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Teachers' Retirement System of the City of New York
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Beneficiaries

Home Forms Beneficiaries

Application for COVID-19 Accidental Death Benefit (code DB301)
COVID-19 Medical Certification A: Date of Onset (To Be Completed by a Medical Professional) (code DB303)
COVID-19 Medical Certification B: Cause of Death (To Be Completed by a Medical Professional) (code DB304)

You can designate beneficiaries when you log in with your claim code to file a death benefit claim online.

Please log in with your claim code to file a death benefit claim online.

Claimant's Affidavit for Benefit Under Section 1310 (code DB14)
Release of Claim Form Under Section 1310 (code DB28)
Beneficiary's Change of Address Form (code DM14)
Cancellation Request Form (code MI5)
Beneficiary's Consent Form for Changes under Section 13-565(c) (code RP114)

TDA Investment Election Change Form (for Beneficiaries) (code TD81)

Affidavit for Check Reissue Request (and Authorization to Stop Payment) (code BK2)
EFT Authorization Form (code BK58)  

 
QPP Direct Rollover Application for Lump-Sum QPP Death Benefit to an Inherited IRA (code DB32b)  
TDA Direct Rollover Application for Lump-Sum TDA Death Benefit to an Inherited IRA (code DB34c)  
1099-R/1099-INT Inquiry Form (code GA5)  
TDA Beneficiary Transfer Application (code TD22b)  
TDA Withdrawal Application for Beneficiaries (code TD32b)  

Top Forms

Beneficiary's Change of Address Form (code DM14)

TDA Withdrawal Application for Beneficiaries (code TD32b)