Employee's Retirement System (ERS) Application for Military Service Credit (RS 5509)

State employee applies for military service credit under article 20-RSSL.

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Employee's Retirement System Application for Military Service Credit (RS 5509)
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  1. Read through all pages of the document to find specific instructions if any
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  4. Get required signatures
  5. Scan a copy of the signed form for your records
  6. Send the original, completed, signed form to:         

Employees' Retirement System
110 State Street
Albany, New York 12244-0001

Need Help Completing the Form?

Lissa Jasinowski.

Lissa Jasinowski

Retirement Administrator

State Benefit Services

Phone: (716) 645-4488

Email: lmt22@buffalo.edu

Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: February 2006

Owner: Office of the New York State Comptroller, New York State and Local Retirement System