Active employee applies to be reinstated to membership of the New York State and Local Retirement System (NYSLRS).
For the best experience in completing this form use a non-mobile device.
New York State and Local Retirement System
110 State Street
Albany, New York 12244-0001
Complete pages 1 and 4 of this form. Pages 2 and 3 provide a comparison of benefits for members covered under regular plans.
If you have questions call the Information Office toll free at 1-866-805-0990, in Albany area at 474-7736 or by email at
Form Type: Downloadable, PDF document
Requirements: Adobe Reader
Owner: Employee's Retirement System