Tier 4

Fact Sheet 716

The Road to Your NYCERS Retirement
Fact Sheet #716

Retiring from your City job is an important step and the beginning of an exciting time in your life! On a practical note, it’s a process that will take at least a few months to complete and can go more smoothly if you fully understand what to do and what to expect. Here at a glance are your 7 Stops on the Road to Retirement.

Form 290

Change of Address
Form #290

Submit this form if you wish to change the address that NYCERS has on file for you.

Members and pensioners with a MyNYCERS account and a registered PIN can change their address online instead of submitting this paper form.

Fact Sheet 725

Personal Service Income
Fact Sheet #725

Tier 3, Tier 4 and Tier 6 disability retirees are required each year to report any earnings from the public or private sector (Personal Service Income). This fact sheet provides answers to the most frequently asked questions regarding Personal Service Income.

Form 623

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.

Form 622

WTC Notice of Participation
Form #622

This Notice is for any active, vested or retired member (retired after 9/11/01) who participated in World Trade Center (WTC) Rescue, Recovery or Clean-up Operations between September 11, 2001 and September 12, 2002. This form must be filed with NYCERS no later than September 11, 2018.

Brochure 926

Retirement Options – Tier 4 and Tier 6 Basic and Special Plan
Brochure #926

This brochure describes the retirement options for Tier 4 and Tier 6 Basic and Special Plan members. By selecting an option, you accept a reduced lifetime retirement allowance in exchange for the payment of a benefit to your designated beneficiary upon your death. If you do not select an option, you will be awarded the Maximum Retirement Allowance. Be sure you understand each option before you submit your retirement forms.

Form 563

Retirement Option Election Form – Tier 4 and Tier 6 – Five-Year and Ten-Year Certain
Form #563

This Retirement Option Election Form allows you to elect an option that provides a continuing benefit to your designated beneficiary after your death. 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.

Form 562

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.

Form 543

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.

Brochure 908

Leaving City Service – Tiers 3, 4, 6 and 22-Year Plans
Brochure #908

Learn about the rights and options available to you after leaving City service. Many options are time-sensitive; we encourage you to read this brochure prior to leaving City service.

Attention Non-Members: You may want to join NYCERS before leaving City service. By becoming a NYCERS member, you preserve your right to membership in the current tier. This may be beneficial if you return to public service in New York City or New York State in the future.

Form 341

Waiver of Right to a Vested Retirement Benefit
Form #341

For members who have at least five but less than ten years of Credited Service and wish to terminate their membership by withdrawing their accumulated member contributions. Note: By filing this form and withdrawing your contributions, you will waive your right to a Vested Retirement Benefit. 

Form 190

Opt Out Election Form – Police Communications Titles – 25-Year Retirement Plan - Tier 4 and Tier 6
Form #190

For Tier 4 and Tier 6 members employed in Police Communications titles who wish to opt out of the 25-Year Retirement Plan for 911 Communications Operators. In order to opt out of the 25-Year Plan for Police Communications titles, you must meet all the requirements outlined in the form. Note that this opt-out election is IRREVOCABLE.

Form 177

Opt Out Election Form – Dispatcher Members – 25-Year Retirement Plan - Tier 4 and Tier 6
Form #177

For Tier 4 and Tier 6 Dispatcher Members who wish to opt out of the 25-Year Retirement Plan for Dispatcher Members. In order to opt out of this plan, you must meet all of the requirements outlined on the form, complete this form and return it to NYCERS within 180 days of becoming a Dispatcher Member. Note that this opt-out election is IRREVOCABLE. 

Brochure 941

911 Operators 25-Year Plan for Tier 4 Members
Brochure #941

The 911 Communications Operators/25 Year Plan is available ONLY to members employed by the New York City Police Department as police communications technicians, supervising police communications technicians, or principal police communications technicians. Collectively these titles define a Police Communications Member.

Brochure 937

Dispatcher 25-Year Retirement Plan for Tier 4 Members
Brochure #937

This brochure describes the obligations and benefits of the Dispatcher 25-Year Retirement Plan (DIS-25). This plan allows participants to retire with 25 years of Allowable Service regardless of age and is available only to Dispatcher Members. A Dispatcher Member is a NYCERS member employed by the City of New York in the titles of Fire Alarm Dispatcher, Supervising Fire Alarm Dispatcher Levels 1 and 2, Director of Dispatch Operations, and Deputy Director of Dispatch Operations.

Brochure 936

Emergency Medical Technician 25-Year Retirement Plan for Tier 4 Members
Brochure #936

This brochure describes the obligations and benefits of the Emergency Medical Technician 25-Year Plan (EMT-25 Plan). This plan allows participants to retire after rendering at least 25 years of Allowable Service, regardless of age. The EMT- 25 Plan is available ONLY to EMT Members. An EMT Member is a NYCERS member employed by the City of New York or the New York City Health and Hospitals Corporation in a title whose duties are those of an EMT, Advanced Emergency Medical Technician (AEMT), or a supervisor of those employees.

Form 189

25-Year Plan Election Form – (911) Police Communications Titles — Tiers 2 and 4
Form #189

For Tier 2 and Tier 4 members employed in Police Communications titles who wish to elect the 25-Year Retirement Plan for 911 Communications Operators.

Members in a Police Communications title are defined as: employed by the New York City Police Department as a Police Communications Technician, Supervising Police Communications Technician, or Principal Police Communications Technician.