Pension Form Nos.25B - Ministry of Public Service

(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………………………………………………………………………..