Tier 2
Election by a Retiree Reentering City Service to Rejoin NYCERS
Form #352
This form is for retirees who are reentering City service and want to rejoin NYCERS. You will not be held to Earning Limitations set by §212 of the RSSL, but your current pension payments will be stopped.
Safeguards Information Affidavit
Form #350
This form is to be completed annually by all Tier 1 and Tier 2 Disability Retirees to verify your eligibility for continued disability benefits.
Birth Evidence Affidavit
Form #205
Submit this affidavit if you are unable to produce a birth certificate or any of the birthdate evidence documents accepted by NYCERS but can submit three alternative birth records. For a list of acceptable birthdate evidence, see NYCERS’ Birthdate Evidence Alternatives Fact Sheet #709.
Birthdate Evidence Alternatives
Fact Sheet #709
A list of alternative documentation that NYCERS will accept as evidence of birthdate if you cannot provide a legible, English-language birth certificate. Depending on the document(s) you provide, you may also be required to submit NYCERS’ Birth Evidence Affidavit #205.
Special Tax Notice Regarding Plan Payments
Fact Sheet #717
Tax consequences and rollover options when receiving a lump-sum payment from NYCERS.
Proof of Identity
Fact Sheet #711
An 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.
WTC Agency Report
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.
WTC Notice of Participation
Form #622
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.
Withdrawal of Disability Retirement Application
Form #619
If you previously filed for Disability Retirement and you now wish to withdraw that application, please complete this form in its entirety and return it to NYCERS.
Questionnaire – Applicants for Disability Retirement
Form #609
This application is to accompany your application for Disability Retirement.
General Authorization for Medical Information
Form #608
This form authorizes NYCERS to obtain medical information pertaining to those filing for disability.
Retirement Options – Tier 2
Brochure #924
This brochure describes the retirement options for Tier 2 members (members who joined NYCERS after June 30, 1973 but prior to July 27, 1976 and Investigators employed in District Attorney offices who joined NYCERS between July 1, 1973 and March 31, 2012.)
Temporary Retirement Option Election Form – Tier 2, 3, 4 and 6
Form #562
This form is for members in Tier 2, 3, 4 and 6 who have filed an application for Service or Disability Retirement or Payment of a Vested Retirement Benefit, or whose agency has filed a Disability Retirement Application on their behalf. This form allows you to elect one of two temporary options before you elect a permanent option and thereby make a final decision regarding the way in which your retirement benefit will be paid. NYCERS recommends that you choose a temporary option as soon as possible.
Selection by Beneficiary(ies) of a Tier 2 Member to Annuitize the Ordinary Death Benefit
Form #560
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 notified of the member’s death.
Retirement Option Election Form – Tier 2 – Option 4
Form #559
This Retirement Option Election Form is for Tier 2 members who wish to provide continuing income to their designated beneficiary upon their death. Option 4 provides for a reduced lifetime monthly retirement allowance. Upon your death, a percentage of the reduced monthly allowance or a specific dollar amount will continue to be paid to your designated beneficiary.
Retirement Option Election Form – Tier 2 – Option 4-4
Form #558
This application is for Tier 2 members who wish to provide continuing income to their designated beneficiary upon their death. Option 4-4 provides for a reduced lifetime monthly retirement allowance. Upon your death, a percentage of the reduced monthly allowance or a specific dollar amount will continue to be paid to your designated beneficiary. If the designated beneficiary predeceases you, your retirement allowance automatically reverts to the Maximum Retirement Allowance.
Retirement Option Election Form – Tier 2, Tier 3, and 22-Year Plan – Five-Year and Ten-Year Certain
Form #554
This Retirement Option Election Form allows you to elect the Five-Year Certain or Ten-Year Certain Option. By electing this option, you will receive a reduced retirement benefit. If you die within five (or ten) years from the date of retirement, the reduced monthly benefit will continue to be paid to the designated primary beneficiary for the unexpired balance of the five- (or ten-) year period.
Retirement Option Election Form – Tier 2 – Option 4 (Lump Sum)
Form #553
This Retirement Option Election Form is for Tier 2 members who wish to provide a lump-sum income to their designated beneficiary(ies) upon their death. By electing a retirement option, you will receive a reduced lifetime retirement allowance.
Request to Change or Correct Retirement Date
Form #543
If you previously filed a Service Retirement Application with NYCERS, you may change your retirement date by filing this form with NYCERS up to the day before your effective retirement date. If your request is received on or after your retirement date, it is denied.
Note: You cannot change your retirement date if you are already receiving your pension from NYCERS.
Withdrawal of Service Retirement Application
Form #542
You may withdraw your Service Retirement Application by filing this form with NYCERS up to the day before your effective date of retirement. If your request is received on or after your retirement date, it is denied.