Application for Deferred Vested Retirement Allowance – Tier 1 and Tier 2 Uniformed Sanitation Force Members Who Discontinue Service Other Than by Death, Retirement or Dismissal
Form #269

Form

For Tier 1 and Tier 2 Uniformed Sanitation Force members who wish to file for a Deferred Vested Retirement. This form must be filed with NYCERS at least 30 days prior to discontinuance from City service. This form serves as both your notice of intent to vest, as well as for payment of a future Vested Retirement Benefit.