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New York City Police Pension Fund

Forms and Publications

Please carefully follow all instructions stated on the form.


NOTE: Some forms require notarization.

Form Number
General Applications
10 ITHP (Increased-Take-Home-Pay)
20 50 % Additional Deductions
30 Pension Annuity Deductions Discontinuance/Reinstatement
40 Pension Loan Application
50 Loans - Request To Change Amount of Repayment
60 Change of Designated Beneficiary
70 Change of Address (Retirees only)
80 Refund of Excess
90 Rollover Election
100 Loan Cancellation
110 EFT Form (Retirees only)
120 Federal Income Tax Withholding Form
130 Discontinuance of Service
140 Designation of Guardian
150 Certification Of Employment (212 Wavier)
160 Shortage Request
170 WTC Disability Law & Application
180 VSF Suspension
190 EFT Stop Form (retirees only)
200 MCU Payroll Deduction Form - Retirees Only
  
  Buy Back Applications
300 Military Service Credit--Chap 548
310 Child Care Credit--Chap 594
330 Bosnia Bill--Chap 606
340 Prior Service Credit--Chap 646
350 Prior Service Credit --Chap 552
360 Deferred Compensation Plan - In Service Distribution Form
370 Amend Prior State Service
380 Application for Prior Credit for service as a NYC EMT Under --Chap 728 Laws of 2004
390 Application to Amend Service Credit -- Chap 498 Laws of 2005
  
Transfer of Membership Forms
500 NYS Employee Retirement System
510 NYC Fire Department
520 Board of Education
530 NYC Employee Retirement System
  
  Legal Forms
550 Sample DRO Forms
560 Request for Pension Valuation in a Matrimonial Action

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