WTC Agency Report

Category: #623 | Disability Retirement | Application Form | Tier 1 | Tier 2 | Tier 3 | Tier 4 | Tier 6

Document Type: Application Form

Tier Number: Tier 1, Tier 2, Tier 3, Tier 4, Tier 6

File Number: 623

Form #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.

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