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Board of Police Officer Relief

Police saluting

Per RI General Law 45-19-2, within the Department of Labor and Training there is a board of police officer's relief consisting of seven members which administers the fund for the relief of police officers.

Please complete the required forms below. Forms can be filled out online, printed and signed. Some forms must be notarized. Please use checklist to make sure you've included all required documentation. Incomplete forms will not be processes

Mail all forms to:
Relief of Injured and Deceased Police and Fire Fighters
Rhode Island Department of Labor and Training
1511 Pontiac Avenue, Building 73-2 
Cranston, RI 02920 

Please email questions to DLT.PoliceFire@dlt.ri.gov

Click here to read the Rules and Regulations for the Board of Policemen's Relief.

Annuity Forms


One Time Death Benefit Application

Petition for Widow Benefits

Affidavit (Annual)

Direct Deposit Authorization

W-9 Payer's Request for Taxpayer Identification Number and Certification

Change of Address Form

Death of Widow or Dependent Form

Checklist of items to include with your application for benefits:

  • Death Certificate (if applicable)
  • Letter from Police Department stating dates of service
  • Copies of Birth Certificates for Dependent Children (if applicable)
  • Form W-9
  • Direct Deposit Application


Click here to read RI General Law 45-19-4

Tuition Reimbursement


Forms must be completed by the following dates:

Fall Semester: June 30
Winter Session: September 30
Spring Semester: October 30 Summer Session I: March 31
Summer Session II: April 30
Eligibility Application for Tuition Benefits

Tuiton Request Affidavit - Deceased
     (include Death Certificate)

Tuition Request Affidavit - Disabled

Statement of Officer

First time applicants must also include:

  • A copy of their Birth Certificate
  • A Letter from the Police Department stating dates of service of their parent

Click here to read RI General Law 45-19-4.1

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