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TRS Beneficiary Form

 

Handle: Document-81241
Owner: Fuller, Tina (User-7387, tfuller:DocuShare)DS
Monday, March 19, 2012 09:40:41 AM EDT
Wednesday, October 23, 2013 09:11:31 AM EDT
Modified By: Dickenson, Rhonda (User-8396, rhonda.dickenson:gvwfl)DS
Locked By:
  • NET-11.4 (3/06)
NEW YORK STATE TEACHERS’ RETIREMENT SYSTEM 10 Corporate Woods Drive, Albany, NY 12211-2395 DESIGNATI ON OF BENE FICI ARY Last Name First Name M.I.
  • Social Security Number
Street EmplID City, State, Zip Is this your permanent address? This form must be properly notarized.
  • 2.
  • Any number of primary and contingent beneficiaries may be named, but you must designate at least
one primary beneficiary.
  • Additional forms can be acquired from your employer, the System or downloaded ...
Allowed
Adobe Portable Document Format (.pdf) - application/pdf
TRS Beneficiary.pdf
No
4
37741
No
Appears In: Payroll Dept.
Preferred Version: TRS Beneficiary Form