To order a death certificate in person, please come to our office during normal business hours. Gather documents you need.You will need: A certified copy of the death certificate. This publication will answer many of your questions about the payment of benefits due to the death of a CalPERS retiree, survivor,. Please read entire document before completing form. Fill in all blanks below. Complete and sign the sworn statement in item 4 in front of the notary public. Request the notary acknowledge your signature in the sworn statement in item 4. During Active Membership Form (Form 104). In order to receive this allowance, members must fill out the Death.