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Date:February 7, 2007
Bulletin Number: 698
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Subject

Amended Next of Kin Affidavit Form (AC 934-P) for OSC’s Bureau of State Payroll Services

Purpose

To notify agencies of the revised Next of Kin Affidavit form, AC 934-P (Rev. 10/06), for payroll transactions.

Affected Employees

Beneficiaries of deceased State employees.

Effective Date(s)

Immediately.

OSC Actions

The Next of Kin Affidavit form, AC 934-P (Rev. 10/06), is revised to include additional information per OSC's Division of Legal Services and Internal Revenue Service regulations. 

NOTE:  OSC will accept only this new revised form for all payroll transactions.

Agency Actions

Agencies must use the revised Next of Kin Affidavit form, AC 934-P (Rev. 10/06), and discard all prior versions.

Click here to access the Next of Kin Affidavit form available on the OSC Web site.

Agencies also may contact OSC’s Office Services by telephone at 518-474-3438 or by fax at 518-473-4560 to request a supply of the new form.  Agencies must specify the AC 934-P form for payroll transactions.

Attachment

AC 934-P Next of Kin Affidavit.

Questions

Questions regarding this bulletin may be directed to the Payroll Deductions mailbox.