Re19 Form – Fill Out and Use This PDF

TIER IV SERVICE RETIREMENT APPLICATION

INSTRUCTIONS

PLEASE READ CAREFULLY

Filing Information

฀ •฀฀฀As฀a฀Tier฀IV฀member฀of฀TRS,฀you฀may฀apply฀for฀service฀retirement฀under฀the฀Qualiied฀Pension฀Plan฀(QPP)฀by฀iling฀a฀ “Tier฀lV฀Service฀Retirement฀Application”฀(code฀RE19).฀TRS฀must฀receive฀your฀retirement฀application฀at฀least฀one฀day,฀ but฀no฀more฀than฀90฀days,฀before฀your฀effective฀retirement฀date.

฀ •฀฀฀Tier฀IV฀members฀may฀only฀elect฀a฀Tier฀IV฀retirement฀beneit.฀If฀you฀are฀a฀Tier฀III฀member,฀you฀may฀elect฀to฀receive฀ either฀Tier฀III฀or฀Tier฀IV฀beneits฀when฀you฀ile฀your฀retirement฀application;฀however,฀you฀may฀not฀combine฀the฀ provisions฀of฀the฀two฀plans.฀Once฀you฀elect฀to฀receive฀a฀beneit฀under฀Tier฀III฀or฀Tier฀IV,฀your฀election฀is฀irrevocable฀ as฀of฀your฀effective฀retirement฀date.

฀ •฀฀฀When฀you฀ile฀this฀application,฀you฀must฀attach฀proof฀of฀your฀date฀of฀birth฀and,฀in฀some฀cases,฀your฀beneiciaries’฀dates฀ of฀birth.฀The฀following฀items฀are฀considered฀acceptable฀proof฀of฀date฀of฀birth,฀and฀only฀one฀of฀the฀following฀is฀required:฀ birth฀certiicate;฀passport;฀or฀naturalization฀document.฀If฀none฀of฀these฀items฀is฀available,฀then฀two฀of฀the฀following฀are฀ required:฀certiicate฀of฀military฀record;฀baptismal฀certiicate;฀life฀insurance฀policy;฀government-issued฀identiication;฀or฀ driver’s฀license.฀(Photocopies฀are฀acceptable฀for฀all฀documents.)฀We฀suggest฀that฀you฀bring฀all฀materials฀in฀person฀to฀ TRS’฀Member฀Services฀Center฀at฀55฀Water฀Street฀in฀lower฀Manhattan.฀Please฀retain฀a฀photocopy฀of฀your฀application฀ and฀all฀forms฀iled฀for฀your฀records.

Retirement Payments

฀ •฀฀฀Generally,฀TRS฀is฀able฀to฀process฀a฀retirement฀beneit฀within฀three฀to฀ive฀months฀of฀your฀effective฀retirement฀date.฀ TRS฀issues฀advance฀payments฀approximately฀one฀to฀two฀months฀after฀your฀effective฀retirement฀date฀to฀provide฀ you฀with฀retirement฀income฀as฀soon฀as฀possible.฀You฀will฀continue฀to฀receive฀an฀advance฀payment฀every฀month฀ until฀your฀regular฀retirement฀allowance฀is฀processed฀and฀initiated฀on฀payroll.฀For฀more฀information,฀please฀see฀the฀ Advance Payments฀brochure.

Change of Information or Cancellation

฀ •฀฀฀You฀may฀change฀any฀information฀on฀your฀application฀after฀you฀have฀submitted฀it;฀TRS฀must฀receive฀your฀changes฀ no฀later฀than฀one฀day฀before฀your฀effective฀retirement฀date.฀However,฀you฀may฀change฀your฀payment฀option฀election฀ up฀to฀30฀days฀after฀your฀effective฀retirement฀date.฀To฀make฀changes฀to฀your฀application,฀you฀may฀visit฀TRS’฀Walk-In฀ Center฀and฀review฀your฀changes฀with฀a฀Member฀Services฀Representative.฀If฀you฀cannot฀visit฀the฀Walk-In฀Center,฀but฀ wish฀to฀make฀changes฀to฀your฀application,฀then฀you฀must฀cancel฀your฀“Tier฀lV฀Service฀Retirement฀Application”฀and฀ submit฀a฀new฀one.

฀ •฀฀฀You฀may฀cancel฀your฀application฀by฀submitting฀a฀“Request฀for฀Withdrawal฀of฀Form/Application/Online฀Filing”฀ (code฀MI5).฀TRS must receive this form at least one day before your effective retirement date, regardless of the date on which you mailed the form or the postmark date on the envelope.฀You฀may฀NOT฀cancel฀your฀ Service฀Retirement฀Application฀on฀or฀after฀your฀effective฀retirement฀date.

For฀your฀convenience,฀TRS฀forms฀and฀publications฀are฀available฀on฀our฀website.฀If฀you฀require฀additional฀assistance,฀we฀ encourage฀you฀to฀contact฀our฀Member฀Services฀Center฀at฀1฀(888)฀8-NYC-TRS.

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HOW TO COMPLETE THE TIER lV SERVICE RETIREMENT APPLICATION

In Part A: PERSONAL INFORMATION

All฀information฀must฀be฀provided.

In Part B: ADDITIONAL MEMBERSHIP INFORMATION

Use฀this฀section฀to฀indicate฀any฀additional฀membership฀information฀(e.g.,฀Multiple฀Employment฀Membership฀or฀Chapter฀683฀ Earnings).฀Multiple฀Employment฀Membership฀status฀is฀assigned฀to฀members฀of฀TRS฀who฀render฀employment฀in฀both฀primary฀ and฀secondary฀TRS-eligible฀positions฀during฀any฀school฀year.฀For฀more฀information,฀please฀see฀the฀Multiple Employment Membership Status฀brochure.

Chapter฀683฀earnings฀apply฀if฀you฀were฀employed฀in฀a฀Special฀Education฀Program,฀in฀accordance฀with฀Chapter฀683฀of฀the฀ Retirement฀and฀Social฀Security฀Law฀(RSSL).฀Please฀note฀that฀conirmation฀of฀your฀Chapter฀683฀earnings฀during฀the฀summer฀ preceding฀your฀retirement฀may฀not฀be฀available฀at฀the฀time฀of฀retirement.฀TRS฀will฀calculate฀your฀retirement฀allowance฀to฀include฀ these฀earnings฀when฀conirmation฀of฀your฀Chapter฀683฀earnings฀becomes฀available.

In Part C: TDA ELECTION

If฀you฀are฀a฀participant฀in฀TRS’฀Tax-Deferred฀Annuity฀(TDA)฀Program,฀you฀must฀make฀a฀decision฀at฀this฀time฀regarding฀the฀distribution฀of฀ your฀TDA฀funds.฀As฀indicated฀below,฀you฀must฀ile฀the฀appropriate฀form(s),฀based฀on฀your฀election,฀in฀conjunction฀with฀iling฀for฀retirement.

ACTION	FORM TO FILE
Receive your TDA funds as an annuity separate	“TDA Annuitization Election Form” (code TD6)
from your QPP retirement allowance.
Withdraw all of your TDA funds.	“TDA Withdrawal Application” (code TD32)
Defer distribution of your TDA funds to a later	“TDA Deferral Status Election Form
date and leave them invested with TRS.	(For Retiring Members)” (code TD30)

For฀more฀information,฀please฀see฀the฀TDA Options at Retirement฀brochure.

In Part D: RETIREMENT ELECTION

You฀must฀provide฀your฀desired฀retirement฀date.฀Your฀retirement฀date฀must฀be฀at฀least฀one฀day฀later฀than฀the฀date฀that฀TRS฀receives฀ this฀application,฀and฀it฀cannot฀be฀earlier฀than฀your฀55th฀birthday.฀In฀addition,฀you฀must฀indicate฀whether฀you฀believe฀you฀are฀eligible฀to฀ receive฀an฀unreduced฀retirement฀allowance฀(full฀beneits)฀or฀a฀reduced฀retirement฀allowance.

In฀general,฀you฀would฀be฀eligible฀to฀receive฀unreduced฀retirement฀allowance฀payments฀(full฀beneits)฀if฀one฀of฀the฀following฀statements฀ applies฀to฀you:

•฀฀You฀are฀at฀least฀age฀62฀as฀of฀your฀retirement฀date฀and฀you฀are฀vested;฀or

•฀฀You฀are฀at฀least฀age฀55฀as฀of฀your฀retirement฀date฀and฀have฀attained฀at฀least฀30฀years฀of฀Total฀Service฀Credit;฀or

•฀฀฀You฀are฀covered฀by฀the฀“55/25”฀provisions฀of฀the฀Age฀55฀Retirement฀Program,฀are฀at฀least฀age฀55฀as฀of฀your฀retirement฀date,฀ and฀have฀attained฀at฀least฀25฀years฀of฀Total฀Service฀Credit;฀or

•฀฀฀You฀are฀covered฀by฀the฀“55/27”฀provisions฀of฀the฀Age฀55฀Retirement฀Program,฀are฀at฀least฀age฀55฀as฀of฀your฀retirement฀date,฀ and฀have฀attained฀at฀least฀27฀years฀of฀Total฀Service฀Credit.

If฀none฀of฀the฀statements฀above฀applies฀to฀you,฀then฀you฀do฀not฀qualify฀for฀unreduced฀payments฀of฀your฀retirement฀allowance.฀ However,฀as฀long฀as฀you฀are฀vested฀and฀at฀least฀55,฀you฀would฀be฀eligible฀to฀retire฀with฀a฀reduced฀retirement฀allowance.฀See฀ Service Retirement Plans and Benefits for Tiers III/IV฀for฀more฀information฀about฀retirement฀allowance฀reductions.

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Vesting

Most฀Tier฀III฀and฀IV฀members฀become฀vested฀upon฀attaining฀ive฀years฀of฀Total฀Service฀Credit.฀However,฀members฀ whose฀TRS฀membership฀began฀after฀December฀10,฀2009,฀and฀who฀are฀working฀in฀a฀title฀represented฀by฀the฀United฀ Federation฀of฀Teachers฀(UFT),฀become฀vested฀upon฀attaining฀10฀years฀of฀Total฀Service฀Credit.

Age 55 Retirement Program*

฀ •฀฀฀Members฀whose฀TRS฀membership฀began฀on฀or฀before฀February฀27,฀2008฀and฀who฀opted฀into฀the฀program฀are฀ covered฀by฀the฀“55/25”฀provisions.

฀ •฀฀฀Members฀whose฀TRS฀membership฀began฀after฀February฀27,฀2008฀and฀on฀or฀before฀December฀10,฀2009฀are฀ covered฀by฀the฀“55/27”฀provisions.฀(Also,฀certain฀members฀whose฀TRS฀membership฀began฀on฀or฀before฀ February฀27,฀2008฀were฀eligible฀to฀opt฀into฀the฀program฀under฀the฀“55/27”฀provisions.)฀

฀ •฀฀฀Members฀whose฀TRS฀membership฀began฀after฀December฀10,฀2009฀and฀before฀April฀1,฀2012฀are฀covered฀by฀the฀ “Chapter฀504”฀provisions,฀which฀include฀the฀vesting฀requirements฀cited฀above.

*Only employees of the Department of Education (DOE) or participating Charter Schools may participate in the Age 55 Retirement Program.

Note for members who participated in the Age 55 Retirement Program: If฀you฀are฀62฀or฀older฀at฀retirement,฀you฀may฀be฀ eligible฀for฀the฀return฀of฀the฀employee portion฀of฀the฀Additional฀Member฀Contributions฀(AMCs)฀you฀made฀under฀this฀program,฀ plus฀accrued฀interest.฀To฀receive฀these฀funds,฀you฀must:฀a)฀retire฀with฀unreduced฀payments;฀b)฀be฀in฀active฀service฀at฀least฀ one฀day฀prior฀to฀your฀effective฀date฀of฀retirement;฀and฀c)฀have฀been฀in฀active฀service฀for฀a฀total฀of฀at฀least฀six฀months฀out฀of฀ each฀of฀the฀two฀twelve-month฀periods฀preceding฀your฀retirement. If฀you฀qualify฀for฀a฀return฀of฀AMC฀funds,฀you฀would฀receive฀a฀separate฀payment฀from฀TRS;฀you฀do฀not฀need฀to฀take฀further฀ action.฀However,฀if฀you฀would฀prefer฀to฀have฀TRS฀directly฀roll฀over฀this฀payment฀to฀an฀eligible฀Individual฀Retirement฀ Arrangement(s)฀or฀other฀successor฀program(s),฀you฀must฀ile฀the฀“Application฀for฀Withdrawal฀of฀Additional฀Member฀ Contributions฀at฀Retirement”฀(code฀RW116)฀and฀the฀“QPP฀Direct฀Rollover฀Election฀Form”฀(code฀RW29)฀at฀this฀time.

In Part E: DESIGNATION OF BENEFICIARY FOR FRACTIONAL PAYMENT OF RETIREMENT ALLOWANCE AND

BENEFICIARY FOR DEATH BENEFIT #2 When฀designating฀beneiciaries฀on฀this฀form,฀please฀provide฀their฀Social฀Security฀numbers฀(or฀alternative฀taxpayer฀ID฀ numbers).฀This฀information฀will฀help฀TRS฀process฀any฀beneits฀that฀later฀become฀payable฀without฀unnecessary฀delay.

Fractional Payment

You฀must฀designate฀a฀beneiciary฀to฀receive฀any฀fractional฀payment฀that฀may฀be฀due฀for฀the฀month฀in฀which฀you฀die.฀This฀ fractional฀payment฀would฀be฀payable฀provided฀that฀you฀do฀not฀die฀on฀the฀last฀day฀of฀the฀month;฀the฀payment฀would฀be฀based฀ on฀the฀number฀of฀days฀that฀you฀are฀alive฀during฀that฀month.

Death Benefit #2

You฀must฀also฀designate฀a฀beneiciary฀to฀receive฀Death฀Beneit฀#2,฀a฀lump-sum,฀post-retirement฀death฀beneit.฀The฀amount฀ of฀this฀death฀beneit฀would฀be฀based฀on฀the฀death฀beneit฀in฀force฀on฀your฀retirement฀date฀(a฀maximum฀equaling฀three฀years’฀ salary,฀subject฀to฀age฀reductions).฀The฀actual฀amount฀payable฀to฀your฀beneiciary฀would฀also฀depend฀on฀the฀amount฀of฀time฀ between฀your฀retirement฀date฀and฀your฀death,฀as฀shown฀in฀the฀table฀below.

	Year of Death
	After Retirement Date				Amount of Death Benefit #2
	1st฀Year฀฀		฀	฀	50%฀of฀benefit฀in฀force฀on฀member’s฀retirement฀date
	2nd฀Year฀฀		฀	฀	25%฀of฀benefit฀in฀force฀on฀member’s฀retirement฀date
	3rd฀Year฀or฀later฀		฀	฀	10%฀of฀any฀benefit฀in฀force฀at฀age฀60฀(or฀10%฀of฀the฀benefit฀in฀force฀on฀
					member’s฀retirement฀date,฀if฀retirement฀occurred฀before฀age฀60.)
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