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ERS Retirement Application

 

Handle: Document-81237
Owner: Fuller, Tina (User-7387, tfuller:DocuShare)DS
Monday, March 19, 2012 09:39:15 AM EDT
Wednesday, October 23, 2013 09:11:31 AM EDT
Modified By: Dickenson, Rhonda (User-8396, rhonda.dickenson:gvwfl)DS
Locked By:
  • Employees’ Retirement System
Membership Registration RS 5420 (Rev.
  • Or fax the application to (518) 486-4382.
  • Maiden or Other Name Used
_ To Be Completed by Present Employer 4 Employer Name (Indicate State, or, if not, name of public entity by which employed and Department, Division, or Institution) ? ?? ( ) ? _______________ _______________ _______________ _____________ ________________ ______________________________ 5 _ ( ) Employer’s Address Street Cit...
Allowed
Adobe Portable Document Format (.pdf) - application/pdf
12 - ERS Application Tier 6.pdf
No
4
143969
No
Appears In: Payroll Dept.
Preferred Version: ERS Retirement Application