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Document Checklist - Deceased Victim Claim

May 22, 2026
Resource type

Change Log:

May 22, 2026:

  • Included required documents under replacement services section
  • New information under pension information for Police and Firemen’s Retirement System of New Jersey (PFRSNJ)
  • Default health insurance amount revised from $2,400 to $7,654
  • Clarification about Personal Representative documentation
  • Added proof of presence section directing claimants to the Interactive Presence Guide and listing eligible dates and sites
  • Revised language related to life insurance documents
  • New section to address burial and funeral expense receipts

February 13, 2026: added text stating that ACH form can be uploaded instead of only mailed or faxed.

December 9, 2024: Updates made in support of policy change to allow amendments for deceased claims. Also updated to indicate that NYSLRS now requires an Exhibit B1 Form for spouses and beneficiaries.

February 1, 2024: Added replacement services section detailing required documents.

June 21, 2023: Updated to include that NYSLRS will only accept original or court certified Letters of Administration.

May 26, 2023: Removed text next to Claim Form Appendix A stating "only required if filing a hard copy claim form".

Updated the document checklist to remove the need for originals, including Exhibit A, and removed Exhibit 1 from the minimally required document list.

November 15, 2022: Notable updates include:

  • Updated information regarding documents to prove presence.
  • Changes related to NYSLRS members and documents to support claims for lost earnings.
  • Removed references to NYCERS/NYSLRS worksheet and Union and Defined Benefit Plan worksheet as these documents are no longer needed for these claims.
  • Added reference to new Lead Personal Representative Form.
  • On Deceased Checklist – added clarifying language re: life insurance.
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