Nycers Form F131 PDF Details

Filing taxes should be a quick and simple process, but often getting started is one of the biggest hurdles. If you’re an NYCer, there’s no need to worry because you can use form F131 to help you get your federal and state taxes done swiftly and easily. This blog post will answer all your questions about form F131, including how it works, what details are required on the form, how to complete it correctly, and more. Keep reading if you want answers that will make filing taxes a breeze in New York City!

QuestionAnswer
Form NameNycers Form F131
Form Length4 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min
Other namesYYYY, affix, SSN, NYCERS

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NYCERS USE ONLY

F131

 

*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 347-643-3000.

Member Number

Last 4 Digits of Social Security #

Date of Birth [MM/DD/YYYY]

 

 

 

 

/

 

/

 

 

 

 

 

 

 

 

 

 

First Name

 

M.I.

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Address

 

 

 

 

 

Apt. Number

 

 

 

 

 

 

 

 

 

City

 

 

 

 

State

 

Zip Code

 

 

 

 

 

 

 

 

 

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,

:

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.

First NameM.I. Last Name

Beneficiary

 

Full Social Security Number

Date of Birth

 

 

 

 

[MM/DD/YYYY]

 

 

 

 

 

/

/

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

Primary

 

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If this beneficiary is a minor, check here and complete the guardian information on Form 137

Relationship

Apt. Number

 

State

Zip Code

 

 

 

%

 

Percentage

 

 

 

 

 

 

 

 

 

Sign this form and have it notarized, Page 4

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NYCERS USE ONLY

F131

 

Member Number

Last 4 Digits of SSN

 

 

 

 

 

 

 

First Name

M.I. Last Name

Beneficiary

 

Full Social Security Number

Date of Birth

 

 

 

 

[MM/DD/YYYY]

 

 

 

 

 

/

/

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

Primary

 

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If this beneficiary is a minor, check here and complete the guardian information on Form 137

Relationship

Apt. Number

 

State

Zip Code

 

 

 

%

 

Percentage

 

 

 

 

 

 

 

 

 

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

 

Full Social Security Number

Date of Birth

 

 

 

 

[MM/DD/YYYY]

 

 

 

 

 

/

/

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

City

If this beneficiary is a minor, check here and complete the guardian information on Form 137

Section B - Designation of Accumulated Deductions:

Relationship

Apt. Number

 

State

Zip Code

 

 

 

%

 

Percentage

 

 

 

 

 

 

 

 

 

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

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Page 2 of 4

NYCERS USE ONLY

F131

 

Member Number

Last 4 Digits of SSN

 

 

First Name

M.I. Last Name

Beneficiary

 

Full Social Security Number

Date of Birth

 

 

 

 

 

[MM/DD/YYYY]

 

 

 

 

 

/

 

 

/

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

 

 

Primary

 

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If this beneficiary is a minor, check here and complete the

 

 

 

 

 

 

 

 

guardian information on Form 137

 

 

 

 

 

 

 

First Name

 

 

M.I.

 

Last Name

Relationship

Apt. Number

 

State

Zip Code

 

 

 

%

 

Percentage

 

 

 

 

 

 

 

 

 

Beneficiary

 

Full Social Security Number

Date of Birth

 

 

 

 

[MM/DD/YYYY]

 

 

 

 

 

/

/

 

 

 

Address

 

 

 

 

 

 

 

 

 

 

Primary

 

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

If this beneficiary is a minor, check here and complete the guardian information on Form 137

Relationship

Apt. Number

 

State

Zip Code

 

 

 

%

 

Percentage

 

 

 

 

 

 

 

 

 

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

/ /

Apt. Number

State

Zip Code

If this beneficiary is a minor, check here and complete the

Percentage

guardian information on Form 137

 

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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If you have an official seal, affix it

NYCERS USE ONLY

F131

 

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 on-the-job accident, an accidental death benefit is payable upon application in this priority*: spouse (who has not remarried), child under the age of 18, or a dependent parent. If no such beneficiary exists, the benefit is payable to the beneficiaries on this form. *One important distinction exists for members of the Uniformed Sanitation Force. Their accidental death benefit is payable to their spouse (for their entire lifetime) even if they have remarried.

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

Date

 

 

 

 

This form must be acknowledged before a Notary Public or Commissioner of Deeds

State of

 

County of

 

 

On this

 

day of

 

 

2 0

 

, personally appeared

before me the above named,

 

 

 

 

 

 

, to me known, and known to

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

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