2024 Nycers forms

www.nycers.org M - F, am to pm Forms, Brochures, Fact Sheets at NYCERS USE ONLY F521 R01/23 Page 2 of 4 Member Number Last 4 Digits of SSN If this beneficiary is under the age of 21, you have the option to name a guardian of the property of the minor by checking this box and completing Form #137.. Driftyjay

1. Enter your name in the search field below to see if you are listed as a beneficiary; or. 2. Enter the beneficiary’s name if you are the Legal Guardian or have Power of Attorney on their behalf; or. 3. Enter the words Estate Of in the last-name field to find a deceased member whose beneficiary is his/her estate.Customer Service Center Call Center Hours Monday-Friday, 8 am – 5 pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments.Jul 1, 2020 · You may drop off your notarized Loan Application Form #302 in person at NYCERS’ Walk-in Center at 340 Jay Street, Brooklyn, NY 11201. Repayment The current interest rate on a Tier 3, 4 and 6 loan is 6.2% – 6% basic interest rate plus 0.2% mandatory loan insurance premium. All loans except non-performing loans are fully insured 30 days 30-30 47th Avenue, 10th Fl Long Island City, NY 11101. Application for Transfer of Member’s Accumulated Salary Deductions to Another Retirement System Within New York State. Member Number Last 4 Digits of SSN. NOTE: If the address you provide on this form is different from your address in our system, the new address will become your official ...2019-2020: S8306, A10324. 2021-2022: S5767, A6697. 2023-S9274 (ACTIVE) - Summary. Extends the benefits of the variable supplements fund for transit police members of the …Dec 27, 2023 · This brochure describes the obligations and benefits of the Triborough Bridge and Tunnel Authority (TBTA) 20-Year/Age 50 Retirement Plan for Tier 6 members (6TB-20). This plan allows participants to retire with 20 years of Credited Service (all service) and at least age 50. The 6TB-20 plan is available ONLY to those employed in a TBTA Eligible ... Login / Register. Login / RegisterForm. Military service must have been satisfactorily completed and a discharge under honorable circumstances must have been granted. A DD214 form is the most common proof of satisfactory military service. Download PDF. Brochure 902. Eligibility, benefits and application process to purchase service credit for time spent on active duty in the U.S ... www.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at How to Join NYCERS Fact Sheet #754 How to Join NYCERS March 2021 NYCERS ˜˚˛˝˙ˆˇ˘ ˚˙˙ ˝ ˙ ˙ˆ˙˜ ˝ ˚ ˙ˆ Join NYCERS Online It’s easy to join NYCERS online using your smartphone, laptop or tablet. Simply follow the step-by-step instructions below: www.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at How to Join NYCERS Fact Sheet #754 How to Join NYCERS March 2021 NYCERS ˜˚˛˝˙ˆˇ˘ ˚˙˙ ˝ ˙ ˙ˆ˙˜ ˝ ˚ ˙ˆ Join NYCERS Online It’s easy to join NYCERS online using your smartphone, laptop or tablet. Simply follow the step-by-step instructions below: Designation of Beneficiary - Tier 3, Tier 4, and Tier 6 - New York City Employees' Retirement System. Designation of Beneficiary – Tier 3, Tier 4, and Tier 6. Form #133 is temporarily unavailable. Form. To make changes to your beneficiaries or their designated guardians, log in to your MyNYCERS account and look for “Manage Beneficiaries ...Dec 27, 2023 · Here are the questions most often asked by NYCERS members (and the answers!). Because laws are constantly changing and the variety of plans is vast, all answers should be read as introductory rather than definitive. For specific information about your NYCERS account, please contact NYCERS’ Call Center at (347) 643-3000 or visit NYCERS’ Walk ... Customer Service Center Call Center Hours Monday-Friday, 8am - 5pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free www.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at How to Join NYCERS Fact Sheet #754 How to Join NYCERS March 2021 NYCERS ˜˚˛˝˙ˆˇ˘ ˚˙˙ ˝ ˙ ˙ˆ˙˜ ˝ ˚ ˙ˆ Join NYCERS Online It’s easy to join NYCERS online using your smartphone, laptop or tablet. Simply follow the step-by-step instructions below: forms online and manage their NYCERS account. Registration instructions are provided on the website. For members who registered before April 2020, a one-time re-registration is required. Terry Members and retirees may chat online with Terry, NYCERS’ Digital Agent, via the MyNYCERS portal at www.nycers.org. Call CenterWTC Agency ReportForm #623. This form is to be completed by the agency whose employee (or former employee) has filed a Notice of Participation with NYCERS indicating that he/she participated in WTC Rescue, Recovery or Clean-Up Operations during certain qualifying periods between September 11, 2001 and September 12, 2002. Download PDF. Form.Adhere to our easy steps to have your Nycers Form 361 ready quickly: Pick the template from the catalogue. Enter all required information in the required fillable fields. The intuitive drag&drop graphical user interface makes it simple to add or move fields. Ensure everything is filled in appropriately, without any typos or absent blocks.Mail completed form to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 Address Apt. Number *290* F290 Change of Address Form Page 1 of 1 IN CARE OF (IF APPLICABLE) Previous Address: NYCERS USE ONLY First Name M.I. Last Name City State Zip Code Address Apt. Number City State Zip Code New Address: IN CARE OF …Application for Membership for NYCERS-Eligible Employees – Tier 3, Tier 4, and Tier 6 Form #103. Form August 29, 2016. ... Forms and Correspondence Mailing AddressAuthorization for Release of InformationForm #615. Authorization for Release of Information. Form. Use this form to authorize the New York City Employees’ Retirement System (NYCERS) to provide information and/or records to someone other than the NYCERS member, retiree or beneficiary. Download PDF.Learn how to sign up for MyNYCERS, your online portal to your NYCERS pension account. You can file forms and applications, view your pension information, and access other …You may drop off your notarized Loan Application Form #302 in person at NYCERS’ Walk-in Center at 340 Jay Street, Brooklyn, NY 11201. Repayment The current interest rate on a Tier 3, 4 and 6 loan is 6.2% – 6% basic interest rate plus 0.2% mandatory loan insurance premium. All loans except non-performing loans are fully insured 30 daysAn explanation of what documents NYCERS will accept from members, retirees, or beneficiaries as proof of their name (not proof of date of birth) or change of name. Download PDF; ... Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30-30 47th Avenue, 10th Floor Long Island City, NY 11101Commodity trading consists of physical trading in the wholesale markets and derivative trading in commodity exchanges. Physical trading can take the form of either spot trades or f...NYCERS WALK-IN and CALL CENTER Hours: Monday & Wednesday 8 am – 6 pm Tuesday & Thursday 8 am – 5 pm Friday 8 am – 3 pm 340 Jay Street, Brooklyn, NY ... your retirement application or Form #349 (Application to Change Federal Income Tax Withheld) to have taxes withheld on a different basis, or, that no taxes be withheld.Dec 27, 2023 · WTC Agency ReportForm #623. This form is to be completed by the agency whose employee (or former employee) has filed a Notice of Participation with NYCERS indicating that he/she participated in WTC Rescue, Recovery or Clean-Up Operations during certain qualifying periods between September 11, 2001 and September 12, 2002. Download PDF. Form. LAST UPDATE DECEMBER 2009. Processing Death Benefits #702 - Page 1. 340 Jay Street, Brooklyn, NY Mezzanine level (347) 643-3000 www.nycers.org 30-30 47th Avenue, 10th Floor Long Island City, NY 11101. Tax Forms Tax Waiver Letters of Administration (if applicable, issued by the Surrogate’s Court of the county in which the deceased pensioner ...The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Read more Contact link April 19, 2017must submit NYCERS Change of Repayment Form #309, available at www.nycers.org. Forms can also be requested by phone by calling NYCERS’ Call Center at (347) 643-3000. • Renegotiated Loan: When you are eligible for another loan, you may change your loan repayment schedule by borrowing additional amounts and changing the repayment …WTC Agency ReportForm #623. This form is to be completed by the agency whose employee (or former employee) has filed a Notice of Participation with NYCERS indicating that he/she participated in WTC Rescue, Recovery or Clean-Up Operations during certain qualifying periods between September 11, 2001 and September 12, 2002. Download PDF. Form.Building or breaking a new habit in 21 days is a myth. But recent research suggests that it can take about 59 to 70 days for someone to form a new habit. How long does it take to f...Application to Purchase Credit for Service Rendered Prior to Membership Date in NYCERS (Buyback)Form #241. Use this application to purchase (buyback) previous full-time or part-time public service rendered within New York State prior to your NYCERS membership. Note: Tier 1 members may only buy back public service …www .nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at Page 2 of 2 Member Number Last 4 Digits of SSN I am a Tier 6 member enrolled in the following retirement plan [check only one]: Basic 63/5 Plan Transit 25-Year/Age 55 Plan TBTA 20-Year/Age 50 Plan Dispatcher 25-Year PlanMail completed form to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 *355* F355 NYCERS USE ONLY First Name M.I. Last Name City State Zip Code Address Apt. Number Payroll Verification Affidavit Page 1 of 1 To help prevent fraud and ensure your identity is secured, we ask that you complete and return this form to the mailing address belowDec 27, 2023 · Form. For NYCERS members who wish to apply for reinstatement of a former membership with NYCERS or any other New York City or New York State public retirement system. If you are eligible, reinstatement could change your Tier and membership date, and may affect your contribution rate and retirement benefits. Download PDF. Brochure. This brochure describes the obligations and benefits of the Triborough Bridge and Tunnel Authority (TBTA) 20-Year/Age 50 Retirement Plan for Tier 6 members (6TB-20). This plan allows participants to retire with 20 years of Credited Service (all service) and at least age 50. The 6TB-20 plan is available ONLY to those employed in a TBTA Eligible ...You may instead opt to use services and/or access relevant forms at www.nycers.org, by contacting NYCERS at 347-643-3000, or by visiting NYCERS’ Customer Service Center at 340 Jay Street, Brooklyn, New York. For more information specific to each Online Service type, see the relevant Online Service in Section II. ...This form gives the designated beneficiary(ies) of a Tier 2 member who died during active service the opportunity to choose to receive the Ordinary Death Benefit under Section 448 of Retirement and Social Security Law as an annuity, rather than as a lump-sum payment.This form must be filed within 90 days after the date that NYCERS is …Form. NYCERS encourages all active, vested or retired members (retired after 9/11/01) who participated in WTC Rescue, Recovery or Clean-up Operations between September 11, 2001 and September 12, 2002 to file a Notice of Participation Form #622 before September 11, 2026. This form is not a disability application. It is simply a …Job compensation often includes more than just a salary; it is increasingly common for businesses to offer their employees stock options. If an employee decides to exercise his sto...Forms rocures Fact Seets at M C F 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 About This Form This form is for NYCERS Retirees and Beneficiaries who wish to change the amount of Federal income tax withheld from their monthly pension payments. NYCERS cannot counsel you on tax matters. If you need assistance in determining which taxDec 27, 2023 · Because laws are constantly changing and the variety of plans is vast, all answers should be read as introductory rather than definitive. For specific information about your NYCERS account, please contact NYCERS’ Call Center at (347) 643-3000 or visit NYCERS’ Walk-in Center at 340 Jay Street in downtown Brooklyn. Read more. Find the most common forms and fact sheets for NYCERS retirees, such as change of address, name change, tax withholding, and beneficiary designation. Download or submit online the forms you need for your pension verification, payment, or information request.NYCERS Members, Your Annual Disclosure Statement Is Ready! ... Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Read more; Contact link April 19, 2017. Clone of Email. Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30-30 …Please Submit your forms as follows: 1) Inquries and questions can be sent via email to the Plan. 2) Forms/documents can be sent via email to [email protected]. Please only include the last 4 digits of your Social Security number, along with your name and address on all forms. Forms can also be faxed to 844-299-2362.Commodity trading consists of physical trading in the wholesale markets and derivative trading in commodity exchanges. Physical trading can take the form of either spot trades or f...NYCERS Members, Your Annual Disclosure Statement Is Ready! ... Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30-30 47th Avenue, 10th Floor Long Island City, NY 11101 Read more; Contact link December 6, 2016. Main Office. Executive OfficesNYCERS Members, Your Annual Disclosure Statement Is Ready! ... Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30-30 47th Avenue, 10th Floor Long Island City, NY 11101 Read more; Contact link December 6, 2016. Main Office. Executive OfficesMail completed form to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 *238* F238 Page 1 of 1 NYCERS USE ONLY First Name M.I. Last Name City State Zip Code Address Apt. Number Signature of Member Date Request to Cancel Application For The Purchase of Pre-Member or Military Service Member Number Last 4 Digits of SSN Home Phone Number Work ...If this beneficiary is a minor, check here and complete the guardian information on Form #137. If Form #137 is not submitted, NYCERS will require letters of Guardianship for the Estate of a minor in order to pay a benefit to a minor. First Name M.I. Last Name Address Apt. Number Ten-Year Certain Primary Beneficiary City State Zip CodeDec 27, 2023 · The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Read more Contact link April 19, 2017 You can place funds in the care of a trustee by creating a legal trust. Some trusts are revocable, meaning that the trust grantor can change the terms of the trust at any time. If ...We walk you through when and how to use Form 944, how to fill it out, and when and how it should be submitted. Human Resources | How To Updated July 25, 2022 REVIEWED BY: Charlette...forms online and manage their NYCERS account. Registration instructions are provided on the website. For members who registered before April 2020, a one-time re-registration is required. Terry Members and retirees may chat online with Terry, NYCERS’ Digital Agent, via the MyNYCERS portal at www.nycers.org. Call CenterNYCERS Members, Your Annual Disclosure Statement Is Ready! Your 2023 Annual Disclosure Statement (ADS) is now available in your secure MyNYCERS account! ... Form #254. Form September 26, 2016. For Tier 3, Tier 4, Tier 6 and 22-Year Plan members who wish to vest their retirement benefit. Vesting refers to your right to receive plan …Customer Service Center Call Center Hours Monday-Friday, 8 am – 5 pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments.www.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at Mail Completed Forms to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 NYCERS USE ONLY F204 R /22 Page 2 of 8 Member Number Pension Number Last 4 SSN PRINCIPAL - Sign this form and have it notarized, Page 5Dec 27, 2023 · Customer Service Center Call Center Hours Monday-Friday, 8 am – 5 pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. R02/17. Mail completed form to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101. NYCERS USE ONLY Page 1 of 1. *233*. F233. NYCERS Member Number Last 4 Digits of SSN Employee ID Current Salary First Name M.I. Last Name Address Apt. Number Personnel/Benefits Representative Phone Number E-mail Address Signature of Personnel/Benefits ...NYCERS Members, Your Annual Disclosure Statement Is Ready! ... Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30-30 47th Avenue, 10th Floor Long Island City, NY 11101 Read more; Contact link December 6, 2016. Main Office. Executive OfficesWebform. Complete this form only if you are terminally or gravely ill and need to apply for a Disability benefit, or if you have already applied and need to notify NYCERS of the gravity of your illness. Contact Information. First Name *. Last Name *. Email *. Mobile Number *. Have you applied, or are you planning to apply for a Disability ... Mail completed form to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 I understand that by signing this form, I am confirming that the information on this form, to the best of my knowledge, is correct. NYCERS USE ONLY F181 Member Number Last 4 Digits of SSN Page 2 of 2 Sign this form and have it notarized, THIS PAGE The adjusted gross income value is one of the most important numbers for every tax filer who files Form 1040. But finding this value may require you to fill out other forms. For th...Form. Military service must have been satisfactorily completed and a discharge under honorable circumstances must have been granted. A DD214 form is the most common proof of satisfactory military service. Download PDF. Brochure 902. Eligibility, benefits and application process to purchase service credit for time spent on active duty …Building or breaking a new habit in 21 days is a myth. But recent research suggests that it can take about 59 to 70 days for someone to form a new habit. How long does it take to f...Please have your Member or Pension number ready when contacting NYCERS’ Call Center. Due to increased call volume, you may experience longer wait times, and voicemails may be returned after hours. (347) 643-3000 – Call Center ... Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30 …Here are the questions most often asked by NYCERS members (and the answers!). Because laws are constantly changing and the variety of plans is vast, all answers should be read as introductory rather than definitive. For specific information about your NYCERS account, please contact NYCERS’ Call Center at (347) 643-3000 or visit …Job compensation often includes more than just a salary; it is increasingly common for businesses to offer their employees stock options. If an employee decides to exercise his sto...NYCERS USE ONLY F137 > If you need assistance completing this form please contact NYCERS at 347-643-3000. > Complete the Designation of Guardian form in ink or type. Except for signature, please print all items. > At the top of the form, print your Membership #, last 4 digits of Social Security #, Date of Birth, name and complete address. Filling out this form and submitting it to NYCERS authorizes: 1. The Office of the Comptroller of the City of New York, on behalf of the New York City Employees' Retirement System (NYCERS) to send my monthly retirement allowance via Electronic Fund Transfer (EFT) to the bank* designated on this form for deposit in my account. 2. Transferred Contributor Affidavit – Board of Education (BERS) EmployeesForm #231. For NYCERS members who are eligible for membership in the Board of Education Retirement System and elect to remain a member of NYCERS as a Transferred Contributor. Download PDF. Form 232.Small business tax deadlines may not roll around until Feb. 1, 2021. But it’s never too soon to brush up on these 1099 tips. Tax deadlines may not roll around until Feb. 1, 2021. B...Certificate of Employment Under Section 212 of the Retirement and Social Security Law (RSSL)Form #353. File this form if you are a retiree who reenters public employment in the City or State of New York, and do not want to rejoin NYCERS. Pension payments will continue but your earnings may be limited.Dec 27, 2023 · Join NYCERS. Generally, NYCERS membership is open to all employees of the City of New York and Participating Employers except those who are eligible for membership in the Police or Fire Department pension fund, or the Teachers or Board of Education retirement system. Am I required to join NYCERS? Top 10 Reasons to Join NYCERS. Monday-Friday, 8am - 5pm. (347) 643-3000 Within NYC. (877) 669-2377 Toll-Free. (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday-Friday, 8am -5pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Forms and Correspondence Mailing Address.Article 14-B Disability Retirement Application. For county sheriffs, undersheriffs and certain deputy sheriffs whose employers elected coverage under Sections 555, 556, 557 or 558 of the Retirement & Social Security Law (RSSL). This is a two-page form and a HIPAA waiver. Please submit all three pages.this form is different from your address in our system, the new address will become your official address in our records. Should you have any questions, please contact our Call Center at 347-643-3000. I request that my name be changed on NYCERS' records from: First Name M.I. Last Name First Name M.I. Last Name To: First Name M.I. Last NameCustomer Service Center Call Center Hours Monday-Friday, 8am - 5pm (347) 643-3000 Within NYC (877) 669-2377 Toll-FreeThe Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Read more Contact link April 19, 2017

Mail completed form to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 I understand that by signing this form, I am confirming that the information on this form, to the best of my knowledge, is correct. NYCERS USE ONLY F181 Member Number Last 4 Digits of SSN Page 2 of 2 Sign this form and have it notarized, THIS PAGE . How many carbs are in bourbon whiskey

This form may be used in conjunction with any of NYCERS’ Designation of Beneficiary Forms (such as form 131,133,134) Member Information: I, the undersigned member of NYCERS, hereby designate First Name M.I. Last Name as Guardian, for the below named Minor, under the Uniform Transfer to Minor’s Act on the Designation ofView, download and print F501 - Designation Of Beneficiary(ies) Post-retirement Lump-sum Death Benefit pdf template or form online. 12 Nycers Forms And Templates are collected for any of your needs.www.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at Mail Completed Forms to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 NYCERS USE ONLY F204 R /22 Page 2 of 8 Member Number Pension Number Last 4 SSN PRINCIPAL - Sign this form and have it notarized, Page 5LAST UPDATE DECEMBER 2009. Processing Death Benefits #702 - Page 1. 340 Jay Street, Brooklyn, NY Mezzanine level (347) 643-3000 www.nycers.org 30-30 47th Avenue, 10th Floor Long Island City, NY 11101. Tax Forms Tax Waiver Letters of Administration (if applicable, issued by the Surrogate’s Court of the county in which the deceased pensioner ...Customer Service Center Call Center Hours Monday-Friday, 8 am – 5 pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments.Customer Service Center Call Center Hours Monday-Friday, 8am - 5pm (347) 643-3000 Within NYC (877) 669-2377 Toll-FreeWhat is a W2 form wage and tax statement? In this article, we'll walk through everything you need to know. Let's dive in! Are you an employee who is curious about what a W2 form Wa...NYCERS Members, Your Annual Disclosure Statement Is Ready! ... Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30-30 47th Avenue, 10th Floor Long Island City, NY 11101 Read more; Contact link December 6, 2016. Main Office. Executive OfficesDec 27, 2023 · Customer Service Center Call Center Hours Monday-Friday, 8 am – 5 pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Learn how to sign up for MyNYCERS, your online portal to your NYCERS pension account. You can file forms and applications, view your pension information, and access other … Complete this form in its entirety, sign it, and mail it to NYCERS, 30-30 47th Avenue, 10th Floor, Long Island City, NY 11101. If you wish to file this form in person, visit NYCERS’ Customer Service Center on the Mezzanine level of 340 Jay Street in downtown Brooklyn. Sign this form and have it notarized, THIS PAGE 30-30 47th Avenue, 10th Fl Long Island City, NY 11101. Member Number OR. Pension Number. Last 4 Digits of SSN. If the foregoing Primary beneficiary(ies) should predecease me, I hereby nominate the following as Contingent beneficiary(ies) for the above Post-Retirement Lump-Sum Death Benefit. First Name. M.I.Dec 27, 2023 · Customer Service Center Call Center Hours Monday-Friday, 8 am – 5 pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. If yes, you should file Form #622. How do I file a Notice of Participation (Form #622)? Download the Notice of Participation Form #622 at www.nycers.org. Complete the form and register for or log in to MyNYCERS at www.nycers.org to upload your form. You can also mail the completed form to 30-30 47th Avenue, 10th Floor, Long Island City, NY ….

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