Superannuation Forms

The following forms are now available to view and download and can now be ordered from us by clicking on the desired title. Some are available to download in Microsoft Word and Adobe Pdf format. To view them just click on the appropriate icon.

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Ref Code	Title	PDF	MS Word
Supp/Notes	Supplementry Notes to 'A Guide for Pensioners and Their Dependants'	Supp/Notes (PDF 34 KB)	Supp/Notes (MS Word 44 KB)
AW6(2008)	Pension Commutation form (must be attached to AW6)	AW6 (2008) (PDF 17 KB)	AW6 (2008) (MS Word 31 KB)
	Changes to The HPSS Superannuation Scheme - Staff payslip leaflet	Changes (PDF 45 KB)	Changes (MS Word 57 KB)
RPA1	Request for Estimate of Premature Retirement Benefits/Costs		RPA 1 Form (MS Word 35 KB) To complete this Form right click mouse over above named and select save target as to save to your pc. Send completed form as an attachment to superannrpaqueries@dhsspsni.gov.uk
RPA2	Redundancy Retirements Proforma and notes.- Attachment to the Pension Application Form AW6 for completion by the member.	RPA 2 (PDF 34 KB) To be attached to Pension Application Form AW6.
2007/08	General Medical Practitioner's Annual Certificate of Superannuable Profits 2007/08		2007/08 Certificate (excel)
	General Medical Practitioner's Annual Certificate 2007/08 - Completion Notes		Guidance Notes
	General Medical Practitioner's Annual Certificate 2007/08 - Frequently Asked Questions - Pensionable Pay		FAQ-Pensionable pay
	General Medical Practitioner's Annual Certificate 2007/08 - Frequently Asked Questions - Trusts/Boards		FAQ'S-Employers
	General Medical Practitioner's Annual Certificate 2007/08 - Frequently Asked Questions - Overlaps		FAQ-Overlaps
	General Medical Practitioner's Annual Certificate 2007/08 Frequently Asked Questions-Completing the certificate		FAQ-Completing the certificate
2006/07	General Medical Practitioner's Annual Certificate of Superannuable Profits 2006/07		2006/07 Certificate (excel)
	General Medical Practitioner's Annual Certificate 2006/07 - Completion Notes	CompletionNotes (PDF 87 KB)
	General Medical Practitioner's Annual Certificate 2006/07 - Frequently Asked Questions - Pensionable Pay	FAQ's - Pensionable Pay (PDF 41 KB)
	General Medical Practitioner's Annual Certificate 2006/07 - Frequently Asked Questions - Trusts/Boards	FAQ's - Trust/Boards (PDF 19 KB)
	General Medical Practitioner's Annual Certificate 2006/07 - Frequently Asked Questions - Overlaps	FAQ Overlaps (PDF 38 KB)
2005/06	General Medical Practitioner's Annual Certificate of Superannuable Profits 2005/06	N/A	Annual Certificate (MS Excel 89 KB)
	General Medical Practitioner's Annual Certificate 2005/06 - Completion Notes	Completion Notes (PDF 60 KB)	Completion Notes (MS Word 81 KB)
	General Medical Practitioner's Annual Certificate 2005/06 - Frequently Asked Questions	FAQs (PDF 33 KB)	FAQs (MS Word 42 KB)
	General Medical Practitioner's Annual Certificate 2005/06 - Frequently Asked Questions - Overlaps	FAQs - Overlaps (PDF 33 KB)	FAQs - Overlaps (MS Word 73 KB)
	General Medical Practitioner's Annual Certificate 2005/06 - GP Provider's Superannuable Pay	Superannuable Pay (PDF 12 KB)	Superannuable Pay (MS Word 27 KB)

OOH	Out of Hours Application for HPSS Superanuation Scheme Employing Authority Status	OOH Application Form (NI) (PDF 18 KB)	OOH Application Form (NI) (MS Word 41 KB)
LOCUM FORMS	GP Locum A (NI)-Revised April 2008		GP_locum_A (NI)- Revised
	GP Locum B (NI)-Revised April 2008		G.P Locum B (NI)-Revised
	GP Locum C (NI)-Revised April 2008		G.P Locum C (NI)-Revised
	GP Locum D (NI)-Revised April 2008		G.P Locum D (NI)- Revised
	GP Solo Form (NI)-Revised April 2008		G.P Solo Form (NI)- Revised
2004/05	General Medical Practitioner's Annual Certificate 2004/05	Annual Certificate (PDF 53 KB)	Annual Certificate (MS Word 133 KB)
	General Medical Practitioner's Annual Certificate 2004/05 - Supplementary Notes	Supplementary Notes (PDF 26 KB)	Supplementary Notes (MS Word 38 KB)
AW6(P) AW6 AW6(T)	Application for Preserved Retirement Benefits (AW6(P)) Application for Retirement Benefits (AW6) (Sample only) AW6 (Transitional) -Tax declaration to be completed and forwarded with the AW6 form AW6 (Transitional) Guidance Notes	AW6(P) (54.2KB) AW6 (69.1kb) AW6(T) (PDF KB)	Guidance Notes (MS Word 80 KB)
AW9	Application for Child Allowance	AW9 (PDF 9 KB)	AW9 (MS Word 30 KB)
AW11	Application for Widow/er’s Benefits and Death Gratuity (In Service or within 12 months of leaving the Scheme)	N/A	N/A
AW11/2	Application for Widow/er’s Benefits and Death Gratuity (following pension or preservation of benefits)	N/A	N/A
AW171	Post Award Revised Details	AW171 (PDF 7 KB)	AW171 (MS Word 24 KB)
AW18	Application for Refund of Contributions	AW18 (PDF 23 KB)	AW18 (MS Word 54 KB)
OHD1	Application for Ill Health Retirement (In Service)	OH1
OHD1	Application for Ill Health Retirement (Preseed Benefits)
DG3	Life Assurance Lump Sum - Current Scheme Member	FROM EMPLOYER
DG3	Life Assurance Lump Sum - Former Scheme Member/Pensioner

IB2	Application for Permanent Injury Benefit	N/A	N/A
Medfee	Claim for Departmental Fee	Medfee (PDF 7 KB)	Medfee (MS Word 20 KB)
J1/J2	Details of Employees Joining Scheme JI - BOARDS/TRUSTS J2 - OOH/DIRECTIONAL BODIES/GP PRACTICES JOINING QUESTIONAIRE JOINING FLOWCHART	J1 (PDF 19.4KB) J2 (PDF 18.0KB) JQ JF	N/A
SS14	Details of Medical/Dental Practitioners Joining Scheme	SS14 (PDF 29 KB)	SS14 (MS Word 81 KB)