Fillable ersri form

APPLICATION FOR REFUND OF ACCUMULATED CONTRIBUTIONS TO MEMBER EMPLOYEES RETIREMENT SYSTEM OF RHODE ISLAND 50 Service Avenue 2nd Floor Warwick RI 02886-1021 Office 401 462-7600 Fax 401 462-7691 Email ersri ersri. If A is selected ERSRI will withhold 20 Federal taxes on the taxable portion of the refund paid directly to the spouse. If option B is selected the enclosed Agreement of Trustee/Custodian must be completed...
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