Forms - NJDCEA

914-949-8529 | president@njdcea.org

Enrollment Forms

Association Enrollment

Anthem Beneficiary

New Member Enrollment Package

Reimbursement Forms

Inner Imaging Benefit Claim Form

Education Reimbursement Form

Dental Reimbursement Form

Hearing Aid Reimbursement Form

Medical Reimbursement Form - Active members

Optical Reimbursement Form

Promotional Exam & Material Form

Claim Form for Retired Members

Other Documents

Affidavit of Dependency

Change of Address Form

Change of Benefit Status Form

Domestice Partnership Form

Guardian Life Insurance Beneficiary Form

Parking Placard Form - 2021-2022

Voluntary Reassignment Form

Our Courts

Westchester Supreme and County Courts

111 Dr. Martin Luther King Boulevard
White Plains, NY 10601

Yonkers City Court

100 South Broadway
Yonkers, NY 10701

Westchester County Family Court - Yonkers

131 Warburton Avenue,
Yonkers, NY 10701

Westchester County Family Court - New Rochelle

26 Garden Street
New Rochelle, NY 10801

White Plains City Court

77 South Lexington Avenue
White Plains, NY 10601

Rockland Supreme and County Courts

1 South Main Street
New City, NY 10956