Membership and Enrollment

Fax Enrollment

Membership and Enrollment

Using Retirement Online is the most efficient way to enroll members. However, we also provide a fax service. The service is available 24 hours a day, seven days a week. The fax number is 518-486-4382.

  1. Individuals joining NYSLRS must complete a membership application for the appropriate system, either form RS5420 for the Employees’ Retirement System (ERS), or PF5022 for the New York State Police and Fire Retirement System (PFRS).

    Please have your employee complete the form in black ink, and make sure that the application is legible.

  2. Fax the completed application with a cover sheet containing the date, the employer name, the sender’s name and phone number, and the fax number. You need only one cover sheet no matter how many applications you’re faxing at the time.

If you have any questions, call us at 518-474-3081.

If faxed applications are received prior to 11:59 pm the day employees are physically working in paid status, they are guaranteed a date of membership for that day. The only exception is if the employee does not work the normal business hours of 9:00 am – 5:00 pm, but does work the afternoon shift or the weekend shift. In that case, you are required to fax us the application on the very next business day after the employee worked.

Example: The employee worked on Monday, October 21, 2019, from 6:00 pm – 8:00 pm. The enrollment form should be faxed on Tuesday, October 22, 2019, stating this employee worked on Monday, October 21, 2019, from 6:00 pm – 8:00 pm. The employee’s date of membership would then be October 21, 2019.


Rev. 10/19