Authorization for Release of Information

Form #615
This form authorizes the New York City Employees’ Retirement System (NYCERS) to provide information and/or records to someone other than the NYCERS member, retiree, or beneficiary.
The authorized representative you specify on Form #615 (e.g., a lawyer, medical professional, family, friend, etc.) may only obtain information about your NYCERS account; however, they cannot make changes to your account or initiate transactions on your behalf, as this type of authorization would require a Power of Attorney. You may withdraw your authorization for the release of information anytime by providing NYCERS with a written, notarized letter revoking your representative’s authorization for information.