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NIS Forms

NIS Forms

Claim, Registration, Student Loan, Grants, Employer, Canada, CARICOM

Document Name Description File Download
Pension    
Age Benefit Claim Form [NEW – June 1, 2024 ] This form is filled out by person nearing the age of pension or persons already attaining the pensionable age. Download
Age Benefit Claim Form [OLD 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
Sickness/Employment Injury    
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
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 [NEW] 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 [NEW – June 1, 2024] This is the form that self-employed persons use to register with the NIS Download
Voluntary Contributor Registration Form [NEW – June 1, 2024] This is the form that voluntary contributors 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 [NEW – June 1, 2024] 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
Form C5 [OLD Form] 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
C5(b) Combined Monthly Contribution Schedule [NEW – June 1, 2024] 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
C5(b) Combined Monthly Contribution Schedule [OLD] 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
Weekly Schedule 2024 [NEW – June 1, 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
Form C1A [NEW Form] 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
Form C1A [OLD Form] 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    
Voluntary Contribution Form (Overseas)[OLD Form] This is the form that Voluntary contributors residing abroad use to register with the NIS. Click here for information on Voluntary contributions Download
Voluntary Contribution Form (Local)[OLD Form] This is the form that Voluntary contributors residing in SVG use to register with the NIS. Download
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
Student Loan Programme    
Regular Student Loan Form This form is for students applying for a student loan Download
Student Loan Form for the Economically Disadvantaged This form is for Economically Disadvantaged students applying for a student loan 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