Application Process for Survivor Benefits

Copies of official documents are acceptable; you don’t need to mail the originals. Ensure that all certificates (such as marriage, birth, and death) are issued and filed by the appropriate government office, such as the county clerk or vital records agency. If you’re unable to obtain these documents, contact us to determine next steps.

Note: Any warrant issued to a retiree or survivor after their death must be returned to CalPERS¹.

Endnotes

1. We'll request reimbursement from the financial institution if the payment was electronically transferred into the deceased's account unless we inform the spouse to keep the warrant. (1)

Completing the entire application for survivor benefits is important.

To ensure timely processing of survivor benefits, it’s essential to complete the entire Application for Survivor Benefits. While it may seem unnecessary to provide information about additional family members, this information is required to comply with legal and administrative procedures.

CalPERS uses the information provided in the application to verify eligibility, determine benefit amounts, and ensure all potential beneficiaries are accounted for according to the California Public Employees’ Retirement Law. Even if you’re the sole beneficiary, completing all sections of the application helps avoid delays in processing your claim. Incomplete or missing information may delay payments, as CalPERS cannot process survivor benefits without all the necessary documentation.

We understand that this may feel overwhelming during a difficult time but providing complete and accurate information is the best way to ensure your benefits are processed as quickly as possible. If you have questions or need assistance, CalPERS representatives are available to guide you through the process.

Step 1: Gather Necessary Information

Before starting the application, collect the following:

• Deceased’s Information:
  • Full name
  • CalPERS ID or Social Security number
  • Date of death
  • Marital status
• Your Information:
  • Full name
  • Social Security number
  • Date of birth
  • Email
  • Phone number
  • Address
• Family Information:
  • Details about the deceased’s spouse, children, parents, and siblings (living and deceased)
• Copies of Supporting Documentation:
  • Death certificate
  • Proof of relationship (e.g., marriage or birth certificate)
  • Any other documents requested in the form

Step 2: Complete Page 1 (Required Information)

1. Your Name: Write your name exactly as it appears on your Social Security card.
2. Social Security Number: Enter your Social Security number or Tax ID.
3. Date of Birth: Write your date of birth in MM/DD/YYYY format.
4. Contact Information: Provide your email address, daytime phone number, and mailing address (include city, state, and ZIP code).
5. Relationship to Deceased: Indicate your relationship to the deceased (e.g., spouse, child, parent).
6. Signature and Date: Sign the form and write today’s date.

Step 3: Complete Pages 2-10 (Family Information)

Section 1: Spouse/Registered Domestic Partner (Page 2)

• Was the deceased married or in a domestic partnership on the date of death?
  • Select Yes or No.
• If Yes, provide the spouse/partner’s:
  • Full name
  • Social Security number
  • Date of birth
  • Date of marriage/partnership
  • Email
  • Phone number
  • Address
• If No, provide details about prior marriages or partnerships:
  • Name of deceased spouse/partner
  • Date of death or date of divorce/termination

Section 2: Children (Pages 3-6)

• Did the deceased have children?
  • Select Yes or No.
• If Yes, for each child, provide:
  • Relationship type
  • Full name
  • Social Security number
  • Date of birth
  • Date of death (if applicable)
  • Email
  • Phone number
  • Address
  • Indicate if the child is disabled or was a stepchild under age 22 living with the deceased.
  • If the child is under 18 or disabled, provide the name and contact information of their custodian, guardian, or conservator.
• If there are more than 4 children, attach an additional sheet with their information.

Section 3: Estate/Trust Information (Page 7)

• Does the estate require probate?
  • Select Yes or No.
• Did the deceased leave a will?
  • Select Yes or No.
• Provide details about the executor/administrator of the estate:
  • Full name
  • Employer ID (if applicable)
  • Email
  • Phone number
  • Address
  • Name of Attorney Handling Probate (if applicable)
    • Email
    • Phone number
    • Address
• If there is a trust, provide details about the trustee:
  • Full name
  • Employer ID (if applicable)
  • Email
  • Phone number
  • Address

Section 4: Parents (Page 8)

• Were the deceased’s parents financially dependent on the deceased?
  • For each parent, select Yes or No.
• If Yes, provide for each parent:
  • Full name
  • Social Security number
  • Date of birth
  • Date of death (if applicable)
  • Email
  • Phone number
  • Address
• If both parents passed away after the deceased or you already provided information for a spouse/child(ren), skip Section 5.

Section 5: Siblings (Pages 9-10)

• Did the deceased have siblings?
  • Select Yes or No.
• If Yes, for each sibling, provide:
  • Full name
  • Social Security number
  • Date of birth
  • Date of death (if applicable)
  • Email
  • Phone number
  • Address
• If there are more than 4 siblings, attach an additional sheet with their information.

Step 4: Submit the Application

1. Review Your Answers: Carefully check each section to ensure all information is complete and accurate.
2. Attach copies of supporting documentation: Include copies of the death certificate, proof of relationship, and any other required documents.

3. Submit the completed form by mail or fax to:

   CalPERS Disability & Survivor Benefits Division
   P.O. Box 942715 
   Sacramento, CA 94229-2715
   Fax: (800) 959-6545

Need Help?

• Call 888 CalPERS (or 888-225-7377)  for assistance.
• Keep a copy of the completed application and all supporting documents for your records.