Other Downloads
2012 Vehicle Identification Form


Click here to download



2012 OCA Transfer Form

Please send to OCA and Union
Click here to download




ELECTION RESULTS



Click here to download



Off Duty Application And Policy


Click here to download



New York Safety Program(6) Hour class

Copy of Flyer for Defensive Driving Program in PDF format
Click here to download



NYSC Sports Clubs

Fact sheet on The Sports Club discount
Click here to download



Saint Josephs College Flyer

This is a copy of the St. Joseph's College program for any Full-Time NYS COURT CLERKS.
Click here to download




Mt Sinai Health Registry

Click here to download




9-11 FORM

Copy of 9-11 form to send to retirement system.
Click here to download



Retirement Options Form (All tiers)


Click here to download



UNUM Adjustment Form and Rate Chart

Unum adjustment form for upgrading or reducing coverage.
Click here to download




New Co-Pay schedule

This is a copy of the new co-pay schedule that will be put into effect slowly.
Click here to download



Stacey Braun Card

Copy of Stacey Braun Card for Financial Planning Call for appointment 1-888-949-1925
Click here to download




TD Bank Flyer

Copy of TD Bank Flyer for Chinatown branch.
Click here to download




BJ'S Application

Click here to download



Sick Leave Formula for Retirees


Click here to download




OCA Retirement Package


Click here to download



Retiree Pamphlet


Click here to download


Madison Planning Flyer

Click here to download



Adult Continuing Education Application

Click here to download



Veteran and Volunteer Fireman Form

You must fill out this form to get credit for veteran or volunteer fireman. You must get a confirmation for human resources that they received the form.
Click here to download





Update Member/Dependant Downloads

Change of Address form


Click here to download



Beneficiary Change


Click here to download




Name Change Form


Click here to download




Change of Benefit Status


Click here to download






Reimbursement Claim Downloads

Non-Participating Optical Reimbursement Form

Non-Participating Optical reimbursement form plus guideline for submitting request for payment.
Click here to download


Hospital Reimbursement Form


Please use this form for all Hospitalization claims.
Click here to download



Corrective Eye Surgery Reimbursement

Click here to download



Hearing Aid Reimbursement Form

Click here to download




Dental Claim Form

NYS Court Clerks Dental Form for active and retirees.

Click here to download