Employee action request - California

Print Form Reset Form PERSONNEL OFFICE USE. STATE OF California STATE CONTROLLER'S OFFICE. Employee action request Who is authorized to receive your pay warrant in case of death? Contact your personnel office to update your designee's name or address (Form STD. 243). A. 01 AGENCY 02 UNIT 03 KEYED BY 04 DATE KEYED. STD. 686 (REV 3/2018) (FRONT) See also retirement beneficiary information on reverse side of Employee copy. CHECK ONE OR MORE BOX(ES) AND COMPLETE LISTED SECTIONS. RETURN COMPLETED FORM TO YOUR PERSONNEL OFFICE. USE BALLPOINT PEN AND PRINT CLEARLY. NO CARBON REQUIRED. }. Withholding Name Change New Employee SECTIONS Birthdate Correction B 01. SECTIONS C, E, F, G, H, I. 03 Allowance Change 04 *Address Change C, F, I. 05 (Attach substantiation) 07. SECTIONS C, H, I. SECTIONS C, E, I SECTIONS C, D, I.

BENEFICIARIES FOR PRE-RETIREMENT SURVIVOR BENEFITS 1. STATUTORY BENEFICIARIES - If you should pass away prior to retirement and you do not name other beneficiaries, surivivor benefits will be paid in the following order: a. Your spouse or registered domestic partner. b. If you have no spouse or domestic partner, your biological and adopted …

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