Search
Change of Address Form (RS5512)
To notify NYSLRS of a change in your address, NYSLRS members use form RS5512.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5512.pdfElection Form for Coverage Under Article 22 (Tier 5) in Accordance with Chapter 263 of the Laws of 2016 (RS5536)
To elect coverage under Article 22 (Tier 5), PFRS Tier 3 members use form RS5536.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5536.pdfFrequently Asked Questions – Understanding Your Responsibilities: Elected & Appointed Officials
… record of activities (ROA) before. Was I supposed to? When do I have to submit my ROA to the clerk of the governing board? What should I do if I take a two-week vacation during the … electoral fundraisers, but what about for other events like testimonial dinners or fundraising events for …
https://www.osc.ny.gov/retirement/members/ea-officials/frequently-asked-questionsRecord of Activities (ROA) – Reporting Elected and Appointed Officials
… January 1, 2016, are required to complete a three-month record of activities (ROA) within 150 days of the start of … out what to do and when to do it. Completing the Record of Activities If there are questions about completing … (for example, wedding ceremonies) When to Complete a New Record of Activities An ROA can be valid for up to eight …
https://www.osc.ny.gov/retirement/employers/reporting-ea-officials/record-activities-roaUpdate Your Contact Information
… have an email address on file, please provide it so we can contact you quickly with important information, such as a … after you retire, not a work address. Note: Updating your contact information with your employer or changing your … 1099-R Tax Forms . Use Retirement Online to Update Your Contact Information Retirement Online is the fast and …
https://www.osc.ny.gov/retirement/update-your-contact-informationState Agencies Bulletin No. 1995.3
… of a pilot program establishing a temporary overtime rate for employees in certain titles represented by PEF or … AFL-CIO (C82) allows DOH to establish a temporary overtime rate of 2.5 times the employee’s regular rate of pay for employees in certain titles. The new overtime …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/19953-pilot-program-establishing-temporary-overtime-rate-employees-certainState Agencies Bulletin No. 1989.3
… of a pilot program establishing a temporary overtime rate for employees in certain titles represented by PEF or … 82 (C82) allows OPWDD to establish a temporary overtime rate of 2.5 times the employee’s regular rate of pay for employees in certain titles. The new overtime …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/19893-pilot-program-establishing-temporary-overtime-rate-employees-certainState Agencies Bulletin No. 1995
… of a pilot program establishing a temporary overtime rate for employees in certain titles represented by PEF or … Janitor 003207 3016000 Launderer 003441 3302200 Lic Mstr Soc Wrkr 1 019228 8156100 Lic Mstr Soc Wrkr 2 018994 8156200 … above are included as salary for retirement purposes. Tax Information These earnings are taxable income, will be …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1995-pilot-program-establishing-temporary-overtime-rate-employees-certainState Agencies Bulletin No. 1995.2
… of a pilot program establishing a temporary overtime rate for employees in certain titles represented by PEF or … AFL-CIO (C82) allows DOH to establish a temporary overtime rate of 2.5 times the employee’s regular rate of pay for employees in certain titles. The new overtime …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/19952-pilot-program-establishing-temporary-overtime-rate-employees-certainState Agencies Bulletin No. 1989.2
… of a pilot program establishing a temporary overtime rate for employees in certain titles represented by PEF or … 82 (C82) allows OPWDD to establish a temporary overtime rate of 2.5 times the employee’s regular rate of pay for employees in certain titles. The new overtime …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/19892-pilot-program-establishing-temporary-overtime-rate-employees-certainState Agencies Bulletin No. 1995.1
… of a pilot program establishing a temporary overtime rate for employees in certain titles represented by PEF or … AFL-CIO (C82) allows DOH to establish a temporary overtime rate of 2.5 times the employee’s regular rate of pay for employees in certain titles. The new overtime …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/19951-pilot-program-establishing-temporary-overtime-rate-employees-certainState Agencies Bulletin No. 1989.1
… of a pilot program establishing a temporary overtime rate for employees in certain titles represented by PEF or … 82 (C82) allows OPWDD to establish a temporary overtime rate of 2.5 times the employee’s regular rate of pay for employees in certain titles. The new overtime …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/19891-pilot-program-establishing-temporary-overtime-rate-employees-certainState Agencies Bulletin No. 1989
… of a pilot program establishing a temporary overtime rate for employees in certain titles represented by PEF or … Housekeeper 003189 3004000 Janitor 003207 3016000 Lic Mstr Soc Wrkr 1 019228 8156100 Lic Mstr Soc Wrkr 2 018994 8156200 … above are included as salary for retirement purposes. Tax Information These earnings are taxable income, will be …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1989-pilot-program-establishing-temporary-overtime-rate-employees-certainMonthly Salary and Service Certification (RS5120)
To certify salary and service for a member’s previous employment, NYSLRS employers use form RS5120.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5120.pdfSection 21 (L) Election Form (RS5379)
For NYSLRS Tier 1 & 2 members (and Tier 3 & 5 PFRS members who are non-contributory) to request to make voluntary contributions to NYSLRS for an annuity.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5379.pdfPensioner's Designation of Beneficiaries (RS6439)
To designate a beneficiary for when a retiree has selected a pension payment option that allows for beneficiary changes beyond the date of retirement use form RS6439.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6439.pdfLoan Payment Change Form (RS5521)
To change the loan payment amount that is being deducted from your earnings by your employer, members use form RS5521.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5521.pdfElectronic Debit Authorization Form (RS5542)
For NYSLRS employers to have payments automatically debited from their account. With direct debit, funds are transferred electronically and securely using the automated clearing house (ACH) system.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5542.pdfApplication for Accidental Disability Retirement (RS6047)
To apply for an accidental disability retirement, PFRS members, ERS Tier 1 and 2 members and ERS members under Section 605-d and 607-e use form RS6047.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6047.pdfApplication for 605A Accidental Disability (RS6410)
For NYSLRS court officers and peace officers in the Unified Court System to apply for a 605A accidental disability retirement.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6410.pdf