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address you provide on this form is different from your address in NYCERS' system, the new address will become your official address in NYCERS' records. If you have any questions regarding this form, please contact NYCERS' Call Center at 347-643-3000. TYPE OF CHECK(S) LOST (please check all applicable boxes from Section A and/or Section B):

Article 14-B Disability Retirement Application. For county sheriffs, undersheriffs and certain deputy sheriffs whose employers elected coverage under Sections 555, 556, 557 or 558 of the Retirement & Social Security Law (RSSL). This is a two-page form and a HIPAA waiver. Please submit all three pages.Mail Completed Forms to: 33 A 1 1111 NYCERS SE ONY F331 R Page 1 of 2 340 ay Street, Bklyn, NY Meanine level 30-30 47th Avenue, 10th Fl. Long Island City, NY 11101 pload Documents at www.mynycers.org (347) 643-3000 www.nycers.org M - F, am to pm Forms, Brochures, Fact Sheets at *331*Designation of Beneficiary - Tier 3, Tier 4, and Tier 6 - New York City Employees' Retirement System. Designation of Beneficiary – Tier 3, Tier 4, and Tier 6. Form #133 is temporarily unavailable. Form. To make changes to your beneficiaries or their designated guardians, log in to your MyNYCERS account and look for “Manage … Filling out this form and submitting it to NYCERS authorizes: 1. The Office of the Comptroller of the City of New York, on behalf of the New York City Employees' Retirement System (NYCERS) to send my monthly retirement allowance via Electronic Fund Transfer (EFT) to the bank* designated on this form for deposit in my account. 2. Form. Military service must have been satisfactorily completed and a discharge under honorable circumstances must have been granted. A DD214 form is the most common proof of satisfactory military service. Download PDF. Brochure 902. Eligibility, benefits and application process to purchase service credit for time spent on active duty in the U.S ...For NYCERS members who wish to apply for reinstatement of a former membership with NYCERS or any other New York City or New York State public retirement system. If you are eligible, reinstatement could change your Tier and membership date, and may affect your contribution rate and retirement benefits. ... Forms and Correspondence …Customer Service Center Call Center Hours Monday-Friday, 8am - 5pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free

An explanation of what documents NYCERS will accept from members, retirees, or beneficiaries as proof of their name (not proof of date of birth) or change of name. Download PDF; ... Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30-30 47th Avenue, 10th Floor Long Island City, NY 11101If your bank account information is incorrect, the bank will return the funds to NYCERS electronically, and you will need to contact NYCERS to have a replacement check mailed. ... Mail your completed form or correspondence to: 30-30 47th Avenue, 10th Floor Long Island City, NY 11101 Read more; Contact link December 6, 2016. Main Office.If you previously filed a Service Retirement Application with NYCERS, you may change your retirement date by filing this form with NYCERS up to the day before your effective retirement date. ... Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30-30 47th Avenue, 10th Floor Long Island City, …Mail completed form to: 30-30 47th Avenue,10th Fl Long Island City, NY11101 *302* F302 Page 1 of 4 NYCERS USE ONLY First Name M.I. Last Name City State Zip Code Address Apt. Number If you have an official seal, affix it Signature of Notary Public or Commissioner of Deeds Official Title Expiration Date of CommissionAbout NYCERS. The New York City Employees’ Retirement System (NYCERS) was founded by the New York State Legislature in 1920 with 13,331 members. Today, NYCERS has grown into the largest municipal public employee retirement system in the United States with more than 350,000 active members and retirees including civilian employees such as ...

If you previously filed a Service Retirement Application with NYCERS, you may change your retirement date by filing this form with NYCERS up to the day before your effective retirement date. ... Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30-30 47th Avenue, 10th Floor Long Island City, …Service Retirement Kits. Members with a registered MyNYCERS account can log in to apply for Service Retirement online instead of submitting a paper application. For paper applications, you may download all the necessary Service Retirement forms at once by downloading a retirement kit below.The ACFR consists of five sections: the Introductory Section, the Financial Section, the Investment Section, the Actuarial Section, and the Statistical Section. NYCERS has received the Government Finance Officers Association award for achievement in excellent financial reporting every year since 1986. Download the 2023 ACFR. Chat with us.NYCERS encourages all active, vested or retired members (retired after 9/11/01) who participated in WTC Rescue, Recovery or Clean-up Operations between September 11, 2001 and September 12, 2002 to file a Notice of Participation Form #622 before September 11, 2026. While the original law required that you were a member during your period of ...NYCERS Members, Your Annual Disclosure Statement Is Ready! ... Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30-30 47th Avenue, 10th Floor Long Island City, NY 11101 Read more; Contact link December 6, 2016. Main Office. Executive OfficesIn order to begin the process of identifying the decedent and their beneficiaries, and determining the death benefits payable, NYCERS will need some general information, including the decedent’s: Full name. Member number or pension number. Last four digits of their Social Security Number. Date of death. Place of death (City/State/Country ...

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Mail completed form to: 30-30 47th Avenue,10th Fl Long Island City, NY11101 *302* F302 Page 1 of 4 NYCERS USE ONLY First Name M.I. Last Name City State Zip Code Address Apt. Number If you have an official seal, affix it Signature of Notary Public or Commissioner of Deeds Official Title Expiration Date of CommissionDec 27, 2023 · Customer Service Center Call Center Hours Monday-Friday, 8 am – 5 pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Authorization for Release of InformationForm #615. Authorization for Release of Information. Form. Use this form to authorize the New York City Employees’ Retirement System (NYCERS) to provide information and/or records to someone other than the NYCERS member, retiree or beneficiary. Download PDF.Tax season is fast approaching! Are you ready for it? This article will explain what a W9 form is, who needs to fill one out, and why it's important for businesses and individuals ...

NYCERS USE ONLY F203 R /22 340 Jay Street, Bklyn, NY Mezzanine level 30-30 47th Avenue, 10th Fl. Long Island City, NY 11101 Upload Documents at www.mynycers.org (347) 643-3000 www.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at Page 1 of 1 Mail Completed Forms to: 30-30 47th Avenue, 10th FlPlease have your Member or Pension number ready when contacting NYCERS’ Call Center. Due to increased call volume, you may experience longer wait times, and voicemails may be returned after hours. (347) 643-3000 – Call Center. (877) 669-2377 – If calling from outside the New York City area (toll-free) (347) 643-3501 – TTY (hearing impaired)Customer Service Center Call Center Hours Monday-Friday, 8am - 5pm (347) 643-3000 Within NYC (877) 669-2377 Toll-FreeMail Completed Forms to t Aenue t on nd t N 1101 YCR Y 604 R23 340 Jay Street, Bklyn, NY Mezzanine level 30-30 47th Avenue, 10th Fl. Long Island City, NY 11101 Upload Documents at www.mynycers.org (347) 643-3000 www.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at Tier 4 with Tier 3 Rights, Social Security DependentForm. Military service must have been satisfactorily completed and a discharge under honorable circumstances must have been granted. A DD214 form is the most common proof of satisfactory military service. Download PDF. Brochure 902. Eligibility, benefits and application process to purchase service credit for time spent on active duty in the U.S ...Designation of Beneficiary - Tier 3, Tier 4, and Tier 6 - New York City Employees' Retirement System. Designation of Beneficiary – Tier 3, Tier 4, and Tier 6. Form #133 is temporarily unavailable. Form. To make changes to your beneficiaries or their designated guardians, log in to your MyNYCERS account and look for “Manage Beneficiaries ...NYCERS Members, Your Annual Disclosure Statement Is Ready! ... Forms and Correspondence Mailing Address Mail your completed form or correspondence to: 30-30 47th Avenue, 10th Floor Long Island City, NY 11101 Read more; Contact link December 6, 2016. Main Office. Executive OfficesOn my census form it says, 'Your response is required by law.' What happens to me if I don't fill it out? Will anyone even notice? Advertisement In the United States, the census is...Forms & Publications. Plan Descriptions; Forms, Brochures and Fact Sheets; Service Retirement Kits; Disability Retirement Kits; Annual Comprehensive …Customer Service. Call Center (347-643-3000) is open Monday through Friday, 8 am to 5 pm, to answer questions and schedule consultations. Telephone and video consultations are available to maximize your health and safety. Please have your Member or Pension number ready when contacting NYCERS’ Call Center. Due to increased call volume, you may ...Health Benefits Program. 22 Cortlandt Street, 12th Floor. New York, NY 10007. 3) Inquiries and questions can be emailed to [email protected] - do not send forms through email (see #1 and #2 above) 4) For questions regarding the PICA prescription drug benefit program please call 1-800-467-2006. 5) If you are a HIP-HMO member turning 65 ...

Dec 27, 2023 · Customer Service Center Call Center Hours Monday-Friday, 8 am – 5 pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments.

Medicare-eligible retirees and their Medicare-eligible dependents will be reimbursed annually for the standard Medicare Part B amount of $170.10 per month ($170.10 x 12 months = $2,041.20), excluding any penalties and late enrollment fees, and subject to be pro-rated. 2022 Medicare Part B reimbursements were issued in April 2023.Mail Completed Forms to: 33 A 1 1111 NYCERS SE ONY F331 R Page 1 of 2 340 ay Street, Bklyn, NY Meanine level 30-30 47th Avenue, 10th Fl. Long Island City, NY 11101 pload Documents at www.mynycers.org (347) 643-3000 www.nycers.org M - F, am to pm Forms, Brochures, Fact Sheets at *331*6 reviews and 4 photos of NYCERS "One of the most professional & courteous NYC agencies around. Information can be obtained in person, snail mail, call center, & their …NYCERS ˜˚˛˝˙ˆˇ˘ ˚˙˙ ˝ ˙ ˙ˆ˙˜ ˝ ˚ ˙ˆ 340 Jay Street, Bklyn, NY Mezzanine level 30-30 47th Avenue, 10th Fl. Long Island City, NY 11101 Upload Documents at www.mynycers.org (347) 643-3000 www.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at Simultaneous Filing of Retirement Applications Fact Sheet #756 – Page 1Mail completed form to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 *371* F371 NYCERS USE ONLY First Name M.I. Last Name City State Zip Code Address Apt. Number Banking Operations Affidavit Page 1 of 1 To help prevent fraud and ensure your identity is secured, we ask that you complete and return this form to the mailing address below forCustomer Service Center Call Center Hours Monday-Friday, 8 am – 5 pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments.Build lasting relationships with sponsors by using sponsorship forms templates to create forms that are visually appealing and easy to navigate. Trusted by business builders worldw...this form is different from your address in our system, the new address will become your official address in our records. Should you have any questions, please contact our Call Center at 347-643-3000. I request that my name be changed on NYCERS' records from: First Name M.I. Last Name First Name M.I. Last Name To: First Name M.I. Last NameThere are so many different types of forms that you can sell online to make people's lives easier. If you have a law background, or just a knack for creating standard forms, you ca...

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This application is for Tier 3 and Tier 4 vested members who wish to receive payment of their Vested Retirement Benefit. When you left City service you filled out a “notice of intention”, form #254, to vest your retirement benefit. It is important that you read the conditions below. Please be sure that you nominate a beneficiary or your ...Application for Membership for NYCERS-Eligible Employees – Tier 3, Tier 4, and Tier 6 Form #103. Form August 29, 2016. ... Forms and Correspondence Mailing AddressCustomer Service Center Call Center Hours Monday-Friday, 8am - 5pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Freewww.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at Mail Completed Forms to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 NYCERS USE ONLY F204 R /22 Page 2 of 8 Member Number Pension Number Last 4 SSN PRINCIPAL - Sign this form and have it notarized, Page 5Please have your Member or Pension number ready when contacting NYCERS’ Call Center. Due to increased call volume, you may experience longer wait times, and voicemails may be returned after hours. (347) 643-3000 – Call Center. (877) 669-2377 – If calling from outside the New York City area (toll-free) (347) 643-3501 – TTY (hearing impaired)Find the 20 most requested forms and documents for NYCERS members, retirees, and beneficiaries. Download or apply online for direct deposit, loan, buyback, retirement …R12/16. Mail completed form to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101. *310*. F310. Page 1 of 2 NYCERS USE ONLY. First Name M.I. Last Name City State Zip Code Address Apt. Number. Request for Change to Recent Loan Application Tier 3, Tier 4 and Tier 6 Basic and Special Plan Members.Forms rocures Fact Seets at M C F 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 About This Form This form is for NYCERS Retirees and Beneficiaries who wish to change the amount of Federal income tax withheld from their monthly pension payments. NYCERS cannot counsel you on tax matters. If you need assistance in determining which tax ….

Dec 27, 2023 · The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Read more Contact link April 19, 2017 NYCERS USE ONLY F203 R /22 340 Jay Street, Bklyn, NY Mezzanine level 30-30 47th Avenue, 10th Fl. Long Island City, NY 11101 Upload Documents at www.mynycers.org (347) 643-3000 www.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at Page 1 of 1 Mail Completed Forms to: 30-30 47th Avenue, 10th FlMail completed form to: 30-30 47th Avenue,10th Fl Long Island City, NY11101 *302* F302 Page 1 of 4 NYCERS USE ONLY First Name M.I. Last Name City State Zip Code Address Apt. Number If you have an official seal, affix it Signature of Notary Public or Commissioner of Deeds Official Title Expiration Date of CommissionArticle 14-B Disability Retirement Application. For county sheriffs, undersheriffs and certain deputy sheriffs whose employers elected coverage under Sections 555, 556, 557 or 558 of the Retirement & Social Security Law (RSSL). This is a two-page form and a HIPAA waiver. Please submit all three pages.NYCERS’ records. Should you have any questions regarding this application, please contact NYCERS’ Call Center at 347-643-3000. *103* Application for Membership. For NYCERS-Eligible Employees . Sign this form and have it notarized, Page 3. Social Security Number Date of Birth [MM/DD/YYYY] In Care of (if applicable) Daytime Phone NumberPlease have your Member or Pension number ready when contacting NYCERS’ Call Center. Due to increased call volume, you may experience longer wait times, and voicemails may be returned after hours. (347) 643-3000 – Call Center. (877) 669-2377 – If calling from outside the New York City area (toll-free) (347) 643-3501 – TTY (hearing …A T3 slip is a Canadian tax form that reports income from trusts for a tax year. An individual taxpayer will include the amounts reported on the T3 on his personal tax return. A co...Affidavit of Personal Service IncomeForm #351. This form is to be completed annually by all Tier 3, Tier 4 and Tier 6 Disability Retirees to verify your eligibility for continued disability benefits. Find out more about Personal Service Income. Download PDF. Form 354. Nycers forms, Important Notice. The Health Benefits Retiree client service walk-in center is closed. Please resubmit your documents as follows: 1) Forms/documents can be submitted …, The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Read more Contact link April 19, 2017, Application to Purchase Credit for Service Rendered Prior to Membership Date in NYCERS (Buyback)Form #241. Use this application to purchase (buyback) previous full-time or part-time public service rendered within New York State prior to your NYCERS membership. Note: Tier 1 members may only buy back public service …, Your Tier is generally determined by your title and the date you joined NYCERS, as follows: Tier 1 – Members who joined NYCERS prior to July 1, 1973. Tier 2 – Members who joined NYCERS between July 1, 1973 and July 26, 1976, and DA Investigators who joined NYCERS between July 1, 1973 and March 31, 2012. Tier 3 – …, Customer Service Center Call Center Hours Monday-Friday, 8 am – 5 pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments., Customer Service Center Call Center Hours Monday-Friday, 8am - 5pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free, Form. For NYCERS members who wish to apply for reinstatement of a former membership with NYCERS or any other New York City or New York State public retirement system. If you are eligible, reinstatement could change your Tier and membership date, and may affect your contribution rate and retirement benefits. Download PDF. Brochure., Customer Service Center Call Center Hours Monday-Friday, 8 am – 5 pm (347) 643-3000 Within NYC (877) 669-2377 Toll-Free (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments., Planets and how they form are explained in this article from HowStuffWorks. Learn about planets and planet formation. Advertisement It's staggering to imagine a time when the Earth..., Adhere to our easy steps to have your Nycers Form 361 ready quickly: Pick the template from the catalogue. Enter all required information in the required fillable fields. The intuitive drag&drop graphical user interface makes it simple to add or move fields. Ensure everything is filled in appropriately, without any typos or absent blocks., NYCERS USE ONLY F203 R /22 340 Jay Street, Bklyn, NY Mezzanine level 30-30 47th Avenue, 10th Fl. Long Island City, NY 11101 Upload Documents at www.mynycers.org (347) 643-3000 www.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at Page 1 of 1 Mail Completed Forms to: 30-30 47th Avenue, 10th Fl, Monday-Friday, 8am - 5pm. (347) 643-3000 Within NYC. (877) 669-2377 Toll-Free. (347) 643-3501 TTY. The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday-Friday, 8am -5pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Forms and Correspondence Mailing Address., The adjusted gross income value is one of the most important numbers for every tax filer who files Form 1040. But finding this value may require you to fill out other forms. For th..., Find the most common forms and fact sheets for NYCERS retirees, such as change of address, name change, tax withholding, and beneficiary designation. Download or submit online the forms you need for your pension verification, payment, or information request., INSTRUCTIONS FOR COMPLETING THIS FORM. If you need assistance completing this form please contact NYCERS at 347-643-3000. Complete this form in ink or type. Except for signature, please print all items. At the top of this form, print your Membership #, Social Security #, Date of Birth, name, and complete address., 30-30 47th Avenue, 10th Fl Long Island City, NY 11101. Member Number OR. Pension Number. Last 4 Digits of SSN. If the foregoing Primary beneficiary(ies) should predecease me, I hereby nominate the following as Contingent beneficiary(ies) for the above Post-Retirement Lump-Sum Death Benefit. First Name. M.I., Find the 20 most requested forms and documents for NYCERS members, retirees, and beneficiaries. Download or apply online for direct deposit, loan, buyback, retirement option, name change, and more. , Forms, Brochures, Fact Sheets at Top 10 Reasons to Join NYCERS Pension – An Invaluable Benefit Your membership with NYCERS provides a guaranteed income for life upon retirement, as well as the opportunity to provide a continued retirement benefit to a designated beneficiary upon your death after retirement. Less Taxable Federal Income, Find the most common forms and fact sheets for NYCERS retirees, such as change of address, name change, tax withholding, and beneficiary designation. Download or submit online the forms you need for your pension verification, payment, or information request., Mail Completed Forms to t Aenue t on nd t N 1101 YCR Y 604 R23 340 Jay Street, Bklyn, NY Mezzanine level 30-30 47th Avenue, 10th Fl. Long Island City, NY 11101 Upload Documents at www.mynycers.org (347) 643-3000 www.nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at Tier 4 with Tier 3 Rights, Social Security Dependent, The Walk-in Center at 340 Jay Street in downtown Brooklyn is open Monday – Friday, 8 am – 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Read more Contact link April 19, 2017, Learn how to sign up for MyNYCERS, your online portal to your NYCERS pension account. You can file forms and applications, view your pension information, and access other …, www .nycers.org M - F, 8am to 5pm Forms, Brochures, Fact Sheets at *351* This form is to be completed annually by all Tier 3, Tier 4 and Tier 6 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, The form and letter may be faxed to 347-643-3884, emailed to NYCERS at [email protected], or mailed to NYCERS at 30-30 47th Ave., Suite 1010, Long Island City, NY 11101. If received, the retiree’s benefit will not be suspended. If you are 85 or older and do not live in a nursing home, please call NYCERS at 347-643-3000., For specific information about your NYCERS account, please contact NYCERS’ Call Center at (347) 643-3000 or visit NYCERS’ Walk-in Center at 340 Jay Street in downtown Brooklyn. ... 5 pm, for drop off of fully completed forms, answers to quick inquiries, and appointments. Read more; Contact link April 19, 2017. Clone of Email. …, Want to know how to create a contact form in WordPress? Learn how to do so using a simple WordPress form plugin in this guide. Plus, other plugin options. Installing & Customizing ..., Complete this form in its entirety, sign it, and mail it to NYCERS, 30-30 47th Avenue, 10th Floor, Long Island City, NY 11101. If you wish to file this form in person, visit NYCERS’ Customer Service Center on the Mezzanine level of 340 Jay Street in downtown Brooklyn. Sign this form and have it notarized, THIS PAGE , address you provide on this form is different from your address in NYCERS' system, the new address will become your official address in NYCERS' records. If you have any questions regarding this form, please contact NYCERS' Call Center at 347-643-3000. TYPE OF CHECK(S) LOST (please check all applicable boxes from Section A and/or Section B): , You may drop off your notarized Loan Application Form #302 in person at NYCERS’ Walk-in Center at 340 Jay Street, Brooklyn, NY 11201. Repayment The current interest rate on a Tier 3, 4 and 6 loan is 6.2% – 6% basic interest rate plus 0.2% mandatory loan insurance premium. All loans except non-performing loans are fully insured 30 days, NYCERS’ online loan application enables Tier 4, Tier 6 and eligible Tier 3 members with a registered MyNYCERS account to log in to their accounts, calculate various loan options, and then apply for a loan online. If you apply online and select Direct Deposit (Electronic Funds Transfer, or EFT), your loan will be processed in three (3) business …, Mail completed form to: 30-30 47th Avenue, 10th Fl Long Island City, NY 11101 I understand that by signing this form, I am confirming that the information on this form, to the best of my knowledge, is correct. NYCERS USE ONLY F181 Member Number Last 4 Digits of SSN Page 2 of 2 Sign this form and have it notarized, THIS PAGE , Insider is looking for nominations for the 2023 edition of our list of the 30 people under 40 who are shaping the future of healthcare. 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