Nycers Form F291 PDF Details

If you're a business owner in New York City, then you know how vital it is to keep your paperwork up to date and filed correctly. One of the most important documents that all NYCers should be aware of is Form F291, which is required by the Department of Finance in order to ensure businesses remain compliant with local laws. In this blog post, we'll provide an overview of what information needs to be completed on Form F291 as well as explain when and where it must be submitted. Keep reading if you need help with this essential document!

QuestionAnswer
Form NameNycers Form F291
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesnycers form f361, Expiration, Notary, applicable

Form Preview Example

If you have an official seal, affix it

NYCERS USE ONLY

F291

 

*291*

Name Change Affidavit

This application is for members who wish to change their name that NYCERS has on file. It is important to provide proof of name change, such as a court order, a copy of a marriage certificate or divorce papers, in order for your application to be processed. Should you have any questions regarding this application, please contact our Call Center at 347-643-3000.

Member Number

OR

Pension Number

 

Last 4 Digits of SSN

Daytime Phone

 

 

 

 

 

 

(

)

 

 

 

 

 

 

 

 

First Name

 

 

M.I.

Last Name

 

 

 

 

 

 

 

 

 

 

in Care of (if applicable)

 

 

 

 

 

Address

 

Apt. Number

 

 

 

 

 

 

City

State

 

Zip Code

 

 

 

 

 

 

To NYCERS

I, the undersigned, am employed in the Department of _________________________________ or retired from service on

[MM/DD/YYYY]

/ /

I request that my name be changed on NYCERS records from:

First Name

 

 

 

M.I.

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TO

 

 

 

 

 

 

 

 

 

 

 

 

First Name

 

 

 

M.I.

Last Name

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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

R06/30/11

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