Pc Form 5209 PDF Details

It is important to understand PC Form 5209 if you are considering making an investment. PC Form 5209, also known as the Purchase Co-Investment Authorization in U.S. securities (PCA), helps to facilitate potential purchases of foreign investments by giving authorization for co-investments in sanctioned countries or organizations abroad and is required when a Canadian institution wishes to invest outwardly in American securities or any other regulated markets around the world. This form allows individuals and institutions access to certain overseas financial markets that might otherwise be inaccessible due to foreign exchange controls or other restrictions placed on international transactions. By understanding this process, investors can better manage their risk while having access to potentially profitable opportunities abroad. In this article, we will provide an overview of PC Form 5209 so readers have a better understanding of what it entails and how it can be used for successful i

Form NamePc Form 5209
Form Length2 pages
Fillable fields0
Avg. time to fill out30 sec
Other namesPERS, STRS, CalPERS, CalPES

Form Preview Example




I hereby resign from employment with the Los Angeles Unified School District, effective at the end of the work






























Employee No.:





































Security No.:






Date of Birth:





Home Telephone (




















Home Address:





















No. & Street









Zip Code













Name of









Job Title









Work Location







Reason for resigning:

I am retiring, effective






(If you plan to continue working as a retired substitute, please contact the Classified Employment Transaction Services Branch.)

If you are retiring, the effective date of your resignation should be the day before your retirement date. You may withdraw your resignation within 48 hours after it is submitted.

I have no other LAUSD employment

I am resigning to accept a certificated assignment with LAUSD

(Employees have only 60 days from date of hire to make a retirement system election. Please complete PC Form 100.)

Name of new work location:

I understand that if I am resigning during a disciplinary investigation or process, I will not be eligible for re-employment with LAUSD.

Employee Signature:












If you wish to receive accrued vacation benefits in a lump sum payment, please contact the timekeeper at your work location. If you are a member of the Public Employees’ Retirement System (PERS), please see the attached for additional information. If you are a member of the State Teacher’s Retirement System (STRS), please contact STRS directly at (800) 228-5453.

If you are a member of the Public Agency Retirement System (PARS), please contact PARS directly at (800) 660-8057.


Site Administrator’s Signature








Employee is to keep a copy. Please send the original to the Classified Employment Transaction Services Branch,



P.O. Box 513307, Los Angeles, CA 90051-1307 or via school mail to the Classified Employment Transaction



Services Branch, Beaudry Building, 12th Floor.



PC Form 5209 Classified Resignation Form, Revised 08/06


Employees who have at least five years of service credit under California Public Employees’ Retirement System (CALPERS) and who are 50 years of age or older are eligible to receive CALPERS retirement benefits. Employees who have at least five years of service credit under CALPERS and who terminate because of illness or disability may be eligible to receive a disability retirement allowance from CALPERS.

In order to retire, employees must complete this resignation form and a CALPERS application for retirement. Employees planning to retire are advised to call CALPERS at (800) 352-2238 approximately three months before the date of anticipated retirement to request a complete retirement packet. If you are interested in an estimate of your monthly retirement allowance, CALPERS can provide you with a request form. Once you have submitted the form to CALPERS, you should receive an estimate in six to eight weeks.

Your resignation date should be your last day of paid service. The effective date of your retirement should be the day following your resignation.

For information on medical insurance benefits after retirement, please contact the Los Angeles Unified School District Employee Benefits Administration at (213) 241-4262. If you receive a monthly retirement allowance, you may be eligible to have your hospital-medical, dental and vision care insurance paid by the Los Angeles Unified School District after retirement. You may be able to convert your District-paid life insurance to another program by contacting the ReliaStar Life Insurance Company at 1-800-955-7736.

If you would like information regarding Social Security benefits, please contact the Social Security Administration at 1-800-772-1213.


A permanent employee who resigns in good standing may request to be reinstated up to 39 months after the last day of paid service. Please remember that reinstatement is a privilege and is not guaranteed. (Personnel Commission Rule 771).

If you are currently on a promotional eligibility list and wish to determine whether it is possible to have your name transferred to an open list (a list including District as well as non-District candidates), please contact the Classified Employment Transaction Services Branch at (213) 241-3900.

You may be eligible to continue your health insurance benefits at your own expense under a federal continuance program known as COBRA. Please contact the Employee Benefits Administration at (213) 241-4262 for information.

PC Form 5209 Classified Resignation Form, Revised 08/06