THE NATIONAL INSURANCE BOARD

OF TRINIDAD AND TOBAGO

GUIDELINES AND CHECKLIST

Application / Application
Benefit:
Form Name: RETIREMENT BENEFIT
Form Number: NI 82

Section A
Description To be completed by Applicant - (This is the insured person who is/has retired from
employment)
No. Questions on form What should be inserted
1 Name Surname followed by First name and middle name (if
applicable)
2 Home Address Where you live currently
3 Postal Address Where your mail is delivered, if different from home address
4 National Insurance No. National Insurance number of the applicant (this is a 9-digit
number)
5 Date of Birth Date of birth of applicant (Year/Month/Day)
6 Gender Is the applicant male or female? The applicant ticks the
relevant box
7 Telephone Numbers Input a working telephone contact - home, work or cellular
8 Marital status Tick the relevant box
9 State Maiden Name For females - in put the surname you used from childhood
until marriage (if you are married)
10 Last occupation What was the last job you were doing when you retired
(e.g Road overseer, Supervisor, Teacher etc)
11 Name of Last employer Give the name of the last business place you worked with
when you retired
12 Last Employer If you know the National Insurance registration number of
Registration number your employer write it here. If you do not know it then you
can leave it blank.
13 Employment record List all the employers you worked with throughout your
from 10 April, 1972 working life from when the National Insurance system
started on 10 April 1972. If you did not start to work on 10
April 1972 use the first row and write that. If your date of
birth is after 1957 you need not respond to 10 April 1972. As
far as possible provide the dates you started and ended with
each employer. If you cannot recall the dates, the month and
year will be sufficient. All periods when you did not work
Question #
must be noted also.
Type of Employment For each employment period you provide say whether your
employment was Casual, Temporary or Permanent. (in
respect of temporary employment - were you temporary but
worked for the whole year or just parts of the year)
14 Did you work or live in The CARICOM countries are St Lucia, Barbados, Guyana, St
Canada or worked in Vincent, etc. If you worked in any of these countries, tick the
any of the CARICOM relevant box. If you lived or worked in Canada, tick the
Countries relevant box. If lived and worked both in Canada and
CARICOM use another sheet of paper to provide the Social
Security numbers and the name of the country in which you
worked and or lived.
15 Last date of employment This means the last date on which your salary or wage was
paid by your employer. (For example, if you were on pre-
retirement leave and that leave started on May 1st, but your
retirement date is July 10th your last salary would have been
up to July 10th, then that is your last date of employment and
NOT May 1st)
 16 Have you ever Is this the first time you are applying to the NIBTT for a
applied for a Retirement Benefit? If yes, then tick "No". If yes, then input
retirement the name of the NIBTT office at which you previously applied
benefit? and tick "Yes".
17 Are you in receipt of If you are at present receiving any of the benefits listed tick
any benefit listed "yes" if you are not tick "No".
below
18 Have you paid Did you ever pay contributions for yourself when you were
Voluntary not working? If you did bring along with you your Voluntary
Contributions Contribution card.
19 Please indicate the Tell us where you want us to send your payment. If you want
method of payment of it to go to your financial institution (Bank, Credit Union, Unit
Benefit Trust) then complete the boxes below. Please ensure you put
in the correct details so that your money will go to only your
account. Bring with you a current statement so that we can
verify that you have provided the correct account number. If
you choose to have it mailed to you please provide evidence
of your current address (utility bill, bank statement etc)
20 Is this a joint account Tick the appropriate box.
21 If "YES" to question 20If your account is joint with someone else provide their name
and address in the boxes provided.
Description Applicant's Declaration
Information needed What should be inserted
Signature or Mark Sign name or affix thumb print
Date Date when the form was completed by applicant
Description Particulars of witness to Mark (where applicant
cannot sign)
Information needed What should be inserted
Name The witness surname and other name
Address The address of the witness
Valid Identification Tick the box for the ID used - Identification should be a valid
form of one of the following:
Passport, Driver's Permit or Electoral Identification Card.
Number Place number from the ID
Occupation What position does witness hold
Signature of Witness to mark The signature of the witness
Date Date the form was completed by the witness
Section B
Section B - To be completed by Employer
Description
Information needed What should be inserted
I certify that The name of the retiree, putting the surname first then the
other name
Whose Date of birth is. Insert the Retiree's date of birth
Retired from our Put in the retiree's retirement date. Check question 15 on the
employment with effect from first page. Do these dates match?
Has been re-employed with If the retiree was re-employed by you tick the box and put the
effect from date, he/she started to work again with your company
Has not been re-employed after If the retiree was not re-employed by you, this date should be
the date his
retirement date

Description Employer's Declaration

Information needed What should be inserted
Name Surname and other name of the person who completed the
form on behalf of
the employer
Position The position/ job title of the employer/employer's
representative
Signature of Employer The signature of the employer/ employer's representative
Company Stamp Stamp of the employer of the retiree
Date Date the form was completed by the employer of the retiree
 Section C
Section C - For Official Use
Description
The Customer Service Representative completes the section of the form

What you should know about this claim

1. Time frame for the submission of claim - 12 months from the retirement date
2. Where the claim is submitted by a third party, valid ID and letter of authorization to conduct business
3. The benefit is payable to the retiree
4. The Retirement Benefit may be paid as a pension if you worked for at least 750 weeks and paid contributions or
a Grant if you worked for less
5. If you reside outside of Trinidad and Tobago and are in receipt of the pension you MUST submit a Life
Certificate to the NIBTT every December and June of each year.
6. Who can sign as witness -

(a) (For a resident of Trinidad and Tobago)

Any Magistrate, Justice of the Peace, Clergyman, Warden, Councilor/Assemblyman, Bank Manager, Medical
Practitioner, Attorney-at-Law, Principal/Vice Principal of any Government/approved School, Head of any
Government Institution or any Police/Military officer of the rank of Sargeant and above or Local Office Staff or
Supervisory Officer of the National Insurance Board. A member of the Trinidad and Tobago Mission in the
Country in which the Beneficiary is a resident OR an Attorney-at-Law, OR a Notary Public, OR a Justice of the
Peace OR a Medical practitioner.
(b) (For a non-resident of Trinidad and Tobago)
A member of the Trinidad and Tobago Mission in the Country in which the Beneficiary is a resident OR an
Attorney-at-Law, OR a Notary Public, OR a Justice of the Peace OR a Medical practitioner.
Supporting Documents
Electronic Birth certificate and affidavit (where applicable), OR
Deed Poll (if applicable)
Marriage Certificate (female applicants only)
Decree Absolute of divorce (female applicants only) where applicable
List of Errors No. Questions on form Possible
Errors
1
2
3

CHECKLIST

• Claim Form – N.I. 82. This form is completed upon retirement:

- Age 60 – 64 (insured MUST be no longer in insurable employment).
- Age 65

• ALL fields must be completed. ALL changes MUST be initialed and / or stamped.
a. Section “A” The form MUST be signed and dated by the applicant.
- If the insured is unable to sign, the thumbprint will be certified at the NIBTT.
- If the claim is being submitted by a third party, at the “Particulars of Witness to Mark” the thumbprint
should be certified by an approved authority.
- Question #13 should be completed in full detail. For the period 1972 – the period of retirement, each
period of employment or unemployment should be stated. Additional paper should be utilized where
necessary.
- Question #14 If the answer is yes, the Social Security number MUST be provided.
b. Section “B” to be completed by the Employer.
- The form MUST be signed, dated and stamped by the insured’s last Employer.
- The retirement date MUST be accurately stated. This date should be the date the insured was no
longer in insurable employment and should correspond with the last date contributions were
remitted/due.

• N.I. 165 – This form should be completed in its entirety along with the N.I. 82.
- The form MUST be signed, dated and stamped by the insured.
- All various names, date of birth and N.I. numbers used during the insured’s lifetime should be clearly
stated.
- Question #16 should state all the information as stated on form N.I. 82, question 13.

• Identification Card of the Insured.

• Original & Copy of the Birth Certificate / Affidavit / Deed Poll / Divorce Decree Absolute / Death Certificate of
Spouse.

• All relevant documentation to support employment, if available, e.g. original & copy of certified payslips,
TD4s, Job letters etc. should be submitted.

• If the method of payment is Financial, the bank statement reflecting the name of the bank, the account
number and the branch should be submitted. If the method of payment is Postal a utility bill, no older than
three (3) months should be submitted.

• If the claim is being submitted by a third party, the Identification Card of the third party MUST be presented.

• The claim MUST be submitted within one (1) year from the date of retirement, if not a letter MUST be written
with an explanation for the late submission.