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CalPERS Special Power of Attorney

A Guide to the CalPERS Special Power of AttorneyThis page intentionally left blank to facilitate double-sided printing. TABLE OF CONTENTS Introduction ..2 Authority Granted by Your CalPERS Special Power of Attorney Form ..3 Duration of Your CalPERS Special Power of Attorney ..3 Changing Your Power of Revoking Your Power of Attorney ..4 Non- CalPERS Power of Attorney Documents ..4 Contacting CalPERS ..5 CalPERS Special Power of Attorney Checklist ..6 Special Power of Attorney Form ..7 Become a More Informed Member .. 13 CalPERS Website .. 13 my| 13 CalPERS Education Center .. 13 Experience CalPERS Through Social Media .. 13 Reach Us by Phone .. 13 Visit Your Nearest CalPERS Regional 14 Privacy Notice .. 15 2 888 CalPERS (or 888-225-7377) INTRODUCTION This publication will help you understand the CalPERS Special Power of Attorney form and the importance of having one on file.

PrintNameofAgent(FirstName,MiddleInitial,LastName) SignatureofAgent. Date(mm/dd/yyyy) S5, continued . WS,C. Put your name and Social Security number or CalPERS ID at the top of every page. Name of Member Social Security Number or CalPERS ID . M: CPERSBSD•P.O.B942716,S,C94229-2716.

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