Membership and Enrollment

Fax Enrollment

Membership and Enrollment

Using Retirement Online is the most efficient way to enroll members. However, we also provide a fax service. The service is available 24 hours a day, seven days a week.

  1. Have the employee complete a membership application for the appropriate system, either form RS5420 for the Employees’ Retirement System (ERS), or PF5022 for the New York State Police and Fire Retirement System (PFRS).

    Please ask your employee to complete the form in black ink, and make sure that the application is legible.

  2. Fax the completed application to 518-486-4382.

If faxed applications are received prior to 11:59 pm the day employees are physically working in paid status, they are guaranteed a date of membership for that day. The only exception is if the employee does not work the normal business hours of 9:00 am – 5:00 pm but does work the afternoon shift or the weekend shift. In that case, you are required to fax us the application on the very next business day after the employee worked.

Example: The employee worked on Monday, January 9, 2023, from 6:00 pm – 8:00 pm. The enrollment form must be faxed on Tuesday, January 10, 2023, stating this employee worked on Monday, January 9, 2023, from 6:00 pm – 8:00 pm, for the employee’s date of membership to be January 9, 2023.


Rev. 1/23