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For those who are part of the New York City Employees' Retirement System (NYCERS), the F380 form serves as a vital tool for managing your retirement benefits. This form is specifically designed for individuals who wish to set up an Electronic Fund Transfer (EFT) for their monthly retirement allowance, allowing for automatic deposits directly into a designated bank account. By completing the F380, retirees can ensure that their funds are transferred seamlessly, providing peace of mind and financial stability. The form requires personal information, including your member or pension number, as well as banking details such as your account number and routing number. Additionally, it is crucial to attach a preprinted check or deposit slip that verifies your account information. This step is necessary to confirm that the name on your bank documents matches the name in NYCERS' records. Notably, if you provide a new address on the form, it will update your official records with NYCERS. The F380 form also includes important acknowledgments regarding the handling of funds transferred in error and outlines the process for canceling the EFT authorization should you choose to do so in the future. Understanding the nuances of this form can greatly simplify the management of your retirement funds, ensuring timely access to your benefits.
Preview - Nycers 380 Form
NYCERS USE ONLY |
F380 |
Mail completed form to: *380*
Long Island City, NY 11101
Authorization for Electronic Fund Transfer (EFT) of Monthly
Retirement Allowance
Complete this form if you wish to have your NYCERS check automatically deposited into your bank (checking or savings) account by Electronic Fund Transfer (EFT). Be sure to read the instructions on the back of this form before submitting it to NYCERS. NOTE: If the address you provide on this form is different from your address in our system, the new address will become your official address in our records. Should you have any questions, please contact our Call Center at
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Provide the banking information below and attach a preprinted personal check or deposit slip or a copy of your checking or savings account bank statement. Your name must appear on the preprinted check or bank document and it must match the name in NYCERS' records exactly in order for us to process this request.
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I wish to deposit my monthly retirement allowance in my |
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conditions on page 2 of this form and hereby authorize NYCERS to send my monthly retirement allowance via EFT. |
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BANKING INFORMATION (please print): |
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Signature of Member |
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This form must be acknowledged before a Notary Public or Commissioner of Deeds |
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before me the above named, |
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, to me known, and known to |
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me to be the individual described in and who executed the foregoing instrument, and he or she acknowledged to me that he or she
executed the same, and that the statements contained therein are true. |
If you have an official seal, affix it |
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Signature of Notary Public or |
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Commissioner of Deeds |
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If payments are transferred in error by NYCERS, the bank will return such payments to NYCERS as authorized by the depositor. The bank also agrees to apply the same procedures described in 31 CFR 210 to such transfers, and agrees to reimburse NYCERS to the same extent as Federal agencies are reimbursed under 31 CFR 210.
R12/16 |
Page 1 of 2 |
NYCERS USE ONLY |
F380 |
Mail completed form to:
Long Island City, NY 11101
Filling out this form and submitting it to NYCERS authorizes:
1.The Office of the Comptroller of the City of New York, on behalf of the New York City Employees' Retirement
System (NYCERS) to send my monthly retirement allowance via Electronic Fund Transfer (EFT) to the bank* designated on this form for deposit in my account.
2.My bank: (a) to receive my monthly retirement allowance via EFT for deposit in my account AND
(b)to deduct from my designated account or deposits in my name at this bank all amounts transferred in error by NYCERS or any amounts sent after my death and to reimburse NYCERS to the extent of such deductions, applying the same procedures described in 31 CFR 210 to such transfers in error and reimbursing NYCERS to the same extent as Federal agencies are reimbursed under 31 CFR 210.
3.My heirs, my estate and designated beneficiaries of my monthly retirement allowance, respectively, to reimburse NYCERS for any amount deposited in error after my death, in event that my account is closed or contains an insufficient balance to reimburse
NYCERS.
This EFT authorization will remain in effect until I have given written notice to NYCERS canceling the EFT.
* The bank you name must be a member of the Automated Clearing House in order for your funds to be deposited electronically.
HOW EFT WORKS:
1.Your net retirement allowance is automatically credited to your bank account on the last day of each month providing it's a business day; if the last day is a weekend or holiday, the funds are deposited on the next business day.
2.Your monthly net retirement allowance will appear on your bank statement.
3.A quarterly statement, issued by the Office of the Comptroller, will be mailed to your home address. It will reflect details of your monthly retirement allowance, including deductions for union dues, health insurance and federal income tax withheld during the
Your monthly retirement allowance can be deposited in either your checking or savings account - NOT split between both.
TO AUTHORIZE EFT:
•Provide your personal and banking information on page 1.
•Attach a preprinted personal check
(name must appear on check) or preprinted savings deposit slip to this page. If your bank no longer provides personal checks or preprinted savings deposit slips, attach a copy of the top portion of your Checking or Savings Account Bank Statement.
•If submitting a preprinted check or deposit slip write VOID (in large letters) across the face, as indicated in the sample.
•Do NOT sign the check that you are attaching to this page.
•The name on your bank account must match exactly your name in NYCERS' records.
Note: It may take up to 45 days from receipt of this form for the account to be processed for EFT.
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Page 2 of 2 |
Form Characteristics
| Fact Name | Details |
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| Purpose | This form allows NYCERS members to authorize the automatic deposit of their monthly retirement allowance into a designated bank account via Electronic Fund Transfer (EFT). |
| Submission Address | Completed forms must be mailed to NYCERS at 30-30 47th Avenue, 10th Fl, Long Island City, NY 11101. |
| Notarization Requirement | The form must be acknowledged before a Notary Public or Commissioner of Deeds, ensuring that the member's identity is verified. |
| Governing Law | This form is governed by New York State laws, specifically referencing procedures outlined in 31 CFR 210 for the handling of electronic fund transfers. |
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