Direct Trustee-to-Trustee Transfer office of the New York State Comptroller New York State and Local Retirement System / New York State and Local Retirement System Police / Call Center / Partial Lump Sum Payment Office / Internal Revenue Service / /
Person
Mary Smith / John Smith / / /
Position
State Comptroller / Signature Date TRUSTEE / tax advisor / professional tax advisor / Director of Member and Employer Services / Governor / Direct Trusteeto-Trustee / trustee / COMPTROLLER / /
Retirement Option Election Form with Partial Lump Sum Payment Office of the New York State Comptroller New York State and Local Retirement System