The New York City Employees' Retirement System (NYCERS) Form F131 is a crucial document for Tier 1 and Tier 2 members, facilitating the formal nomination of beneficiaries for specific death benefits in the unfortunate event of a member's demise while in active city service. This comprehensive form is designed to ensure that the death benefit, which could be a substantial sum reflecting a multiple of the member's annual salary, and the accumulated deductions benefit, which includes contributions plus any accrued interest, are distributed according to the member's wishes. Members have the flexibility to nominate individual persons, multiple beneficiaries, or even their Estate to receive one or both of these benefits. Importantly, the form caters to the need for detailed specification through sections that allow for the designation of both primary and contingent beneficiaries, ensuring clarity in the distribution of benefits. Additionally, members desiring to nominate more beneficiaries than the form accommodates can do so by utilizing a supplementary form. The F131 form requires careful completion and notarization before submission, underscoring the significance of the information provided and the necessity for it to reflect the member’s current intentions regarding the disposition of their benefits.
| Question | Answer |
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| Form Name | Nycers Form F131 |
| Form Length | 4 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min |
| Other names | YYYY, affix, SSN, NYCERS |
NYCERS USE ONLY |
F131 |
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*131*
Designation of Beneficiary
Tier 1 and 2 Members Only
This application is for Tier 1 or Tier 2 members who wish to nominate one (or more) beneficiaries to receive a death benefit payable upon the death of a member who dies while in active City service . This benefit is actually two distinct benefits which can be designated to one or more beneficiaries, or to an Estate. To nominate an Estate, in lieu of a specific person or persons, check the Estate box within the specific section (Section A or Section B, or both) but DO NOT complete the name, address, relationship or percentage portion of those sections. The Fact Sheet on Page 4 contains a brief overview of these benefits. For any additional questions, please contact our Call Center at
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Section A - Designation of Ordinary Death Benefit
Tell us who you want to receive your death benefit. You may nominate one or more Primary Beneficiaries, (or one optional Contingent Beneficiary, or your Estate. If you want to nominate more beneficiaries than this space allows, use
Form # 136 (Supplemental Form to Designate Beneficiaries). If you wish to nominate your Estate for this specific benefit,
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check the Estate box below and DO NOT complete the name, address, etc. portion of Section A.
Estate
I wish to nominate my Estate for this specific benefit. If you check this box DO NOT name anyone as Primary or Contingent.
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If this beneficiary is a minor, check here and complete the guardian information on Form 137
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Sign this form and have it notarized, Page 4
R07/26/11 |
Page 1 of 4 |
NYCERS USE ONLY |
F131 |
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Last 4 Digits of SSN |
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First Name |
M.I. Last Name |
Beneficiary |
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If this beneficiary is a minor, check here and complete the guardian information on Form 137
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Read this before you nominate a Contingent Beneficiary: A Contingent Beneficiary is only eligible if all of the Primary Beneficiaries are deceased at the time this benefit is payable. You do not have to nominate a Contingent Beneficiary, it is strictly optional. If you need additional space - use Form # 136 (Supplemental Form to Designate Beneficiaries).
First NameM.I. Last Name
OPTIONAL BeneficiaryContingent |
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If this beneficiary is a minor, check here and complete the guardian information on Form 137
Section B - Designation of Accumulated Deductions:
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Tell us who you want to receive your accumulated deductions benefit. You may nominate one or more Primary Beneficiaries, (or one optional Contingent Beneficiary), or your Estate. If you want to nominate more beneficiaries than this space allows, use Form # 136 (Supplemental Form to Designate Beneficiaries). If you wish to nominate your Estate for this specific benefit, check the Estate box below and DO NOT complete the name, address, etc. portion of Section B.
Estate
I wish to nominate my Estate for this specific benefit. If you check this box DO NOT name anyone as Primary or Contingent.
Sign this form and have it notarized, Page 4
R07/26/11 |
Page 2 of 4 |
NYCERS USE ONLY |
F131 |
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Member Number |
Last 4 Digits of SSN |
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First Name |
M.I. Last Name |
Beneficiary |
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Full Social Security Number |
Date of Birth |
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If this beneficiary is a minor, check here and complete the |
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guardian information on Form 137 |
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Beneficiary |
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Full Social Security Number |
Date of Birth |
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If this beneficiary is a minor, check here and complete the guardian information on Form 137
Relationship
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Zip Code |
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Read this before you nominate a Contingent Beneficiary: A Contingent Beneficiary is only eligible if all of the Primary Beneficiaries are deceased at the time this benefit is payable. You do not have to nominate a Contingent Beneficiary, it is strictly optional. If you need additional space - use Form # 136 (Supplemental Form to Designate Beneficiaries).
First Name |
M.I. Last Name |
OPTIONAL
Contingent Beneficiary
Full Social Security Number
Address
City
Date of Birth [MM/DD/YYYY] |
Relationship |
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Apt. Number
State |
Zip Code |
If this beneficiary is a minor, check here and complete the |
Percentage |
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guardian information on Form 137 |
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Please read the Fact Sheet on Page 4. You must also sign this form and have it notarized before filing it with NYCERS. Sign this form and have it notarized, Page 4
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R07/26/11 |
Page 3 of 4 |
NYCERS USE ONLY |
F131 |
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FACT SHEET
Can you explain the two benefits?
If you should die while in active City service, the person you nominate as your beneficiary is eligible to collect a death benefit (typically some multiple of your annual salary) and the refund of your accumulated deductions (contributions) plus
the interest they have accrued.
Can the same person receive both benefits?
You do not have to name the same person, but you can - the choice is yours. You can nominate one or more people (or your Estate) to receive the death benefit and the refund of the accumulated deductions. If you nominate more than one person each will be paid according to the percentages you indicate on this form (combined percentages must total 100%). If no percentages are indicated, the benefits will be shared equally.
What happens if I want to nominate more beneficiaries than this form has allotted me?
This forms allows for only two Primary and one Contingent beneficiaries for each benefit. If you want to nominate more than that you can file Form # 136 which is the Supplemental Form to Designate Beneficiaries.
What happens if I want to nominate my estate rather than a person?
All you have to do is check off the Estate box in the appropriate Section (A or B or both). For example, you could nominate your Estate for the death benefit (Section A) and a specific person for the refund of your accumulated deductions (Section B). However, if you select Estate for either or both benefits you must leave the name, address and relationship information blank in each section.
Do the people I have listed here act as my nomination for all benefits?
No. You are nominating people (or your Estate) only for this specific benefit. Should your death be the result of an
How do I change my beneficiary on file?
To change an existing beneficiary nomination you must file another Designation of Beneficiary form. It is important that you always have a current beneficiary on file. You can check the status of your beneficiary on file when you receive your Annual Disclosure Statement. All active members receive this statement in February/March every year.
What happens if my beneficiary information is out of date?
You must change it right away. NYCERS is required to make payments to the person we have listed on file as your designated beneficiary.
Signature of Member |
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This form must be acknowledged before a Notary Public or Commissioner of Deeds
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before me the above named, |
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me to be the individual described in and who executed the foregoing instrument, and he or she acknowledged to me that he or she executed the same, and that the statements contained therein are true.
Signature of Notary Public or Commissioner of Deeds
Official Title
Expiration Date of Commission
Sign this form and have it notarized, THIS PAGE
R07/26/11 |
Page 4 of 4 |