NIS Forms
Self Employed Sickness/Injury
| Document Name | Description | File Download |
|---|---|---|
| Pension | ||
| Age Benefit Claim Form | This form is filled out by person nearing the age of pension or persons already attaining the pensionable age. | Download |
| Survivors Benefit Claim Form | Persons claiming for the Survivor’s Benefit would use this form. The form also makes provision for children of claimants on the other page. | Download |
| Invalidity Benefit | To be completed by an insured person who was granted an invalidity benefit by the medical board. | Download |
| Disablement Claim Form | To be completed by an insured person who was granted disablement by medical board. | Download |
| Life certificate Form | All pensioners are required to complete this form twice per year on or before July 31st and January 31st. | Download |
| Maternity | ||
| Maternity Allowance / Grant Form | This form is completed by a woman who is pregnant and must be submitted no later than six weeks before the expected date of confinement or within one month after the birth of the baby. | Download |
| Certificate of Confinement Form | To be completed by an insured woman within one month after confinement | Download |
| Claim for maternity grant on behalf of spouse | To be completed by wife/common-law wife of an insured. Must be submitted within one month of confinement. | Download |
| National Provident Fund | ||
| National Provident Fund (NPF) Claim Form | This form should be submitted on reaching age 60 years or on permanent incapacity. Only persons with NPF contributions are eligible | Download |
| NPF Survivor’s Claim Form | To be submitted by the named beneficiary of a deceased NPF member or an administrator for the benefits. | Download |
| Registration Forms | ||
| Employee Registration Form | This is the form that is filled out and returned to the NIS office or is filled out at the NIS office with the required Birth Certificate or Passport | Download |
| Employers Registration Form | Employers must register with the National Insurance Scheme by Law. When registering, Employers are required to fill out the Employer Registration form and return it to the NIS office | Download |
| Self employed Registration Form | This is the form that self-employed persons use to register with the NIS | Download |
| Funeral Grant | ||
| Funeral Grant Form | This form is used by persons claiming funeral grant | Download |
| Funeral Grant Form on behalf Of | To be submitted by an insured person who is claiming for death of an uninsured child/spouse | Download |
| Wage Reporting | ||
| Form C5 | This is the form that employers use when submitting their employees’ wages to the National Insurance manually. This form is recommended if you have more than ten employees. This should be submitted with the C2 remittance form. | Download |
| Weekly Schedule 2024 | Wages week of daily paid workers and the number of contribution weeks in each month | Download |
| Weekly Schedule 2023 | Wages week of daily paid workers and the number of contribution weeks in each month | Download |
| Weekly Schedule 2022 | Wages week of daily paid workers and the number of contribution weeks in each month | Download |
| Weekly Schedule 2021 | Wages week of daily paid workers and the number of contribution weeks in each month | Download |
| Weekly Schedule 2020 | Wages week of daily paid workers and the number of contribution weeks in each month | Download |
| Weekly Schedule 2019 | Wages week of daily paid workers and the number of contribution weeks in each month | Download |
| Weekly Schedule 2018 | Wages week of daily paid workers and the number of contribution weeks in each month | Download |
| C2 Remittance Form | This is the form that employers use when presenting their employees’ wages, in a shorter format for small business employers. | Download |
| Combined Monthly Contribution Schedule | This is the form that employers use when submitting their employees’ wages to the National Insurance manually. This form is recommended if you have ten employees or less. | Download |
| Form C1A | This is the utilized by employers to present a summary of each employee details for the entire year. It is used in tandem with the Form C1/1 to be submitted by March 31st each year. | Download |
| Voluntary Contributions | ||
| Payment Voucher Voluntary Contribution | This is the form that Voluntary contributors use to make payments to the NIS. | Download |
| Payment Voucher Self Employed | This is the form that the Self Employed use to make payments to the NIS. | Download |
| Sickness Benefit/Employment Injury Claim Form | As the name suggests this form facilitates both the Injury Benefit as well as the Sickness Benefits. For more information on who should claim using this form review the Employment Injury requirements and or the Sickness Benefit requirements | Download |
| Employment Injury Report Form | This form should be submitted when reporting injuries relating to employment | Download |
| Canada | ||
| Canada – SVG Age Benefit Claim Form | This form is filled out by person nearing the age of pension or persons already attaining the pensionable age for Vincentian nationals in Canada | Download |
| Canada – SVG Funeral Grant Form | This form is used by persons claiming funeral grant | Download |
| Canada – SVG Invalidity Benefit | Download | |
| Canada – SVG Survivors Benefit Claim Form | Download | |
| CARICOM | ||
| Caricom – Retirement/Age Pension Application | Download | |
| Caricom – Invalidity Pension Application | Download | |
| Caricom – Survivors’ Pension Application | Download | |
| Caricom – Industrial Disablement/Occupational Disease Pension Application | Download | |
| Caricom – Industrial Death Benefit Application | Download | |
| Caricom – Certificate of Dependency | Download | |
| Caricom – Notification of Claim Received | Download | |
| Caricom – Details of Insurance Periods completed by Claimant/ Deceased Person | Download | |
| Caricom – Customer Service Questionnaire | Download |