Forms you need to manage a member’s pension record.
Employers should use Pensions Online (POL) to produce an estimate where possible.
If you don’t have access to POL or you need a manual calculation, you can use these forms:
For those without access to Pensions Online/Electronic Staff Record
Joiners:Joining or rejoining the NHS Pension Scheme (SS10) (PDF: 181KB)Joining or rejoining the NHS Pensions Scheme (SS10GP) (PDF: 171KB)Joining or rejoining the NHS Pension Scheme (SS14) (PDF: 183KB)Application to contribute to the NHS Pension Scheme under a Section 7(2) Direction (SD65) (PDF: 268KB)Joiner excel spreadsheet (Excel: 17.1KB)
Notification to Paymaster of an NHS pensioners re-employment:Re-employment of a NHS pensioner (AW140) (PDF: 76KB)
Notification to Paymaster of a change in circumstances for a re-employed NHS Pensioner:Change of circumstances for a re-employed NHS pensioner (AW140A) (PDF: 118KB)
Leavers:Leaver spreadsheet (Excel: 23KB)
Protection of Pay
For all protection of pay and voluntary protection of pay requests
Please read the factsheet before making an enquiry
Mental Health Officer and Special Class Status
Request for Mental Health Officer status - Automatic grades (SM333) (Word: 107KB)Request for Mental Health Officer status - Trainee / Qualified Clinical Psychologists (SM215) (Word: 327KB)Request for Mental Health Officer status - non automatic grades (SM1) (Word: 107KB)Request for retention of Mental Health Officer / Special Class status on promotion to a manager (SMR) (Word: 108KB)
Options on leaving
Retirement benefits claim form (AW8) (PDF: 445KB)AW8 annex (PDF: 589KB)AW8 supplementary form (PDF: 103KB)Supplementary form – Step Back pensionable pay (Word: 249KB)Fixed Protection - Benefit Accrual Declaration (FPBA1) (Word: 220KB)Consideration of entitlement to ill health retirement benefits (AW33E) (PDF: 478KB)Consideration of entitlement to ill health retirement benefits AW33E Part C (PDF: 177KB)Redundancy supplementary information checklist (Word: 129KB)Retirement on grounds of interests of efficiency checklist (Word: 300KB)Concurrent pensionable employment (AW343) (PDF: 138KB)Revised retirement benefit details (AW171) (PDF: 299KB)Final pay controls supplementary form (FPC1) (PDF:309KB)
Family benefits and life assurance
Claim for adult dependant's pensions, children's pensions and allocated pensions (G60) (PDF: 221KB)Claim for adult dependant's pension on death of an active member (AW9) (PDF: 396KB)Claim for a lump sum on death of an active member (AW11) (PDF: 257KB)Payment of an initial or limited pension to a survivor (AW135) (PDF: 167KB)Claim for repayment of initial widows / widowers pension (FIN9GP) (Excel: 34KB)Claim for repayment of initial widows / widowers pension (FIN9EA) (Excel: 74.5KB)
Application form for children's pension:
If you don’t have access to the calculator, you can complete the Election to purchase Additional Pension (AP1) form (Word: 277KB).