CCOERA Forms

 

Misc Information & Forms

Account Management Options (Ways to manage accounts)
Investment Options (Current investment options)
Asset Allocation Worksheet (Use for allocation decisions)
Schwab PCRA Account (Self-Directed Brokerage Account)
457 Contribution Limits (Use to increase 457 savings)
W-4P Withholding Form (Use for eligible payment plans)

 

     

401(a) Plan Forms     Click Here

Form 1 - 401(a) Plan Enrollment Form (contact your employer)
Form 3 - 401(a) Beneficiary Designation (Multiple beneficiaries designations)
Form 4 - Incoming Transfer/Rollover to the CCOERA 401(a) Plan
Form 5 - 401(a) Info Change Request
Form 11 - 401(a) Distribution/Rollover Form*
Form 13 - 401(a) Alt Payee Dist. Form
Form 17 - 401(a) Auto Min Distribution
Form 19 - 401(a) Electronic Fund Transfers (ACH Credits)
Form 23 - 401(a) Death Benefit Claim Form
Form 27 - 401(a) Salary Deferral (Voluntary After-tax Contributions)
Form 29 - 401(a) Disability Certification

*Note: Participants may maintain their accounts with CCOERA (when they retire or leave
their current employer) without completing a 401(a) Distribution Form.

Jefferson County Forms

401(a) and 457 Loan Info & Application(s)
457 Contribution Changes (Jeffco Employees Only)

 
 

     

457 Plan Forms    Click Here

Form 1 - 457 Plan Enrollment Form
Form 3 - 457 Beneficiary Designation (Multiple beneficiaries designations)
Form 4 - Incoming Transfer/Rollover to the CCOERA 457 Plan
Form 5 - 457 Info Change Request
Form 11 - 457 Distribution/Rollover Form*
Form 13 - 457 Alt Payee Dist. Request
Form 17 - 457 Auto Min Distribution
Form 19 - 457 Electronic Fund Transfers (ACH Credits)
Form 23 - 457 Death Benefit Claim Form
Form 27 - 457 Salary Deferral (Deferred Compensation Agreement)
Form 29 - 457 Disability Certification
Form 30 - 457 Catch-up Application

*Note: Participants may maintain their accounts with CCOERA (when they retire or leave
their current employer) without completing a 457 Distribution form.