RHM Pension Plan 35 and Plan 45 - RHM Pension Scheme - UK.com

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SECTION 2 To be completed by the employer (IN BLOCK CAPITALS)
EMPLOYEE’S SURNAME INITIAL(S) MR/MRS/MISS MAIDEN NAME (married woman or widow only)
FORENAMES
Reduced Rate N.I.
(women members only)
YES/NO
EMPLOYER LOCATION
EMPLOYER’S SIGNATURE DATE
Copy of marriage certificate attached
(married woman or widow only)
Copy of birth certificate attached
YES/NO
YES/NO
NATIONAL INSURANCE NO. DATE OF BIRTH DATE OF ENTRY TO SERVICE
Note 1: Ignore any period of temporary employment before
becoming a permanent employee.
DATE OF ENTRY TO PLAN
DAY MONTH YEAR DAY MONTH YEAR
0 6
DAY MONTH YEAR
Note 2: Date of entry to the Plan will normally be the 6th of the month immediately following the completion of three months’
continuous service.
Certification by the Employer – please tick box(es) to confirm the following statements:
Salaried staff employee
YES/NO
I certify that the employee is eligible for membership of the Plan selected
For employees who are not joining the Plan at their first opportunity (see Note 2 above):
I certify that the employee is not currently absent from work on medical grounds
I certify that, to the best of my knowledge, the employee is not currently suffering from
any illness or medical condition which is likely to lead in the foreseeable future to a
claim for either ill-health retirement benefits or death-in-service benefits from the Plan
If any of the boxes are unticked, please forward details.
NOTE TO EMPLOYER: This Form should now be passed to the employee’s Pay Office for their information and signature below.
PAY OFFICE PAY OFFICE SIGNATURE DATE
NOTE TO PAY OFFICE: After the contents have been noted by the Pay Office, this Form should be sent to RHM Pension
Services, 96 George Street, Croydon, CR9 1TB at the time the employee enters the Plan. (Please do not wait until you have
completed the next Monthly Contributions Statement before forwarding the Form.) If the employee dies during the
three months’ qualifying period, the Form should be forwarded at the time of death.