Pensions Form NS7 - Ministry of Public Service
Pensions Form NS7 - Ministry of Public Service
Pensions Form NS7 - Ministry of Public Service
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PENSIONS FORM <strong>NS7</strong> (REVISED 2009) Attach stamp<br />
The Permanent Secretary,<br />
<strong>Ministry</strong> <strong>of</strong> <strong>Public</strong> <strong>Service</strong><br />
<strong>Pensions</strong> Department<br />
Po Box 7003, Kampala<br />
Employer or LC1<br />
1. From: Retiring/ <strong>Public</strong> Officer/Deceased: …………………………………………………..<br />
<strong>Ministry</strong>/District……………………………………………………………………………..<br />
Department…………………………………………………………………………………….<br />
PAB. No. (For deceased soldiers <strong>of</strong> UPDF)……………………………………………………<br />
Address………………………………………………………………………………………<br />
2. PLEASE RECORD THE FOLLOWING RECORDS AND INFORMATION<br />
My address after retiring/ Address <strong>of</strong> the claimant will be:<br />
Name <strong>of</strong> the retiring <strong>of</strong>ficer/ claimant…………………………………………………….<br />
Village/ zone……………………………….. Sub-county/ Division………………………….<br />
County…………………………………….. District……………………………………….<br />
P.O Box…………………………………….. Telephone ……………………………………<br />
3. My pension/gratuity should be to the credit <strong>of</strong> my account at:<br />
Bank………………………………………………. Branch……………………………<br />
Account tittle…………………………………………………………………………….<br />
Account number………………………………………………………………………….<br />
Confirmed by bank manager:<br />
Attach passport size<br />
Photograph <strong>of</strong> claimant.<br />
Name………………………………………. signature and stamp…………………………
4. The following are the members <strong>of</strong> my immediate family:<br />
Spouse(s) (where applicable)<br />
1……………………………………………………………………………………………<br />
2…………………………………………………………………………………………….<br />
Children ( In case <strong>of</strong> deceased, the children <strong>of</strong> the late)<br />
Names Date <strong>of</strong> birth<br />
1…………………………………………… …………………..………………….<br />
2…………………………………………… ……………………………………….<br />
3…………………………………………… ………………………………………..<br />
5. Employer’s certification<br />
i) Head <strong>of</strong> personnel ………………………………Signature and date……………………………<br />
ii) Head <strong>of</strong> Accounts…………………….…………Signature and date…………………………<br />
6. I certify that the above information is correct to the best <strong>of</strong> my knowledge and belief.<br />
Name <strong>of</strong> claimant………………………………………. Signature……………………………….<br />
Date………………………….<br />
N.B.<br />
1. All services by the ministry <strong>of</strong> <strong>Public</strong> <strong>Service</strong> are free<br />
2. In case <strong>of</strong> deceased <strong>Public</strong> <strong>of</strong>ficers, this form should be filled by the beneficiary (S)