State University of New York
Retirement Program		
Election Form
(Please type or print)

Name:
     
SS#:
     
Phone#:
     
College:
     

(This form must be submitted to the Office Human Resources of your college within 30 days 
of your initial date of eligible appointment.)

Having satisfied myself as to the desired retirement program available to me by or pursuant to law in 
connection with my employment by State University of New York, I hereby elect to participate in the 
retirement program specified below.

0 1. New York State Teachers' Retirement System

0 2. New York State Employees' Retirement System

0 3. SUNY Optional Retirement Program

0 A. Teachers Insurance and Annuity Association and College Retirement 
Equities Fund, (TIAA-CREF)

Alternative Funding Vehicles (AFV)
(Note: If you participate in an AFV, you must also elect CREF)

0 B. ING Financial Services

0 C. Metropolitan Life and Affiliated Companies

0 D. AIG Retirement 

0 4. I have been advised of my eligibility and elect to decline membership in a
         Retirement System at this time (only for non-mandatory positions)

Signature:

Date:
     
												(mm/dd/yyyy)

Note: Upon timely receipt of this form, the Human Resources Office will send you the appropriate application 
and other forms for the retirement program you have elected above.


Revised:  May, 2008			ORP-1