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Notification of Death (RS6082)
To notify NYSLRS of a member’s death so that benefits can be paid, the member’s employer or survivors use form RS6082.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6082.pdfRequest for Estimate (RS6030)
To request an estimate of your pension benefit under each of the standard retirement options, NYSLRS members use form RS6030.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6030.pdfTiers 1 & 2 Loan Application (RS5025)
For NYSLRS Tiers 1 & 2 members to request a loan from NYSLRS.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5025.pdfTiers 3, 4, 5 & 6 Loan Application (RS5025-A)
For NYSLRS Tier 3, 4, 5 & 6 members (covered by Articles 14, 15 or 22) to request a loan from NYSLRS.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5025-a.pdfMonthly 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.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.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.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.pdfPreparing and Applying for Retirement
… Retirement is a big step, and we want to make sure you’re ready when the … NYSLRS; or Served in the U.S. Armed Forces and received an honorable discharge from active military duty. Or you may … upload documents while applying or after submitting your application. And if you need to update your application, you …
https://www.osc.ny.gov/retirement/members/preparing-and-applying-for-retirementApplication to Reinstate a Former Membership (RS5506)
To reinstate a former membership in a public retirement system in New York State, NYSLRS members use form RS5506.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5506.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.pdfApplication for 507-A Disability Retirement (RS6409)
For NYSLRS Tier 3, 5 and 6 correction officers and security hospital treatment assistants to apply for a 507-A disability retirement.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6409.pdfEmployees' Retirement System Membership Registration (RS5420)
For NYSLRS employers to enroll new Employees' Retirement System (ERS) members.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5420.pdfApplication for Ordinary Disability Retirement (RS6038)
For NYSLRS PFRS members and ERS Tier 1 and 2 members to apply for an ordinary disability retirement.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6038.pdfApplication for Transfer of Membership (RS5534)
To transfer your current Retirement System membership to another public retirement system in New York State use form RS5534.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5534.pdfAffidavit for Benefit Payment (1310.4) (RS4139)
To make a written statement for the purpose of receiving a deceased NYSLRS retiree’s death benefit when there is no executor, administrator of the deceased's estate, surviving spouse, minor child, or beneficiary use form RS4139.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs4139.pdfMember Salary & Service Detail Request (RS2413)
For NYSLRS employers to request salary and service details for members.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs2413.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.pdfState Agencies Bulletin No. 1602
… Units 02, 03, 04 and 47 Background Chapter 165 of the Laws of 2017 which implemented the 2016-2021 Agreement between the State of New York and the … Out R4C – Retro Over 40 Cash Out LCO Longevity adjustment OT CSEA LAO – Longevity Adjustment Overtime N/A N/A O4C Over …
https://www.osc.ny.gov/state-agencies/payroll-bulletins/state-agencies/1602-new-overtime-earnings-codes-overtime-eligible-employees-civil-service