Pension Form Nos.25B - Ministry of Public Service

PENSION FORM NOS.25BSAVINGREF.:FROM: PARMANENT SECRETARYMINISTRY OF PUBLIC SERVICEP.O. BOX 7003KAMPALATO:DATE:Mr./Dr./Mrs./Miss/Ms./Rev……………………………………………………………PARTI1. (a). The retirement of the above mentioned officer Ref. No…………………..of………………………………………… Recommended by you has been accepted.(b). As formally notified in letter Ref. No…………………………………….of……………………..to the above named officer, the appointing authority directed his orher retirement from the public service in the Public interest/ on Medical grounds/ onabolition of Office.2. (a) Please, Urgently forward to this Ministry his or her particulars of service onPension Form N.S 1 together with the attached Pensions Form N.S 20B duly andaccurately completed.(b) Please, also state and certify on the attached duplicate of the savingram thefollowing(i) Date of birth………………………………………………………(ii) Reckonable service: from…………………………………………To………………………………………………………….………(iii) Period of pensionable Service:form……………………………….to………………………………………(iv) Period excluded: from………………….. To…………………………….Reason for exclusion……………………………………………………......................…………………………………………………………………………………………

(v) Date of commencement of retirement leave is……………………………….(vi) Date retirement leave expires is………………………………………………(vii) Final Annual pensionable emoluments as at the last day of pensionable serviceis shs……………………………………………………………(viii) Any other necessary information(e.g. Certificate Of Learner/Trainee Service,Copy of the service Card, Copy of letter approving accumulation of annualleave, death certificate, e.t.c. attached):………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………3.Unless all information required on pensions Form N.S 14, NS.20B and on thissavingram is received in this office, correctly completed and certified, no further actionwill be taken in determining the officers terminal benefits.……………………………………………..EstablishmentsDelete that which is inappropriate………………………………………………………………………………………………. PART IICERTIFICATE(To be completed and signed by a personal assistant/ establishments officer not below the U4 scale)I certify that the information given in part 12 (b) of this form is correct, to the best of myknowledge and belief.Full Names and Signature……………………………………………………………………………………………………………………………….Titles……………………………………………………………………….Date………………………………………………………………………..