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Forms

Forms below are interactive -- you may type information directly onto the form. Once completed, print out the form, sign form (if applicable), and return it to LACERS via mail, fax, or in person:

LACERS
202 W. First Street, Suite 500
Los Angeles, CA 90012-4401

Note: The following forms are in PDF format and are best viewed with Adobe Acrobat® 5.0 or later. Adobe Acrobat Reader can be downloaded for free by clicking on the icon below.

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Beneficiary Forms

Health Benefit Forms

For 2019 Open Enrollment Health Plan Enrollment Forms, click here


2018 (Non-Open Enrollment) Health Plan Forms*

Retirement Benefit Forms
Tax Forms

Others