclip. No deposit slips. ) If you are authorizing your payment to your savings account or do not have pre-printed, personalized checks, please have your financial institution complete this section.\u003Cbr>* Trust Accounts You also need to complete and submit a Request for Payment of Monthly Allowance to a Trust form or the Certification of Trust and Request for Continued Payment of Monthly Allowance to a Trust form [available at](available at www.calpers.ca.gov)[ www.calpers.ca.gov](available at www.calpers.ca.gov) and a copy of the Certification of Trust from your trust document. |  |  |\n| Routing Number (Nine Digits) | Account Number (Do not include the check number) |  |\n| Name of Financial Institution | Branch Phone Number |  |\n| Address |  |  |\n| City State ZIP Code\u003Cbr>You confirm the identity of the above-named payee and the account number. As a representative of the above-named financial institution, you certify the financial institution agrees to receive and deposit the payment identified above. |  |  |\n| Signature of Bank Representative Print Bank Representative Name Date (mm/dd/yyyy)\u003Cbr>Mail to: |  |  |\n\nCalPERS Retirement Benefit Services Division, P.O. Box 942716 , Sacramento, CA 94229-2716 888 CalPERS (or 888-225-7377) TTY: (877) 249-7442 Fax to (800) 959-6545  \nCalPERS-1288 (Revised 08/2024) Page 1 of 3  \nCalPERS—Direct Deposit Authorization  \nPut your name and Social Security number or CalPERS ID at the top of every page.  \nName (First Name, Middle Initial, Last Name) Social Security Number or CalPERS ID  \nSection 3: Information About Joint Account Holder (If applicable)  \n\n| Name (First Name, Middle Initial, Last Name) | Social Security Number or CalPERS ID |\n| --- | --- |\n| Address | Daytime Phone |\n| City\u003Cbr>Section 4: Certification | State ZIP Code |\n\nSignature is required.  \nI certify I am entitled to the payment identified above. In signing this form, I authorize my payment to be sent to my financial institution and deposited to my designated account. I authorize amounts transferred after my death or transmitted in error to be debited from my account. Additionally, I certify that the funds received are not deposited to an account that is subject to being transferred to a foreign financial institution.  \nTo comply with National Automated Clearing House (NACHA) regulations regarding International ACH Transactions (IAT), CalPERS will not accept requests for electronic fund transfers (EFT) in association with financial institutions outside of the territorial jurisdiction of the United States. (The territorial jurisdiction of the United States includes all 50 states, U.S. Territories, U.S. military bases, and U.S. embassies in foreign countries. ) If your entire benefit allowance will be received by a financial institution outside the territorial jurisdiction of the U.S. , you will be issued a paper check in lieu of the EFT.  \nSignature of Payee Date (mm/dd/yyyy)  \nYou can view and print your benefit statement, which shows your total deposit amount, including any reimbursements or aut","cbCaiuSOPVgNiS9M","https://ap.wps.com/l/cbCaiuSOPVgNiS9M","pdf",175930,"English","# Section 1: Information About You\n# Section 2: Information About Your Account\n# Section 3: Information About Joint Account Holder (If applicable)\n# Section 4: Certification\n# Privacy Notice","[{\"question\":\"What confirmation will you receive after submitting the completed authorization form?\",\"answer\":\"You will receive a confirmation letter with the effective date once CalPERS has processed the completed form.\"},{\"question\":\"What account details are required to set up direct deposit?\",\"answer\":\"You must select an account type and provide the routing number and account number for the designated financial institution.\"},{\"question\":\"What certification and signature are required on the form?\",\"answer\":\"A signature is required to certify entitlement to the payment and authorization for depositing the payment to the designated account, including debits for certain transfers after death or in case of transmitted error.\"}]","Direct Deposit Authorization - California Public Employees’ Retirement System (CalPERS) Form | PDF",1789617607]