Designation of Beneficiary – Tier 3, Tier 4, and Tier 6
Form #133


For Tier 3, Tier 4, and Tier 6 members who wish to nominate one or more beneficiaries to receive a death benefit payable upon the death of a member while in active City service.

Members with a registered MyNYCERS account can manage their beneficiaries online instead of submitting this paper application.

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