Standard Forms
Attached are the standard forms for use when notifying the Pension Team of any amendments to a member's pensionable status. All forms are available for downloading in PDF and Word formats:
Form(PDF version) |
Form (Word Format) |
Form Title
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Description
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| Submit your estimate request online | |||
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Employer Estimate Request |
Please complete this form for all employer estimate requests | ||
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Brief Guide to
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To be used for members commencing employment from 1st April 2011 | ||
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Election to Opt into the LGPS |
An opt-in form for members wishing to join the LGPS | |
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Opt-out form new employees |
A form for new employees wishing to opt-out of the LGPS before commencement of employment | |
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Option to pay contributions to avoid a break in service |
A form to be completed by a member wishing to pay back pension contributions to avoid a break in membership following a period of absence | |
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Strike Break repayment form |
Option to pay back contributions for a break in service following a trade dispute | ||
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Starter form |
This form is to be completed for all new entrants to the LGPS. | ||
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Changes to Pensionable Status |
This form should be used to notify the Pension Team of changes in hours, term-time weeks, maternity leave, leave of absence, change in name/status, change of employee contribution rate, change of home address | ||
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Withdrawal from the Scheme |
This form is to be completed for any member leaving employment or opting out of the LGPS | ||
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Employer Contribution Return |
Monthly employer contribution return | ||
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Final Pay Calculation Sheet |
This form can be used to show how you have calculated the final pay for a member leaving the scheme and can be attached to form LGS15C upon submission to the Pension Team | ||
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Opt-out form with entitlement to a Refund |
This form enables an existing scheme member, who has less than 3 months membership, to opt out of the scheme and claim a refund. Please note that if a member has transferred previous pension rights to the LGPS they cannot claim a refund even if they have less than 3 months membership | |
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Refund Application form |
A refund application form to be used by a Scheme member leaving employment within 3 months of joining the Scheme and who has not transferred any former pension rights into the LGPS. Such a refund will be paid by the Pension Team and not through payroll. The form, once completed by the member, should be returned to the Pension Team | |
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Opt-out form |
Form to be completed by a member wishing to opt-out of the LGPS who has more than 3 months membership and is therefore entitled to deferred benefits | ||
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Occupational Health Certificate |
for a current employee who is retiring on ill-health post 30 September 2008 | ||
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Occupational Health Certificate |
for a Deferred Beneficiary who ceased membership as an employee on or after 1 April 2008 | ||
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Occupational Health Certificate |
for a Deferred Beneficiary who ceased membership as a employee on or after 1 April 1998 and before 1 April 2008 | ||
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Occupational Health Certificate |
for a Deferred Beneficiary who ceased membership as an employee before 1 April 1998 | ||
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Occupational Health Certificate |
Third Tier Ill-Health retirement review certificate for a 3rd tier pensioner review taking place within 3 years of date of cessation of employment | ||
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Occupational Health Certificate |
Third Tier Ill-Health retirement review certificate for a suspended 3rd tier pensioner review taking place within 3 years of date of original date of leaving |
