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123 results found
Retirement
Employees’ Retirement System Membership Registration (RS-5420)

Use this form to enroll in the NYS Employees' Retirement System. 

  • Download about Employees’ Retirement System Membership Registration (RS-5420)
Retirement
Declination of Membership in the New York State Employees' Retire...

Use this form to decline membership in the NYS Employees' Retirement System.  This form can only be used by temporary, part-time, or provisional employees.

  • Download about Declination of Membership in the New York State Employees' Retirement System (BSC-B4)
Retirement
Application for Service Retirement (RS-6037)

Complete this form if you are ready to schedule your retirement. It must be submitted between 15 and 90 days before you actually retire. This...

  • Download about Application for Service Retirement (RS-6037)
Benefits
Certification of Health Care Provider for Employee's Serious Heal...

This form is for your physician to fill out when you (the employee) are filing for FMLA for a serious medical condition.

  • Download about Certification of Health Care Provider for Employee's Serious Health Condition (WH-380-E)
Benefits
Certification of Health Care Provider for Family Member's Serious...

This form is for your physician to fill out when your family member has a serious medical condition and you are filing for FMLA.

  • Download about Certification of Health Care Provider for Family Member's Serious Health Condition (WH-380-F)
Benefits
Workers' Compensation Medical Records Release (BSC-B21)

This is the form to give your physician to release your medical records for a Workers' Compensation claim.

  • Download about Workers' Compensation Medical Records Release (BSC-B21)
Benefits
Workers' Compensation Accident Reporting Form (BSC-B20)

This is the form you need to file for an accident or injury that is covered by workers' compensation.

  • Download about Workers' Compensation Accident Reporting Form (BSC-B20)
Benefits
Workers' Compensation Estimated Physical Capabilities Form (BSC-B...

This is the form that your doctor completes to estimate your physical capabilities from a workers' compensation injury or accident.

  • Download about Workers' Compensation Estimated Physical Capabilities Form (BSC-B22)
Retirement
Designation of Beneficiary with Contingent Beneficiaries (RS-5127...

Use this form to add or update beneficiaries for retirement payouts.

  • Download about Designation of Beneficiary with Contingent Beneficiaries (RS-5127)
Retirement
Application for Ordinary Disability Retirement (RS-6038)

This form is for police & fire retirement system members and Tier 1 & Tier 2 employee retirement system members.

  • Download about Application for Ordinary Disability Retirement (RS-6038)

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