Embarking on a transition between retirement systems within New York State embodies a significant step for city employees aiming to align their retirement benefits with their career movements. The NYCERS F321 form stands as a pivotal document in facilitating this process by enabling members of the New York City Employees' Retirement System (NYCERS) to transfer their accumulated salary deductions and any associated interest to a new retirement system within the state. Such an application not only signifies a member's intent to move their retirement funds but also involves a carefully structured agreement to release NYCERS from any liability following the transfer. This official procedure is capped by the member's cessation of service in one city position and the initiation of another, necessitating a detailed documentation of employment transitions, departmental affiliations, and respective service dates. Additionally, the form addresses specifics like member contributions, especially for Tier 2 and Tier 4 members affected by special programs under Chapter 96 of the laws of 1995, offering a path to reclaim deposited additional member contributions. A crucial aspect of completing this transfer procedure is the notarization of the form, a step that underscores its legal importance and the member's acknowledgment of the statements therein. This application process embodies a bridge between past and future service, ensuring that employees’ retirement contributions continue to reflect their career trajectory within New York State's public service sectors.
| Question | Answer |
|---|---|
| Form Name | Nycers Form F321 |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | nycers 331 form, nycrs form 321, nycers form 321, f321 nycer |
NYCERS USE ONLY |
F321 |
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*321*
Application for Transfer of Member’s Accumulated Salary
Deductions to Another Retirement System Within New York State
Member Number Last 4 Digits of SSN
I, the undersigned, do hereby make application to have the accumulated salary deductions, and accrued interest on the same, standing to my credit in the New York City Employees' Retirement System (NYCERS) transferred to my membership
in the
Retirement System.
In consideration of the transfer of such amount, and upon the transmittal of such funds to the retirement system to which I am transferring, I do hereby release and discharge from any and all liability the New York City Employees' Retirement System in connection therewith.
My City service in the position of
ceased on the |
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with the Department of
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with the Department of
.I have accepted a position as a(n)
on the
day of
I hereby authorize NYCERS to draw a check made payable to the retirement system of which I am now a member, to be credited to my account in that retirement system under Membership Number
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For Tier 2 and Tier 4 members who participated in a special program enacted by Chapter 96 of the laws of 1995 only.
If eligible, I hereby elect to receive a refund of my share of the ADDITIONAL MEMBER CONTRIBUTIONS required to have been contributed by me due to my participation in one of the programs enacted by Chapter 96 of the Laws of 1995 and which are now to my credit in NYCERS in my Retirement Reserve Fund account.
Signature of Member
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Sign this form and have it notarized, Page 2
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NYCERS USE ONLY |
F321 |
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Member Number |
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This form must be acknowledged before a Notary Public or Commissioner of Deeds
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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. |
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Sign this form and have it notarized, THIS PAGE
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Page 2 of 2 |