Are you a New Yorker who needs to file Form F321? If so, we’re here to help. Preparing and filing your Form F321 can be confusing and time-consuming, but our comprehensive guide will provide you with all the information you need to make sure that your form is filed correctly and on time. In this guide, we’ll explain what Form F321 is; how to determine if it applies in your situation; how to prepare and submit the form; and tips for ensuring everything goes smoothly with its processing. Read on to get started!
| 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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day of |
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with the Department of
, 20
.
, 20
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
.
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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In Care of (if applicable)
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Apt. Number |
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Home Phone Number
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Work Phone Number
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Sign this form and have it notarized, Page 2
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Page 1 of 2 |
NYCERS USE ONLY |
F321 |
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Member Number |
Last 4 Digits of SSN |
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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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, to me known, and known to |
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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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Expiration Date of Commission |
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Sign this form and have it notarized, THIS PAGE
R07/26/11 |
Page 2 of 2 |