Auth Details

Nycers Form 380 gives authorization to the New York City Retirement Systems (NYCERS) to purchase bonds. The form is used to submit a request for bond purchase, and it must be signed by an authorized officer of the company. The document provides information about the company, including its financial statements and credit rating. It also includes a statement of intent from the company, which confirms that it is aware of the risks associated with purchasing bonds. Nycers Form 380 must be submitted at least five days before the purchase date.

In the listing, there's some information concerning the nycers form 380. It may be beneficial to find out its size, the typical time needed to fill out the form, the fields you will need to fill in, and so forth.

QuestionAnswer
Form NameNycers Form 380
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesNew_York, instuctions, Alessandro, Pensioner

Form Preview Example

NEW YORK CITY EMPLOYEES’ RETIREMENT SYSTEM

NYCERSBrooklyn, NY 11201-3724

Brooklyn, NY 11201-3724

Mail Only:

Customer Service Center:

335 Adams Street,

340 Jay Street,

Suite 2300

Mezzanine Level

 

Tel: (347) 643-3000

RETIREMENT AND BENEFITS

Executive Director: Diane D'Alessandro

Authorization forElectronic FundTransfer(EFT) of Monthly

RetirementAllowance

For Office Use Only

Clock-in-Date

CompletethisformifyouwishtohaveyourNYCERScheckautomaticallydepositedintoyourbank(checkingorsavings) account by Electronic Fund Transfer (EFT). Be sure to read the instructions on the back of this form before submitting it to NYCERS. Should you have any questions, please contact our Call Center at 347-643-3000.

Information to be completed by the depositor (pleaseprint)

 

 

 

 

 

 

 

 

 

 

Last 4 Digits of Social Security #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Member Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

or Pensioner Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Apt.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Home Phone Number (

 

 

 

 

 

 

)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

I wish to deposit my monthly retirement allowance in my

Checking

 

 

 

Savings account. I have read and underst-

and the conditions on page 2 of this form and hereby authorize NYCERS to send my monthly retirement allowance via EFT.

Signature of Member

 

Date

 

 

 

 

 

/

 

 

 

 

 

/

 

 

 

 

 

 

 

 

 

 

 

 

 

M M

 

 

D D

 

 

Y Y Y Y

Information to be completed by an officerof yourbank (pleaseprint).

Bank

BranchAddress

Zip

City State Code

Account Number

Transit Routing/ABA Number

Savings

Checking

(Checkone)

Phone Number (

 

 

 

 

 

 

Officer’s Name

Officer’s Signature

)

If payments are transferred in error by NYCERS, the bank will return such payments to NYCERS as authorized by the depositor. The bank also agrees to apply the same procedures described in 31 CFR 210 to such transfers, and agrees to reimburse NYCERS to the same extent as Federal agencies are reimbursed under 31 CFR 210.

In use beginning November 2008

Auth for EFT

Page 1

Form #380

Page 1 of 2

NYCERS

RETIREMENT AND BENEFITS

NEW YORK CITY EMPLOYEES’ RETIREMENT SYSTEM

Mail Only:

Customer Service Center:

335 Adams Street,

340 Jay Street,

Suite 2300

Mezzanine Level

Brooklyn, NY 11201-3724

Brooklyn, NY 11201-3724

Tel: (347) 643-3000

Executive Director: Diane D'Alessandro

Authorization forElectronic FundTransfer(EFT) of Monthly

RetirementAllowance

Filling out this form and submitting it to NYCERS authorizes:

1.The Office of the Comptroller of the City of NewYork, on behalf of the NewYork City Employees' Retirement System (NYCERS) to send my monthly retirement allowance via Electronic Fund Transfer (EFT) to the bank* designated on this form for deposit in my account.

2.My bank: (a) to receive my monthly retirement allowance via EFT for deposit in my accountAND

(b)todeductfrommydesignatedaccountordepositsinmynameatthisbankallamountstransferredinerrorbyNYCERS and to reimburse NYCERS to the extent of such deductions.

3.My heirs, my estate and designated beneficiaries of my monthly retirement allowance, respectively, to reimburse NYCERS for any amount deposited in error after my death, in event that my account is closed or contains an insufficient balance to reimburse NYCERS. (Deposits may be made only to an individual or joint account. Trust accounts are not acceptable)

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 theAutomated Clearing House (ask your bank manager about this).

IMPORTANTNOTICE

How EFTworks:

1.Your net retirement allowance is automatically credited directly to your bank account each month.

2.Your monthly net retirement allowance will appear on your bank statement.

3.Aquarterly 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.

Your monthly retirement allowance can be deposited in either your checking or savings account - NOT split between both. Deposits may be made to individual or joint accounts; trust accounts are not acceptable.

IfyouwishtotakeadvantageofEFT,followtheseinstuctions:

Make sure you complete the front page of this form, page 1. (Only the information to be completed by the depositor)

Attachoneofyourpreprintedpersonalchecks(namemustappearoncheck)orpreprintedsavingsdepositslipstothispage.If yourbanknolongerprovidespersonalchecksorpreprintedsavingsdepositslips,attachacopyofthetopportionofyour CheckingorSavingsAccountBankStatement.

If submitting a preprinted check or deposit slip write VOID (in large letters) across the face, as indicated in the sample below.

Do NOT sign the check that you are attaching to this page.

BANKINGINFORMATION

Bank Name

Account #

SavingsAccount

Bank Routing Code

CheckingAccount

Name ofYour Bank

Account Number

Bank Routing Code

Name ofYour Bank

Account Number

Bank Routing Code

In use beginning November 2008

Auth for EFT

Page 2

Form #380

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