The NYCERS F351 form is a critical document for Tier 3 and Tier 4 Disability Retirees within the New York City Employees' Retirement System (NYCERS). Its main purpose is to ensure the continued eligibility of disability benefits recipients by requiring them to report any Personal Service Income received throughout the year. Failure to submit this affidavit, along with the required documentation, may result in the suspension of retirement benefits until compliance is achieved.
The New York City Employees' Retirement System (NYCERS) necessitates that all Tier 3 and Tier 4 Disability Retirees annually complete the F351 form, an Affidavit of Personal Service Income. This critical process ensures that these retirees maintain their eligibility for continued disability benefits by disclosing any personal service income they've received over the year. Not only is the submission of this affidavit mandatory, but the failure to provide it alongside the relevant documentation could result in a suspension of retirement benefits until compliance is achieved. This form distinguishes between various income types, explicitly excluding certain sources like the retiree's NYCERS’ pension check, Social Security benefits, Workers' Compensation, and income derived from rental property, stocks, bonds, IRAs, and interest on bank deposits from the need to report. Moreover, the affidavit demands details of any personal service income from both the public and private sectors for the stipulated year, which in the document provided is 2012. It also outlines the necessary steps for those who filed a Federal Income Tax Return, including the submission of W-2 forms and, if applicable, W-2 forms for a spouse in the case of a joint filing. Significantly, the form carries legal weight, indicating that the provision of false information could lead to felony charges, underscoring the seriousness with which this document and the information it solicits are regarded.
NYCERS USE ONLY
F351
*351*
Affidavit of Personal Service Income - 2012
Tier 3 or Tier 4 Disability Retirees
This form is to be completed annually by all Tier 3 & Tier 4 Disability Retirees. The purpose of this form is to verify your eligibility for continued disability benefits by reporting any Personal Service Income you received throughout the year. If NYCERS does not receive this affidavit, as well as the appropriate documents, your retirement benefit could be suspended until the information is received. Should you have any questions, please contact our Call Center at 347-643-3000.
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
Personal Service Income is considered to be any income, including income earned from both the public and the private sectors, you received for the year excluding the following:
-Your NYCERS’ Pension Check
-Social Security
-Workers’ Compensation
-Income earned from: rental property, stocks, bonds, IRAs and interest earned on deposits in bank accounts.
Any income earned from the above list does not have to be reported to NYCERS on this form.
A.Please answer the following questions:
1 Excluding the income listed above, have you earned any other monies for the year 2012? Yes
No
2.If you checked yes in question # 1, these monies you received are considered "Personal Service Income." Please calculate only your Personal Service Income for 2012 and place the amounts in the appropriate boxes below:
,.
(income earned from the private sector)
(income earned from the public sector)
Sign this form and have it notarized, Page 2
R11/16/12
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B. If you filed a Federal Income Tax Return for 2012, you must submit a copy of your Tax Return and your W-2 forms. If
you are married and filed a joint return, you must also submit a copy of your spouse's W-2 forms. If you did not file taxes for 2012, you still are required to submit copies of any W-2 forms you received.
I am including with this affidavit, the following:
A copy of my Federal Tax Return for the year of 2012 and my W-2 forms (if married and filed jointly please also include W-2 forms for your spouse).
I did not file my Federal Tax Return for the year of 2012 but I have attached my W-2 forms.
I did not file my Federal Tax Return for the year of 2012 and I have 0.00 Personal Service Income and no W-2 forms to submit.
To verify my eligibility for continued benefits, I have included the required documents with this affidavit.
Signature of Member
Date
Pursuant to The Penal Code of the State of New York, offering a document containing false statements or false information constitutes a felony punishable by a maximum of 4 years imprisonment. All documents suspected of containing false statements will be referred to The New York City Department of Investigation for investigation.
This form must be acknowledged before a Notary Public or Commissioner of Deeds
State of
County of
On this
day of
2 0
, personally appeared
before me the above named,
, to me known, and known to
me to be the individual described in and who executed the foregoing instrument, and he or she acknowledged to me that he or she
executed the same, and that the statements contained therein are true.
If you have an official seal, affix it
Signature of Notary Public or
Commissioner of Deeds
Official Title
Expiration Date of Commission
Sign this form and have it notarized, THIS PAGE
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After completing the Nycers F351 form, it's essential to follow the provided instructions closely. This form is a necessary step for Tier 3 and Tier 4 Disability Retirees to confirm their eligibility for continued benefits by disclosing any Personal Service Income received throughout the year. Failing to submit this affidavit, along with the required documents, could result in the suspension of benefits until the necessary information is provided. To ensure smooth processing, review the instructions carefully and verify that all information is accurate and complete before submission.
Before submitting the completed form and any attachments, double-check all entries for accuracy and completeness. This careful attention to detail will help avoid delays in the processing of your affidavit and ensure your benefits continue uninterrupted. Should you have any questions during the process, do not hesitate to contact the call center for assistance.
Many retirees, especially those on disability from their public service careers, have questions regarding the NYCERS F351 form. Below, find answers to some of the most commonly asked questions.
What is the NYCERS F351 form?
The NYCERS F351 form is an affidavit that needs to be filled out annually by all Tier 3 and Tier 4 Disability Retirees. Its primary purpose is to confirm your eligibility for continued disability benefits by reporting any Personal Service Income you received throughout the year. It helps ensure that retirees adhere to the income requirements associated with their disability pension benefits.
Why do I need to submit the F351 form?
This form is crucial because it verifies whether you've received any income outside of your pension that might affect your disability benefit eligibility. If the form, along with the required documents, isn't received by NYCERS, your retirement benefits could be temporarily suspended, pending submission. It's a compliance document that keeps everything transparent and updated with NYCERS.
What income needs to be reported on the F351 form?
When filling out the F351 form, you will exclude any income you receive from your NYCERS Pension Check, Social Security, Workers' Compensation, and income earned from rental property, stocks, bonds, IRAs, and bank account interests. Thus, any income you received from personal services outside the exclusions listed needs to be reported. This includes earnings from both public and private sectors that aren’t explicitly excluded on the form.
What if I did not earn any Personal Service Income?
If you did not earn any Personal Service Income in the year you're reporting for, you would indicate this by answering "No" to the question asking if you've earned any money outside the exclusions. It's still essential to submit the form to NYCERS to ensure they have your current information and to avoid any potential suspension of your benefits.
What documents must accompany the F351 form?
If you filed a Federal Income Tax Return for the year you're reporting, you should include a copy of your tax return and your W-2 forms. If married and filed jointly, include your spouse's W-2 forms as well. If you did not file a tax return for that year but received W-2 forms, those should be included. And if you earned no Personal Service Income and therefore have no W-2 forms to submit, you should state this clearly on the form.
What happens if I submit false information?
Submitting a document with false information to NYCERS is considered a felony under the Penal Code of the State of New York. Such an action could result in up to four years of imprisonment. All documents suspected of containing false statements will be reviewed and possibly investigated further, emphasizing the importance of truthful reporting.
How do I submit the F351 form?
After filling out the form, ensure that it is notarized. This means it must be signed in the presence of a Notary Public or Commissioner of Deeds who will also sign it. You should then submit it to NYCERS along with any required documents as outlined on the form. If you have questions about submission or need further details, contacting the NYCERS Call Center at the provided phone number is advised.
Filling out the NYCERS F351 form, an essential document for Tier 3 and Tier 4 Disability Retirees verifying their eligibility for continued disability benefits, necessitates careful attention to detail. Errors made during this process can lead to unnecessary delays or even the suspension of benefits. Here are eight common mistakes:
To avoid these common mistakes, individuals are encouraged to review their forms thoroughly before submission. Ensuring accuracy, completeness, and compliance with all requirements is essential for the maintenance of disability benefits. By paying attention to these details, retirees can help secure their financial wellbeing.
In conclusion, while the F351 form serves as a critical tool for Tier 3 and Tier 4 Disability Retirees in verifying their income and maintaining eligibility for benefits, its proper completion cannot be overstated. By avoiding these common mistakes, retirees can ensure the continued receipt of their disability benefits without interruption.
When dealing with the administration of benefits for Tier 3 and Tier 4 Disability Retirees, the NYCERS F351 Affidavit of Personal Service Income form plays a crucial role. This form is designed specifically to ascertain eligibility for continued disability benefits by documenting personal service income received throughout the year. However, completing the F351 form is often just one step in the process. There are several other documents and forms that retirees may need to gather and submit to ensure a smooth and uninterrupted benefits experience.
Gathering and accurately completing these documents is key for Tier 3 and Tier 4 Disability Retirees looking to confirm their eligibility for continued benefits. While each document serves its specific purpose, together they create a comprehensive profile of the retiree’s financial and employment status. It’s important to approach this process with diligence and attention to detail, ensuring that all required information is complete and accurate to avoid any potential disruption in benefits.
The Form 1099-MISC is quite similar to the NYCERS F351 form in its purpose of reporting income that falls outside of regular wage earnings, specifically focusing on miscellaneous income. Both documents serve to inform respective authorities about earnings that may not typically be subject to withholding, ensuring that individuals accurately report their total income. While the F351 focuses on personal service income for disability retirees, the 1099-MISC encompasses various types of payments such as rent, prizes, and freelance work, highlighting their similar goal of comprehensive income reporting for specific purposes.
The SSA-1099 form, issued by the Social Security Administration, also shares characteristics with the NYCERS F351 form by targeting a specific demographic to report annual income, in this case, individuals receiving social security benefits. Much like the F351, which requires disability retirees to report non-pension and non-social security personal service income, the SSA-1099 helps recipients to include social security benefits in their annual income tax returns, ensuring accurate income reporting and tax liability calculation for individuals receiving federal benefits.
The W-2 form is integral for employees and employers alike, mirroring the requirement aspect seen in the F351 form. This document reports an employee's annual wages and the amount of taxes withheld from their paycheck, a necessary step for filing taxes accurately. The NYCERS F351 form, by contrast, focuses on income earned from personal services beyond the typical employer-employee relationship but similarly necessitates the inclusion of this information for proper documentation of income and verification of benefits eligibility.
The Schedule C (Form 1040) is used by sole proprietors to report income or loss from a business they operated or a profession they practiced as a sole proprietor, closely aligning with the NYCERS F351 form's aim to report personal service income. Both forms cater to individuals needing to report specific types of income that fall outside regular employment wages, demonstrating the broader responsibility individuals have to report all sources of income, perhaps from self-employment or personal services, for accurate tax and benefits assessment.
The Pension Benefit Statement, albeit not a form filed with the IRS, resembles the NYCERS F351 in its purpose of informing individuals about their pension-related income. While the Pension Benefit Statement provides a summary of pension benefits one is either receiving or entitled to receive, the F351 requires reporting of income other than pension money. Both documents, however, are pivotal for individuals to understand their financial inflow from retirement benefits and other personal service income, ensuring they have a comprehensive overview of their annual income for tax and eligibility purposes.
When completing the NYCERS F351 form, there are specific steps and precautions that Tier 3 and Tier 4 Disability Retirees should follow to ensure their disability benefits continue without interruption. Here is a list of things you should and shouldn't do:
Following these guidelines closely will help ensure that your benefits remain in effect and reduce the risk of legal repercussions due to omitted or falsified information on your NYCERS F351 form.
There are several misconceptions about the NYCERS F351 form, especially among Tier 3 and Tier 4 Disability Retirees. It's important to understand what this form is about and what it requires to avoid any mistakes that could affect one's benefits. Here's a list of eight common misconceptions and the truth about each.
Understanding these misconceptions and knowing the facts can help ensure that the process of completing and submitting the NYCERS F351 form goes smoothly, preventing any unnecessary interruptions to your benefits.
Filling out the NYCERS F351 form is an essential annual task for Tier 3 and Tier 4 Disability Retirees to ensure the continuation of their disability benefits. Key takeaways about handling this form include:
Additionally, the form serves as a reminder of the importance of maintaining transparent and honest communication with NYCERS regarding income status, to ensure that disability retirees remain eligible for their deserved benefits.
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