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Application 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.pdfApplication 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 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.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.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 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.pdfLife Changes: How Do I Prepare to Retire?
… of our lives in retirement, it’s important to consider how you can enjoy financial security in your retirement. By … your address, beneficiaries or other similar information. If you have questions about the salary and service … with the exception of our New York City location, you do not need an appointment to drop off forms, pick up …
https://www.osc.ny.gov/retirement/publications/life-changes-how-do-i-prepare-retireThe Survivor’s Benefit Program for New York State Management / Confidential Employees
… ensures that your survivors will receive a death benefit if you die before retiring. Your survivors may be eligible … your retirement system, up to $50,000, if that payment does not equal your annual salary. If you do not qualify for … revoked when a divorce, annulment or judicial separation becomes final, unless the terms of a Domestic Relations Order …
https://www.osc.ny.gov/retirement/publications/survivors-benefit-program-nys-management-confidential-employeesRetirement Option Election Form for Tier 3, 4, 5 and 6 Members for Designating Multiple Beneficiaries (RS6400)
To select a pension payment option when applying for retirement, Tier 3, 4, 5 and 6 members with multiple beneficiaries use form RS6400.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6400.pdfRetirement Option Election Form For Tier 3, 4, 5 and 6 Members (RS6399)
To select a pension payment option when applying for retirement, Tier 3, 4, 5 and 6 members with one beneficiary use form RS6399.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6399.pdfCertification for Determining Independent Contractor or Employee Status (RS2415)
To determine whether an individual they’ve reported is an employee or independent contractor, NYSLRS employers use form RS2415.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs2415.pdfDesignation of Beneficiary Trust With Contingent Beneficiaries (RS5127-T)
To change their beneficiary designations, with a trust as either primary or contingent beneficiary, NYSLRS members use form RS5127-T.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5127-t.pdfPreparing and Applying for Retirement
… Retirement is a big step, and we want to make sure you’re ready when the time comes. Below you’ll … for retirement, including topics to consider as you plan and actions to take. When you’re ready to apply for … guiding NYSLRS members through the retirement process and highlighting important topics and information to consider …
https://www.osc.ny.gov/retirement/members/preparing-and-applying-for-retirementApplication for Article 14B Disability Retirement (RS6408)
For NYSLRS county sheriffs, undersheriffs and certain deputy sheriffs whose employers elected coverage under Sections 555, 556, 557 and 558 of the Retirement &
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6408.pdfApplication for Article 14 Disability Retirement (RS6411)
For NYSLRS ERS Tier 3 members and PFRS Tier 3 members covered by Article 14 benefits to apply for an Article 14 disability retirement.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6411.pdfWithdrawal of Application for Service Retirement (RS6354)
For NYSLRS members to withdraw a service retirement application.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6354.pdfApplication for Article 15 Disability Retirement (RS6340)
For NYSLRS Tier 3, 4, 5 and 6 members to apply for Article 15 disability retirement.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs6340.pdfApplication for Internal Transfer of Membership (RS5535)
To transfer your NYSLRS membership between the Employees’ Retirement System (ERS) and Police and Fire Retirement System (PFRS), use form RS5535.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5535.pdfApplication for Refund of Excess Contributions (RS5195)
To apply for the refund of excess member contributions, NYSLRS Tier 1 & 2 members (and Tier 3 & 5 Police and Fire Retirement System members who are non-contributory), who voluntarily contribute, use form RS5195.
https://www.osc.ny.gov/files/retirement/forms/pdf/rs5195.pdf