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Board of Police Officer Relief

If you have any questions, please email us at DLT.PoliceFire@dlt.ri.gov or call 462-8855. We will respond as soon as we can. Thank you!

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 notorized. Please use checklist to make sure you've included all required documentation. Incomplete forms will not be processed.

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 Police Badge

Annuity Forms   Tuiton Reimbursement 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


Forms must be completed by the following dates:
Fall Seminster: June 30
Winter Session: September 30
Spring Semister: October 30 Summer Session I: March 31
Summer Session II: April 30
> Eligibility Application for Tuition Benefits

> Tuiton Request Affidavit - Deceased
     (include Death Certificate)

> Tuiton 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   Click here to read RI General Law 45-19-4.1
Click here to read the Rules and Regulations for the Board of Policemen's Relief

RI Department of Labor and Training
Center General Complex
1511 Pontiac Avenue, Cranston, RI 02920

Phone: (401) 462-8000
Fax (401) 462-8872
TTY via RI Relay: 711
1/30/19 MDF
State Seal
  DLT is an equal opportunity employer/program - auxiliary aids and services available upon request