Please fill in as much information below as possible. Once you have submitted this information, you will receive a acknowledgement letter from the NC Retirement Systems within 7-10 business days.

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* 1. Decedent's name

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* 2. Are you reporting the death of a Retirement Systems' member, or a beneficiary of a member?

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* 3. If you are reporting a beneficiary of a Retirement Systems' member, was the beneficiary also a Retirement Systems' member?

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* 4. Last 4 digits of decedent's Social Security Number, or Member ID

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* 5. Date of death

Date

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* 6. Decedent's spouse's name (if applicable)

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* 7. Decedent's address

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* 8. Your name

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* 9. Your phone number

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* 10. Your relationship to the decedent

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* 11. Executor or responsible party's name (if applicable)

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* 12. Executor or responsible party's address (if not spouse)

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* 13. Please mail a certified copy of the death certificate to:
Death Benefits
N.C. Dept. of State Treasurer
3200 Atlantic Avenue
Raleigh, NC 27604

Or upload a certified copy of the death certificate here:

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