New York City Employees' Retirement System Forms

This Form is used for requesting a change to a recent loan application for Tier 3, Tier 4, and Tier 6 Basic and Special Plan Members in New York City.

This form is used for applying for a loan against additional member contributions for Tier 1 and Tier 2 members in New York City.

This Form is used for members to apply for a refund of their accumulated salary deductions in New York City.

This document is used for creating a special durable power of attorney in New York City. It provides instructions on how to fill out and complete Form F204, ensuring that individuals understand the process of appointing an agent to handle specific legal matters on their behalf.

This form is used for reporting workers' compensation payments made in New York City. It is an affidavit that requires information about the payments made to an injured worker.

This form is used for retired members of NYCERS (New York City Employees' Retirement System) who want to transfer their membership to a different retirement plan tier, either Tier 1 or Tier 2 CPP or ISF.

This form is used for applying for a loan by Tier 3, Tier 4, and Tier 6 Basic and Special Plan Members in New York City.

This form is used for designating beneficiaries for Tier 3, 4, and 6 members in the New York City retirement system.

This form is used for designating primary and contingent beneficiaries for Tier 3, 4, and 6 members of the New York City retirement system.

This Form is used for reinstating membership or tier status in New York City.

This form is used for Tier 3, Tier 4, and Tier 6 basic and special plan members in New York City who want to apply for a change in their loan repayment schedule.

This form is used for applying to purchase credit for military service in New York City.

This form is used for transferring a member's accumulated salary deductions from one retirement system to another within New York State, specifically for New York City residents.

This form is used for making changes to federal tax withholding in New York City.

This Form is used for retirees who want to reenter city service and rejoin NYCERS in New York City.

This Form is used for notifying participation in World Trade Center rescue, recovery, or clean-up operations in New York City.

This form is used for employees in New York City who want to waive their right to a vested retirement benefit.