Std 243 Form PDF Details

The State of California acknowledges the importance of ensuring employees' financial allocations are appropriately managed even after their passing, which is meticulously facilitated through the STD. 243 form, implemented by the State Controller’s Office. This crucial document, updated in October 2019, empowers California state employees to specify one or more individuals, trusts, estates, or corporations to receive state warrants originally payable to them, effectively bypassing the probate process for these assets. It is designed with the flexibility to appoint a primary designee alongside contingent designees, ensuring there is a clear line of succession should the primary individual be unable to fulfill this role. Notably, this designation is exclusive to state warrants and does not extend to direct deposit payments nor does it encompass death benefits or employee retirement contribution refunds, which require separate documentation with the California Public Employees' Retirement System. The form mandates thorough completion and submission protocols, underscoring the necessity to accurately identify and maintain current information on the designees to ensure the intended transition of warrants. Additionally, it empowers employees to rescind or amend their designations as personal circumstances evolve, highlighting the form’s role in facilitating a thoughtful and structured approach to posthumous financial planning for state employees.

QuestionAnswer
Form NameStd 243 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namescalifornia state std 243 form, california designation persons, std designation form, california designation authorized form

Form Preview Example

STATE OF CALIFORNIA – STATE CONTROLLER’S OFFICE

DESIGNATION OF PERSON(S) AUTHORIZED TO RECEIVE WARRANTS (GC § 12479)

STD. 243 (Rev. 10/2019)

EMPLOYEE NAME (First, Middle, Last)

NAME OF EMPLOYING STATE AGENCY

AGENCY LOCATION (City)

Pursuant to Section 12479 of the Government Code, I hereby designate the following person(s), trust, estate, or corporation which, notwithstanding any other provision of the law, shall be entitled upon my death to receive all state warrants that would have been payable to me had I survived.

NOTE: Direct deposit payments are not subject to the provisions of this designation.

Important: This is NOT a designation for payment of death benefits or refund of employee retirement contributions. A form PERS-BSD-241, Beneficiary Designation, must be completed to file a designation with the California Public Employees' Retirement System for death benefits.

PRIMARY DESIGNEE (Must be 18 years of age or older)

PRIMARY DESIGNEE NAME (First, Middle, Last)

RELATIONSHIP TO EMPLOYEE

TELEPHONE NUMBER

 

 

 

 

ADDRESS

CITY AND STATE

 

ZIP CODE

 

 

 

 

CONTINGENT DESIGNEE(S) (Must be 18 years of age or older)

FIRST CONTINGENT DESIGNEE NAME (First, Middle, Last)

RELATIONSHIP TO EMPLOYEE

 

TELEPHONE NUMBER

 

 

 

 

 

ADDRESS

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

SECOND CONTINGENT DESIGNEE NAME (First, Middle, Last)

RELATIONSHIP TO EMPLOYEE

TELEPHONE NUMBER

 

 

 

 

 

ADDRESS

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

 

 

 

 

 

THIRD CONTINGENT DESIGNEE NAME (First, Middle, Last)

RELATIONSHIP TO EMPLOYEE

TELEPHONE NUMBER

 

 

 

 

 

ADDRESS

CITY AND STATE

 

ZIP CODE

 

 

 

 

 

I hereby revoke all designations that I have previously filed.

The primary designated person shall be the designated person that receives the warrants. If the primary designated person predeceases the employee, the next designated person who survives the employee will receive the warrant(s).

If the above-named designee does not file a written request with the personnel/payroll office of my employing state agency/campus for such warrants within sixty (60) days after the date of my death, this designation shall be and become null and void.

This designation will remain in full force and effect during my

 

 

 

 

employment with any California state agency/campus until revoked in

 

FOR AGENCY/CAMPUS USE ONLY

writing by me.

 

 

REVIEWED BY THE PERSONNEL/PAYROLL OFFICE AND FILED

 

 

 

 

 

 

 

 

EMPLOYEE HOME ADDRESS

 

 

SIGNATURE OF AUTHORIZED OFFICER

 

 

 

 

 

 

CITY, STATE, ZIP CODE

 

 

TYPED NAME

 

DATE

 

 

 

 

 

 

EMPLOYEE SIGNATURE (Please sign in ink)

DATE SIGNED

 

 

 

 

 

 

 

 

 

INSTRUCTIONS

1.Complete this form; print clearly in ink or type all information requested.

2.Show the full name of all designees; for example, “Mary Jane Smith”, not Mrs. John E. Smith.

3.Specify the relationship of each person designated, such as wife, husband, domestic partner, daughter, son, mother, father, parent, friend, etc.

4.Verify that the form is complete and correct. No erasures or corrections may be made in the name of the primary designee or contingent(s). If any error has been made, complete a new form.

5.Sign the form in ink and submit to your personnel/payroll office. A copy will be returned to you for your records.

6.You may change your designation at any time by filing a new form STD. 243 with your personnel/payroll office.

7.You may completely revoke a designation at any time by submit- ting either of the following with original signature: A new form STD. 243 indicating “NONE” for the primary designee name or a letter to your employer.

8.Inform your personnel/payroll office when a change occurs in your primary designee’s or contingent’s address.

9.You may wish to file a new designation upon any change in your marital or domestic partnership status.

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1. It's important to fill out the std 243 properly, thus be mindful while filling in the parts containing all of these blank fields:

designation persons authorized receive warrants completion process outlined (part 1)

2. Right after performing the previous part, head on to the next step and fill out the necessary details in these blanks - ADDRESS, CITY AND STATE, ZIP CODE, THIRD CONTINGENT DESIGNEE NAME, RELATIONSHIP TO EMPLOYEE, TELEPHONE NUMBER, ADDRESS, CITY AND STATE, ZIP CODE, I hereby revoke all designations, The primary designated person, If the abovenamed designee does, This designation will remain in, FOR AGENCYCAMPUS USE ONLY, and REVIEWED BY THE PERSONNELPAYROLL.

Part number 2 for submitting designation persons authorized receive warrants

Always be very attentive when filling in If the abovenamed designee does and I hereby revoke all designations, because this is the part where a lot of people make errors.

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