ISO 9001 Implementation
In an effort to improve customer service by meeting customer requirements as well as enhancing overall customer satisfaction, the National Insurance Scheme is currently in the process of becoming ISO 9001 certified. As such, in accordance with the requirements set out in the ISO 9001:2015 Standard, the National Insurance Scheme has implemented a Quality Management System effective December 1, 2019. As part of the implementation, a unique control number was added to all application and claim forms. The revised forms are available for download and would now be used when requiring services provided by the Scheme; the use of older forms would no longer be accepted.
Note: Downloads are in pdf form and will automatically open if you have Adobe Acrobat Reader installed. If you are desirous of printing the NIS forms available here, please ensure that you print back and front for each page in the order it is set in the download. If the pages are not printed correctly, they will not be accepted by NIS.
Types of Benefits and their respective Application Forms
Long Term Benefits
- Old Age
- Invalidity
- Constant Attendance
- Survivors
- Funeral
- Life Certificates
- P300F61 R0 -- Local Life Certificate *Updated
- P300F51 R0 -- Overseas Life Certificate *Updated
- Appointing a representative
Short Term Benefits
- Sickness
- Sickness Medical Care
- Maternity
- MD800F1A MB R0 -- Certificate by Self Employed Person in Support Of Maternity Benefit Claim *Updated
- B700F2 MB R0 - MD800F3 R0 -- Claim for Maternity Benefit - Medical Certificate of Expected Confinement *Updated
- B700F6 MB R0 -- Notification of Employee's Resumption After Maternity Leave *Updated
- B700F5 MB R0 -- Maternity Benefit - Statement of Earnings *Updated
- MD800F1 PC R0 -- Medical Certificate - Post Confinement / Claim for Extended Maternity Allowance *Updated
- B700F2A MB R0 - B700F2B MB R0 -- Claim for Maternity Grant - Declaration by Spouse to Support Claim for Maternity Grant *Updated
- MD800F11 R0 -- Claim for Fees for Medical Certification & Treatment for Employment Injury and/or Sickness Cases *Updated
Industrial Benefits
- Injury
- B700F1 IB R0 -- Notice of Accident *Updated
- Injury Medical Care
- MD800F1 PC R0 - MD800F1 MB R0 -- Medical Certificate - Post Confinement / Claim for Extended Maternity Allowance *Updated
- MD800F7 R0 -- Request for X-Ray or Other Laboratory Examination *Updated
- B700F2 MB R0 - MB800F2 R0 -- Claim for Maternity Benefit - Certificate of Confinement *Updated
- MD800F11 R0 -- Claim for Fees for Medical Certification and Treatment for Employment Injury and/or Sickness Cases *Updated
- MD800F12 R0 -- Claim for Travelling Subsistence and Allowance for Loss of Pay Due to Employment Injury *Updated
- Disablement
- Death
Other Forms
- R400F1 VC R0 -- Application For Certificate For Voluntary Insurance *Updated
- R400F7 VC R0 -- Payment Voucher For Voluntary Contributors *Updated
- B700F1 UB R0 -- Application for Undrawn Benefit *Updated
- CA1400F2 CA1 R0 -- CARICOM - Application For Retirement / Old Age Pension *Updated
- F200F16A R0 -- Notification of Lost Pension Order Book *Updated
- F200F16 R0 -- Notification of Lost Benefit Payment Voucher *Updated
- C900F2 SC R0 -- Notification of Lost Form *Updated
- AP1100F4 R0 -- Notice of Appeal *Updated
Compliance
- C100F72 R0 -- Application for Compliance Certificate - Employers *Updated
- C100F72A R0 -- Application for Compliance Certificate - Self Employed Persons *Updated
Types of forms used to pay Contributions
- C100F1A CS R0 -- Statement Of Income - Self-Employed *Updated
- F200F1 CS R0 -- Self Employed Contribution Schedule *Updated
- F200F2 CS R0 -- Employer Contribution Schedule - Monthly Paid Employees *Updated
- F200F3 CS R0 -- Contribution Schedule Summary Sheet - Electronic Submission *Updated
- F200F6 CS R0 -- Employer Contribution Schedule - Weekly Paid Employees *Updated
Types of forms used for Registration and who would use them:
For Employed Persons
- R400F4A R0 -- Self Employed Person’s Application for Registration *Updated
- R400F4 R0 -- Employed Person’s Application for Registration *Updated
- NIS Security Card
- R400F6 R0 -- NIS Security Card (Permanent)
- R400F13 R0 -- Application for Replacement of Social Security Card *Updated
- R400F23 R0 -- Application for Change of Name on Records *Updated
- R400F23A R0 -- Application for Change of Address on Records *Updated
For Employers
- R400F1 R1 -- Application for Registration as an Employer *Updated
- R400F5 R0 -- List of Employed Persons for Registration *Updated
- R400F23 R0 -- Application for Change of Name or Records *Updated
Electronic Schedule Files
- Electronic Schedule Manual
- Data Cleansing Excel Input File
- Data Cleansing Text File Format Description
- CS3 - Contribution Summary Sheet
- Electronic Schedule Excel File * Updated for 2024.
- * NOTE - All contributors are required to remit at a rate of 14% as at September 2015.
National Insurance Scheme Brochures
- Benefits Payable by N.I.S
- Claim for Spectacles
- Manual for Employers and N.I.S Clerks
- Maternity Benefit
- N.I.S Appeals
- Self Employed Persons
- Sickness Benefit