NUI Galway PRD10 Employment Declaration Form Pension-Related Deduction Employment Declaration

NUI Galway PRD10 Employment Declaration Form Pension-Related Deduction Employment Declaration

Only enter youremployment and pension details for public service employers in Ireland

Following the implementation of the Pension Related Deduction with effect from 1st March 2009, employees are required to declare their overall pension status with regard to any Irish public service pension scheme.

The following details are required to be completed and returned urgently to NUI Galway Payroll Department:

Q.1 (A) Are you working with any other Irish public service employer on commencement or during employment at NUI Galway (full-time, part-time or otherwise)? /
If NO to Q.1 (A) Skip to Q.2 & Ignore (B), (C), (D), (E)
(B) Please state is your other employment
Full-Time, Part-Time or Casual.
(C) If yes to (A) please enter period of employment / Start Date:
End Date (if applicable):
(D) Name your current Main Public Service Employer:
(You receive most of your income for the current tax year with this employer)
(E) Name your subsidiaryPublic Service Employer (s): Include all employers that are not your main employer(You receive your least earnings for the current tax year with this employer) / 1.
2.
Q. 2. Are you a member of a Public Service Pension Scheme? /

If YES, Name of Employer:
Q.3. Do you have a future entitlement to a benefit under a Public Service Pension Scheme? /

If YES, Name of Employer:
Q.4. Are you retired and in receipt of a pension from a Public Service Pension Scheme? /

If YES, Give Name of Previous Public Service Employer(s):
Q.5. Have you opted out of any such scheme? /

Q.6. Do you receive a payment in lieu of membership in such a scheme? /

I certify the foregoing information to be correct to the best of my knowledge and belief, and I undertake to immediately notify the Payroll Department at NUI Galway of any change affecting the details given. I understand that if I am a member of a public service pension scheme or have a future entitlement to a benefit under such a scheme that I will be liable for pension related deduction at the appropriate rate.

For help to complete this form please see Payroll & Expenses Website: PRD Information

NAME (First & Surname):

PPS NUMBER:

NUIGPAYROLL/ STAFF NUMBER:

DATE FORM COMPLETED:

SIGNATURE:

*A signature is not required if you send the completed form by email from your own email address

Email completed form to:

If you don’t have access to your email account please post the form to: Payroll Dept, The Quadrangle, NUI Galway