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.

Question Title

* 1. Decedent's name

Question Title

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

Question Title

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

Question Title

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

Question Title

* 5. Date of death

Date

Question Title

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

Question Title

* 7. Decedent's address

Question Title

* 8. Your name

Question Title

* 9. Your phone number

Question Title

* 10. Your relationship to the decedent

Question Title

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

Question Title

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

Question Title

* 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:

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File
No file chosen

T