Oakland is experiencing a network outage that is affecting key services such as Oak311, permitting and business tax. Several non-emergency systems including phone lines within the City of Oakland are currently impacted or offline. Thank you for your patience while we work to restore services.
Benefit Forms
Documents
Oakland Firefighter Dental Enrollment Form
(PDF)
Dental enrollment form for Oakland sworn fire and fire trainees.
Beneficiary Designation Form - 457 Deferred Compensation Plan
(PDF)
Beneficiary Designation Form - CalPERS
(PDF)
Beneficiary Designation Form - Life Insurance (Hartford)
(PDF)
Beneficiary - Designation of Check
(PDF)
457 Deferred Compensation Contribution Change Form
(PDF)
457 Deferred Compensation Rollover Form
(PDF)
457 Deferred Compensation Enrollment Form
(PDF)
457 Deferred Compensation Age 50 Catch-Up Contribution Form
(PDF)
Deferred Compensation Age 50 Pre-Retirement Contribution Catch-up Form
457 Deferred Compensation Pre-Retirement Catch-Up Form
(PDF)
CalPERS Address Change Form
(PDF)
CalPERS Affidavit of Parent Child Relationship form
(PDF)
CalPERS Questionnaire & Medical Report For Disabled Dependent
(PDF)
CalPERS Authorization To Disclose Health Information
(PDF)
CalPERS Reciprocal Self-Certification Form
(PDF)
Commuter Benefits Program
(PDF)
Domestic Partner Imputed Income Declaration
(PDF)
2023 FSA Enrollment Form
(PDF)
Medical Waiver Premium Plan - Cash In Lieu
(PDF)
The Club at City Center Payroll Deduction Authorization Form
(PDF)
The Club at City Center Payroll Deduction Authorization Form.
Voluntary Life Insurance Enrollment Form
(PDF)
DE-4
(PDF)
W-4
(PDF)
Emergency Contact
(PDF)
SSA-1945
(PDF)
Predesignation of Personal Physician Form
(PDF)
Direct Deposit Form
(PDF)
Was this page helpful?
Report a problem with this page