Qualified Survivors Forms
Find all Qualified Survivor forms here.
DOMESTIC PARTNERSHIPS
Declaration of Domestic Partnership
Notice of Termination of Domestic Partnership
STATUTORY POWER OF ATTORNEY
Statutory Power of Attorney Form
OPEN ENROLLMENT
LAFRA - Deduction Card
LAFRA - Kaiser Group Election Enrollment Form
LAFRA - Kaiser Senior Advantage Enrollment Form
LAPPL - Verification of Dependents
LAPPL - Delta Dental Enrollment Form
UFLAC - 2018 Special Retired Enrollment Form
LAFRA - Cancellation of Payroll Deduction Card
LAFRA - Kaiser Senior Advantage Information
GENERAL
Request Information to Purchase Survivor Benefits Form
Survivor Benefits Handbook
Direct Deposit Form
Income Tax Withholding Form
Change of Address Form
How to Access CPI Data
Surviving Domestic Partner Affidavit Declaration
Surviving Spouse Affidavit Declaration
Survivor Application
Survivor Information Sheet