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Get NY PS-932 2011-2024

For Enrollees and Agencies: On the back of this form are instructions for choosing to continue, convert or cancel life insurance coverage after retirement. For more information, refer to letter PS-931 or contact your agency's benefits administrator. Personal Privacy Protection Law The information you provide on this application is being requested in accordance with Section 158 of the Civil Service Law for the principal purpose of processing your request to continue, convert or cancel life insur.

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