Nycers are busy people, and filing the necessary documents to keep their finances in order is often a labor-intensive but essential task. One of those forms Nycers might be familiar with is F266—the form utilized by NYCERS (New York City Employees Retirement System) when terminating active or retired member service. It’s an important document for making sure your records are accurate so that you get just the benefits due to you upon retirement. In this blog post, we’ll cover what exactly Nycers need to know about filling out Form F266 correctly so they don’t miss out on any potential financial rewards down the road!
| Question | Answer |
|---|---|
| Form Name | Nycers Form F266 |
| Form Length | 4 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min |
| Other names | MTA, YYYY, 20-Year, NYCERS |
NYCERS USE ONLY |
F266 |
*266*
Application for Payment
Tier 3 and Tier 4 Vested Retirement Benefit
This application is for Tier 3 and Tier 4 vested members who wish to receive payment of their Vested Retirement Benefit. When you left City service you filled out a “notice of intention”, form #254, to vest your retirement benefit. It is important that you read the conditions below. Please be sure that you nominate a beneficiary or your estate to receive a death benefit payable should you die while in City service. You may only nominate one or the other. Should you have any questions regarding this application, please contact our Call Center at (347)
No advance (partial) pension payment will be sent to you until NYCERS has a copy of your birth certificate on file.
Member Number |
Last 4 Digits of SSN |
Home Phone Number |
( )
Work Phone Number
()
First Name |
M.I. |
Last Name |
|
|
|
|
|
|
|
|
|
Address |
|
|
|
Apt. Number |
|
|
|
|
|
|
|
City |
|
|
State |
|
Zip Code |
|
|
|
|
|
|
I am a Tier 3 member enrolled in the (Choose one):
Correction Officer/Captain
Correction Officer/Captain
Correction Force
I am a Tier 4 member enrolled in the (Choose one):
Basic 62/5 Tier 4 Plan
Age 57 and
Sanitation
Transit
MTA Bridges and Tunnels (formerly TBTA)
EMT
Special Officer
Deputy Sheriff
Automotive Service Workers
Police Communications Titles (911 Operators)
Sign this form and have it notarized, Page 4
R06/08/11 |
Page 1 of 4 |
NYCERS USE ONLY |
F266 |
Member Number |
Last 4 Digits of SSN |
|
|
Option Selection:
Once your eligibility is verified and this form is processed, you will receive a letter from NYCERS providing the full complement of retirement options available. In the interim, to afford you maximum protection from the date of your vested retirement until the date of your first full payment, you must select a temporary retirement option, as well as a beneficiary. Once vested, if you should die before selecting either of the options, or if you fail to name a beneficiary, NO DEATH BENEFIT WILL BE PAYABLE FROM
NYCERS.
The two temporary options are: The Ten Year Certain Option and the 100%
If you die within ten years from the date of your retirement, the reduced monthly retirement benefit will continue to be paid to your surviving primary beneficiary for the unexpired balance of the
100%
This option assures you and your designated beneficiary a reduced benefit for lifetime. Should you die, your designated beneficiary will receive the same lifetime benefit. Because this option guarantees two specific people an income for life, the life expectancies of the retiree as well as the beneficiary are taken into consideration. Therefore, once you designate a beneficiary and the option is in force, you cannot change your beneficiary designation, even if he/she precedes you in death. You may only nominate a primary beneficiary under this option.
Beneficiary Selection
This is split into two sections: Section A - Designation of Beneficiary and Section B - Nomination of Your Estate. It is important that you only fill out one section, for if you fill out both, your selection will be voided.
Section A - Designation of Beneficiary
A designated beneficiary is the person who is on file at NYCERS to receive a survivor benefit payable upon the death of a member. If you decide to nominate your estate rather than a person DO NOT FILL OUT THIS SECTION, see Section B.
The beneficiary whom I wish to nominate to receive my death benefit is:
Primary Beneficiary
First Name
Full Social Security Number
Address
City
M.I. Last Name
Date of Birth [MM/DD/YYYY] |
Relationship |
/ /
Apt. Number
State |
Zip Code |
If this beneficiary is a minor, check here and complete the guardian information on Form 137
Sign this form and have it notarized, Page 4
R06/08/11 |
Page 2 of 4 |
NYCERS USE ONLY |
F266 |
Member Number |
Last 4 Digits of SSN |
|
|
If I have chosen the Ten Year Certain and my designated primary beneficiary dies before the
Contingent Beneficiary
First Name
Full Social Security Number
Address
City
M.I. Last Name
Date of Birth [MM/DD/YYYY] |
Relationship |
/ /
Apt. Number
State |
Zip Code |
If this beneficiary is a minor, check here and complete the guardian information on Form 137
Stop
and
Read
Section B - Designation of Estate: Please initial the box below if you wish to nominate your estate. You may not fill in the above section if you fill out part B.
I am nominating my Estate as my beneficiary for my regular death benefit. I understand that in order for this selection to be valid I may not write in any other beneficiary’s name on this form, and I have, in fact, left all other designation of beneficiary sections on this form blank.
Should your death be the result of an
Federal Tax Withholding
Federal tax law provides that all payers are required to withhold Federal income tax on periodic payments (similar to wages), unless you elect to be excluded from such withholding. This election will remain in effect until revoked by you. If you do not complete this election, Federal income tax will be withheld at the rate of a married individual claiming three exemptions.
Please indicate your withholding selection by marking the appropriate choice below:
1.
Do not withhold Federal income tax from my pension. (Do not complete 2 or 3 if you select this option)
2. |
Withhold based on |
|
|
|
|
|
|
(Check one only) |
Single |
||
number of exemptions using the following status (You may also enter a dollar amount in choice 3):
Married |
|
Married, but withhold at higher "Single" rate |
3.
In addition to the amount withheld based on my exemptions and filing status in choice 2,
I would like to withhold $ |
|
Per Month (Must specify dollar amount only) |
|
|
|
Note: You cannot enter an amount here without entering a number of exemptions in choice 2 (even if that number is zero).
Sign this form and have it notarized, Page 4
R06/08/11 |
Page 3 of 4 |
NYCERS USE ONLY |
F266 |
Member Number |
Last 4 Digits of SSN |
|
|
I, the undersigned, hereby make application for payment of a Vested Retirement Benefit under the provisions of my retirement plan.
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. |
If you have an official seal, affix it |
|||||
Signature of Notary Public or |
|
|||||
|
||||||
Commissioner of Deeds |
|
|||||
|
|
|
|
|
|
|
Official Title |
|
|||||
|
|
|
|
|
||
Expiration Date of Commission |
|
|||||
|
|
|
|
|
|
|
Sign this form and have it notarized, THIS PAGE
R06/08/11 |
Page 4 of 4 |