Form 380 at a glance
What it is: NYCERS Form 380 is the Authorization for Electronic Fund Transfer (EFT) of Monthly Retirement Allowance.
Where and when to file: Mail completed form to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 It may take up to 45 days from receipt of this form for the account to be processed for EFT.
Notary: This form must be acknowledged before a Notary Public or Commissioner of Deeds.
Complete this form if you wish to have your NYCERS check automatically deposited into your bank (checking or savings) account by Electronic Fund Transfer (EFT).
What to bring and attach to Form 380
Provide the banking information and attach a preprinted personal check or deposit slip or a copy of your checking or savings account bank statement.
Attach a preprinted personal check (name must appear on check) or preprinted savings deposit slip.
If your bank no longer provides personal checks or preprinted savings deposit slips, attach a copy of the top portion of your Checking or Savings Account Bank Statement.
If submitting a preprinted check or deposit slip write VOID (in large letters) across the face, as indicated in the sample.
Do NOT sign the check that you are attaching.
Your name must appear on the preprinted check or bank document and it must match the name in NYCERS' records exactly in order for NYCERS to process this request.
A filled-in Form 380 example: a retiree sets up direct deposit
How to fill out Form 380, box by box
Member Number OR Pension Number, name and address
Enter your Member Number OR Pension Number, the Last 4 Digits of SSN and your Daytime Phone.
Enter your First Name, M.I. and Last Name.
Enter your Address, Apt. Number, City, State and Zip Code.
If the address you provide on this form is different from your address in the NYCERS system, the new address will become your official address in the NYCERS records.
Checking or Savings
Your monthly retirement allowance can be deposited in either your checking or savings account, NOT split between both.
Mark Checking or Savings.
Banking information
Please print the banking information: Bank Name and Phone Number.
Enter the Branch Address, City, State and Zip Code.
Enter the Account Number and the Bank Routing Number.
Signature of Member and Notary Public
Sign on the Signature of Member line and enter the Date.
This form must be acknowledged before a Notary Public or Commissioner of Deeds.
The Notary Public or Commissioner of Deeds fills in State of, County of and On this day of 2 0.
If the Notary Public or Commissioner of Deeds has an official seal, they affix it and add the Signature of Notary Public or Commissioner of Deeds, the Official Title and the Expiration Date of Commission.
More rules for Form 380
Your net retirement allowance is automatically credited to your bank account on the last day of each month providing it's a business day; if the last day is a weekend or holiday, the funds are deposited on the next business day.
Your monthly net retirement allowance will appear on your bank statement.
A quarterly statement, issued by the Office of the Comptroller, will be mailed to your home address. It will reflect details of your monthly retirement allowance, including deductions for union dues, health insurance and federal income tax withheld during the three-month period.
This EFT authorization will remain in effect until I have given written notice to NYCERS canceling the EFT.
The bank you name must be a member of the Automated Clearing House in order for your funds to be deposited electronically.
Common questions about Form 380
Where do I file it?
Mail completed form to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101
Where to get help with Form 380
Should you have any questions, please contact the NYCERS Call Center at 347-643-3000.
Sources
[1] Form 380 (R12/16), Authorization for Electronic Fund Transfer (EFT) of Monthly Retirement Allowance, NYCERS (the Official source link on this page).
