Tier 4

By filing this form, you consent to report your annual income to NYCERS while a disability retiree.

This form is for applicants for disability retirement benefit who want to waive the process by which a member can contest the findings of NYCERS’ Medical Board denying their disability claim

This form must be completed by your employer.

This form must be filed along with your application for disability retirement benefit.

Information about loan eligibility, borrowing capacity, and filing and processing a loan application for members in Tier 3, Tier 4, and Tier 6 Basic and Special Plans.

For NYCERS members who are eligible for membership in the NYC Teachers Retirement System and elect to remain a member of NYCERS as a Transferred Contributor.

This fact sheet provides the Maximum Compensation Limit under IRC 401(a)(17) for 2022 and prior retirements, as applicable.

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.

If you receive your pension check in the mail, this fact sheet will explain the information that appears on the check. We encourage you to instead consider having your pension check directly deposited into the account of your choice through Electronic Fund Transfer (EFT).

This brochure describes the earnings limitations that service and disability retirees may be subject to if they decide to return to public service within New York City or New York State.

Use this affidavit to report Workers’ Compensation payments you have received, and/or are currently receiving.

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.

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.

Tax consequences and rollover options when receiving a lump-sum payment from NYCERS.

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.

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.

This form authorizes NYCERS to obtain medical information pertaining to those filing for disability.

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.

This Retirement Option Election Form allows you to elect either the Maximum Retirement Allowance or an option that provides a continuing benefit to your designated beneficiary after your death. By electing a retirement option, you will receive a reduced retirement benefit. 

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.

Complete this form to designate a Power of Attorney whose power will be limited to retirement benefit transactions involving NYCERS, and will not apply to any other matters.

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.

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. 

For Tier 3, Tier 4, Tier 6 and 22-Year Plan vested members who have reached retirement age and wish to receive payment of their Vested Retirement Benefit. 

For Tier 3, Tier 4, Tier 6 and 22-Year Plan members who wish to vest their retirement benefit. Vesting refers to your right to receive plan benefits even if you terminate employment before you are eligible for payment of a Service Retirement Benefit. 

The consequences of a Non-Performing Loan and an explanation of how you can avoid these consequences in the event you are no longer on City payroll.

ONLY for Tier 3, Tier 4 and Tier 6 Basic and Special Plan members who have submitted a Loan Application and the Voucher Date has not passed.

For employees of the School Construction Authority (SCA) who wish to purchase service for the time they were laid off for economic reasons on or after December 1, 2002 and prior to January 8, 2008.

For NYC Carpenters and Supervisory Carpenters who wish to purchase service for the time they were laid off for economic reasons on or after June 1, 1991 and returned to service prior to July 1, 1993.

This application is to be completed by the agency of the NYCERS Tier 1, Tier 2 or Tier 3 Corrections member who has applied to purchase previous child care leave.

In order to process a buy-back application, NYCERS must verify the salary and service history for the period of time the member wants to purchase. This form is to be completed by the agency the member worked for to provide verification of the member’s salary and service. It is not acceptable without the documentation listed on the form.

For members who are currently paying for pre-member and/or military service through payroll deductions and want an estimate of their lump-sum payoff balance.

For members who applied to purchase pre-member and/or military service and wish to cancel their application before payroll deductions begin.

This affidavit is for the spouse of a deceased NYCERS member who is receiving an accidental death benefit and is required to attest to his/her marital status each year.

Participants in the 57/5 Retirement Plan who have five or more years of Credited Service, at least two years of which are Membership Service, are eligible to receive a Service Retirement Benefit at age 57.

This brochure describes the obligations and benefits of the 911 Operators 25-Year Retirement Plan (PCT-25 Plan). The 911 Communications Operators / 25 Year Plan (PCT-25) 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.

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.

This brochure describes the benefits of the Sanitation 20-Year Retirement Plan (SA-20) which is available ONLY to employees in the uniformed-force of the NYC Department of Sanitation. 

This brochure describes the benefits of the Deputy Sheriff 25- Year Plan (DSH-25 Plan). The DSH-25 Plan is available ONLY to members employed by the City of New York as Deputy Sheriff level one, Deputy City Sheriff level two, Supervising Deputy Sheriff, or Administrative Sheriff.

This brochure outlines the benefits of the Transit 25- Year/Age 55 Retirement Plan (T25/55 Plan). The T25/55 Plan is available only to those employed in a Transit Operating Force (TOF) position.