Form F852 "Request for Information" - New York City

What Is Form F852?

This is a legal form that was released by the New York City Employees' Retirement System - a government authority operating within New York City. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on December 1, 2016;
  • The latest edition provided by the New York City Employees' Retirement System;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form F852 by clicking the link below or browse more documents and templates provided by the New York City Employees' Retirement System.

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Download Form F852 "Request for Information" - New York City

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F852
NYCERS USE ONLY
*852*
Mail completed form to:
30-30 47th Avenue, 10th Fl
Long Island City, NY 11101
Request for Information
Member Number
OR Pension Number
Last 4 Digits of SSN
Home Phone Number
Work Phone Number
(
)
(
)
First Name
M.I.
Last Name
Address
Apt. Number
City
State
Zip Code
Subject of Inquiry (for ex., loan, beneficiary)
Title
I would like NYCERS to supply me with the following information:
Signature
Date
R12/16
Page 1 of 1
F852
NYCERS USE ONLY
*852*
Mail completed form to:
30-30 47th Avenue, 10th Fl
Long Island City, NY 11101
Request for Information
Member Number
OR Pension Number
Last 4 Digits of SSN
Home Phone Number
Work Phone Number
(
)
(
)
First Name
M.I.
Last Name
Address
Apt. Number
City
State
Zip Code
Subject of Inquiry (for ex., loan, beneficiary)
Title
I would like NYCERS to supply me with the following information:
Signature
Date
R12/16
Page 1 of 1