Get Ny Nycert Form 624 2021-2025

This guide provides detailed instructions for completing the NY NYCERT Form 624 online. Understanding each component of the form is essential for a successful application for disability retirement.

Follow the steps to fill out the NY NYCERT Form 624 online.

1. Click the ‘Get Form’ button to access the form and open it for editing.
2. Read through the instructions and terms on the first page to familiarize yourself with the eligibility requirements for filing a disability retirement application.
3. Begin filling out the 'Select a Benefit' section. Choose all applicable benefits you're applying for, such as the EMT Heart Law, Disability Retirement with 10 Years of Service, or other relevant options.
4. Complete the 'Member Information' section. Provide your member number, last four digits of your social security number, date of birth, phone number, first name, middle initial, last name, and address including city, state, and zip code.
5. In the 'List your Disabling Conditions' section, clearly specify any conditions you wish to have considered by the Medical Board.
6. Select a temporary option in the designated section, making sure to carefully read each option’s description. If choosing the 100% Joint-and-Survivor or Ten-Year Certain Option, ensure to name your beneficiaries.
7. If necessary, provide details for your Joint and Survivor Beneficiary or for your Ten-Year Certain Beneficiary, including their full names, relationship to you, and applicable identification numbers.
8. Complete the Federal Tax Withholding section to indicate your preferences for tax withholding on your pension.
9. Sign the form where indicated, and ensure that your signature is notarized to validate the document.
10. Review the completed form for accuracy and clarity. Once reviewed, save the changes, and download or print your form for submission.
11. Submit your form and any additional required documents as per the instructions provided in the form.

Take action now and complete your NY NYCERT Form 624 online to ensure a timely submission.