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Of Birth / First Name M.I. MM/DD/YYYY / Last Name In Care of (if applicable) Address Apt. Number City State Zip Code ELECTING AN OPTION The law requires that you file your option election within 60 days of the date NYCERS mails a Retirement Options letter to you. The option you elect is important to both you and your beneficiary. Be sure you understand each option, and elect the one that best fulfills your needs. Double check that you have marked the proper box for the option that y.

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