Employee's Retirement System (ERS) Designation of Beneficiary (RS 5127)

State employee designates beneficiary trust with contingent beneficiaries.

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

Form must be notarized

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Lissa Jasinowski

Retirement Administrator

State Benefit Services

Phone: (716) 645-4488

Email: lmt22@buffalo.edu

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Form Facts

Form Type: Downloadable, PDF document

Requirements: Adobe Reader

Updated: March 2011

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