Opt out form - Pensions

TR 263 (IOM) 1
Isle of Man Teachers Superannuation Order 2007
Pension scheme opt out form
You can opt out of the Isle of Man Teachers Superannuation Order 2007 (the Scheme) using this
form. This means you will not be a member of the Scheme and will not be using it to save for your
retirement. This form must be read in conjunction with the Teachers Opting Out Fact Sheet (TFS1).
Section 1 – Your personal details
Title (Mr, Mrs, Miss, Ms)
Surname
Previous Surname (if applic)
Other names
Address
Scheme Number (if known)
National Insurance number
Date of birth
Employer and location
Teachers Ref Number if known
Section 2 – Your declaration
I have read the notes overleaf and the related fact sheet and in full knowledge of the potential benefits
available to me, I declare that I do not wish to remain a member of the Scheme and that after this
election takes effect I will no longer be pensionable under the Scheme.
I understand that I will not be able to claim any benefits under the Scheme in respect of any
employment covered by this election. These include:
» A fully inflation-protected retirement pension payable from retirement based on my pay and
length of service.
» My employer contributing towards the cost of my benefits.
» The option to take a tax-free lump sum.
» A survivor pension paid to my eligible partner if I die.
» Death benefits including lump sum payable to my beneficiaries.
» Children’s pensions if I die.

TR 263 (IOM) 2
» Access to Ill-health retirement benefits.
I have read and understand the points on page 1 and above.
Your signature
Date
Notes:
You must now forward this application to your last employer to complete Section 3. If you have more
than one employer, each must complete a Section 3.
Section 3 – To be completed by your Employing Authorities pay office
The section below is to be completed by your relevant payroll or finance representative once you have
completed Section 1 and 2 of your form.
Date Opt Out form issued to
employee
Date Opt Out form received
from employee
Date current period of
employment commenced
Date current period of scheme
membership commenced
Employee last day of scheme
membership
Employee payroll or
assignment number
Has the member paid
contributions in this
employment
Did you receive this form from
the employee within the first 3
months pay period without
crossing a financial year end
YES/NO
Yes - please refund the
contribution through the pay
roll system
No – The PSPA will pay any
refund due on receipt of the
members leaver form and
Gen 1/12 from the employer
Date Gen 1/12 and Gen 2/12
forwarded to PSPA (if
relevant)

TR 263 (IOM) 3
Completed by: Name and
designation
Employing Authority Name and
Address
Signature
Date
Important notes about your decision
Please read these notes carefully:
1. You should only complete this form if you do not wish your future employment to be pensionable under the
Teachers Superannuation Order 2007 (the Scheme) and you are either:
a. currently in employment which is pensionable under those regulations; OR
b. intending to take up such employment in the future.
2. The election will have effect from either of the following:
a. If you complete the form within three months after taking up an appointment in employment which
would be pensionable under the Scheme, the first day of that employment.
b. The first day of the month following the date you sign the form.
You will be notified as soon as the election has been processed.
3. Any teaching service you do complete after the date the election takes effect will not be pensionable under the
Teachers Scheme Regulations. The election will not, however, affect any pension rights you have built up in
respect of service completed before the date on which it takes effect.
4. If at any time in the future you wish to consider coming back into the Scheme you can obtain further
information about the conditions for rejoining the Scheme by contacting the administrator.
5. Please complete Sections 1 and 2, before returning it to your employer to complete Section 3.
6. Note to employers: Upon receipt of this form from your employee, action opt out decision and complete Section
3 and then return the completed form to:
Public Sector Pensions Authority
Goldie House
1 - 4 Goldie Terrace, Upper Church Street
Douglas
ISLE OF MAN
IM1 1EE
Or Email to pensions@pspa.im
Where can I find more information
You can find more information using the resources on our website