Privacy Notice

This notice is provided pursuant to the Information Practices Act of 1977.

The California Department of Human Resources (CalHR) is requesting the information specified on this form pursuant to the Privacy Act of 1977.

The information collected will be used for state civil service employment as a retired annuitant and will be disclosed to other State Departments for business purposes only as required by law.

Individuals should not provide personal information that is not requested or required. The submission of all information requested is mandatory unless otherwise noted. If you fail to provide the information requested, CalHR or other Departments will not be able to contact you as necessary.

Department Privacy Policy

The information collected by CalHR is subject to the limitations in the Information Practices Act of 1977 and state policy. For more information on how we care for your personal information, please read our Privacy Policy.

Access to Your Information

The CalHR Privacy Officer is responsible for maintaining collected records. You have a right to access records containing your personal information we maintain. To request access, contact: