Edit, Download, and Sign the Change of Address Form for NYSLRS Members
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How do I fill this out?
To fill out the Change of Address Form, ensure you have your NYSLRS ID and Social Security Number ready. Start by entering your old and new address details clearly. Lastly, provide your signature and the date to validate the form.

How to fill out the Change of Address Form for NYSLRS Members?
1
Gather your NYSLRS ID and last four digits of your Social Security Number.
2
Fill in your old address information as accurately as possible.
3
Provide your new address details including street, city, state, and zip code.
4
Enter your daytime telephone number and email address.
5
Sign and date the form before submission.
Who needs the Change of Address Form for NYSLRS Members?
1
Members of the New York State and Local Retirement System who have changed their residence.
2
Employees nearing retirement to ensure they receive retirement communications.
3
Individuals who have moved to ensure their pension checks are sent to the correct address.
4
Those who wish to update their tax information linked to their new address.
5
Any individual wanting to maintain streamlined communications with retirement services.
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Once you've made your changes, preview the document to ensure accuracy.
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What are the instructions for submitting this form?
To submit this Change of Address Form, you may mail it to the New York State and Local Retirement System at 110 State Street, Albany, NY 12244. Alternatively, you can fax it to the Member & Employer Services at 518-474-7736. For any inquiries, you can also reach out through the emails provided on the NYSLRS website.
What are the important dates for this form in 2024 and 2025?
The Change of Address Form should be submitted as soon as a member changes their residence. It is advisable to update your details before any major communication period from the retirement office to avoid missed notifications. Make sure to check for any specific deadlines communicated by NYSLRS.

What is the purpose of this form?
The primary purpose of the Change of Address Form is to keep the New York State and Local Retirement System updated with accurate member information. Ensuring your address is current helps the retirement system provide timely communications regarding benefits and services. Additionally, it facilitates the smooth processing of your retirement benefits and related correspondence.

Tell me about this form and its components and fields line-by-line.

- 1. NYSLRS ID: A unique identifier for each member of the retirement system.
- 2. Received Date: The date the form is received by the retirement system.
- 3. Social Security Number: Last four digits of your Social Security Number for verification.
- 4. Name: Your current name as it appears in retirement records.
- 5. Former Name: Your previous name, if applicable, for identification purposes.
- 6. Date of Birth: Your date of birth in the format mm/dd/yyyy.
- 7. Old Address Information: Your previous address details including street, city, state, and zip.
- 8. New Address Information: Your new address details including street, city, state, and zip.
- 9. Daytime Telephone Number: Best contact number during the day.
- 10. E-mail Address: Your current email address for communications.
- 11. Signature: Your signature for verification.
- 12. Date: The date the form is signed.
What happens if I fail to submit this form?
Failure to submit this form may result in outdated records within the retirement system, potentially leading to the non-receipt of vital information. Benefits may be delayed or misdirected, causing inconvenience and confusion for the member. It is crucial to ensure timely submission to avoid these issues.
- Outdated Contact Information: If the address is not updated, members may miss important communications regarding their benefits.
- Delayed Benefits: Failure to update may lead to delays in receiving pension checks and other benefits.
- Increased Confusion: Incomplete or incorrect information can lead to confusion regarding benefit eligibility.
How do I know when to use this form?

- 1. Change of Residence: To update the retirement system with the member's new home address.
- 2. Name Changes: For members who have legally changed their name and need to update their records.
- 3. Contact Updates: To ensure all contact methods (phone and email) are current.
- 4. Preparing for Retirement: To ensure the member receives all relevant retirement information at the correct address.
- 5. Tax Document Updates: To guarantee that tax information is sent to the appropriate address.
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