New York Public Employee Retirement System Special Durable Power Of Attorney

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NEW YO RK PUBLIC EMPLOYEE RETIREM ENT S YS TEM
SPECIAL DURABLE POWER OF ATTORNEY
PREAMBLE: This is a Public Retirement System Special Power of Attorney prepared pursuant to General
Obligations Law Article 5, Title 15. This form has been prepared and circulated by the public retirement systems
listed below as a convenience to their members, retirees and beneficiaries. This form is limited to retirement benefit
transactions involving those retirement systems and does not apply to any other matters.
(a) PURPOSE CLAUSE: The purpose of this Power of Attorney document is to
authorize my agent to act in my name, place and stead with respect to retirement benefit
transactions and my interest in benefits provided by one or more of the public retirement systems
listed below pursuant to the Retirement and Social Security Law, the Education Law and the
Administrative Code of the City of New York, as applicable.
Please note: By executing this special Power of Attorney without placing any limitations in
Section (g) MODIFICATIONS, you are authorizing your agent to conduct ANY transaction that
you would be authorized to do (discuss retirement benefits, request access to personal
information, change depository account information, etc.) to the exclusion of naming him or
herself as beneficiary unless your agent is an immediate family member or domestic partner.
A public retirement system for the purposes of this form shall include:
 The New York State and Local Employees’ Retirement System
 The New York State and Local Police and Fire Retirement System
 The New York State Teachers’ Retirement System
 The New York City Employees’ Retirement System
 The New York City Teachers’ Retirement System
 The New York City Police Pension Fund
 The New York City Fire Department Pension Fund
 The New York City Board of Education Retirement System.
(b) CAUTION TO THE PRINCIPAL: Your Power of Attorney is an important
document. As the “principal”, you give the person whom you choose (your “agent”) authority to
engage in retirement benefit transactions during your lifetime without telling you.
You,
however, do not lose your authority to act even though you have given your agent similar
authority.
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