CERBT-02 (Revised 8/2023) Page 1 of 1
State of California
California Public Employees’ Retirement System California Employers’ Retiree Benefit Trust (CERBT) 400 Q Street,
Sacramento, CA 95811
www.calpers.ca.gov
Delegation of Authority to Request Disbursements
California Employers’ Retiree Benefit Trust
(CERBT)
RESOLUTION
OF THE
(GOVERNING BODY)
OF THE
(NAME OF EMPLOYER)
The delegates to the incumbents
(GOVERNING BODY)
in the positions of and
(TITLE)
, and/or
(TITLE)
authority to request on behalf of the
(TITLE)
Employer disbursements from the Other Post Employment Prefunding Plan and to certify as to the purpose for which the disbursed funds will be used.
By
Title
Witness
Date