Deferred Compensation Forms - Treasurer-Tax Collector

457 Plan Forms

To start the online enrollment process for the Deferred Compensation Plan, please click here.

To start the online Payroll Modification process for the Deferred Compensation Plan, please click here.

To start the online Name/Address Change process for the Deferred Compensation Plan, please click here.

To start the online Beneficiary Designation (Change) process for the Deferred Compensation Plan, please click here.

New! To start the online Distribution Election process for the Deferred Compensation Plan, please click here.

DEFERRED COMPENSATION INFORMATION:
Phone: 1-855-WOW-457B (1-855-969-4572)
Fax: (510) 268-5377

To Print and Submit Forms:

Print, complete and sign. Return form to:
Treasurer's Office
1221 Oak Street, Oakland, CA 94612
-or- Interoffice mail: QIC 20114

You will receive an email receipt or a signed copy from the Treasurer's Office.

To view or print these files you need the free Adobe Acrobat Reader.

Enrollment Forms - Please call the Deferred Compensation forms line for Enrollment booklet at 510-272-5373 or tie-line 25373.
Change of Name or Address (PDF - 61kb) *
Beneficiary Designation (Change) (PDF - 78kb) *
Payroll Modification (PDF - 143kb) * Your request will be effective the following month after receipt.
Payout Instructions (PDF - 30kb) *
Payout Request (PDF - 120kb) * Distribution Election for Governmental 457 Plans
Payout Systematically (PDF - 124kb) *
Payout Direct Deposit (PDF - 22kb) *
Rollover of Qualified Plan to Prudential (PDF - 59kb) *
Emergency Withdrawal (PDF - 118kb) *

Where can I get more information?
For questions about filling out and submitting the Deferred Compensation forms, contact Darnell Williams in the Treasurer’s Office via phone at 510-272-6821 (x26821) or via email.

Call Prudential Telephone Exchange Line to modify investments: 1-800-333-3829 - or - you can access Prudential's web site: http://www.prudential.com/online/retirement (requires PIN).