1 of 3
STANDARD NOTICE OF RETIREMENT
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1.
Account Holder’s Particulars :
Surname
First Name
Middle Name
PIN
Date of Birth Sex (M/F) Effective Date of Retirement Marital Status (M/S/D/W)
(dd/mm/yy) (dd/mm/yy)
Permanent Home
Address:
Current Contact/
Mailing Address:
Contact/Mailing
Address:
(After retirement)
House Tel. Number
Mobile Tel Number
2.
Current Employment Details:
Employer’s Name
and Address
Employer Code
Total Annual Remuneration N:
( ( ( Attach last Pay Slip)
3.
Details of Benefits:
Accumulated Contributions
Amount of Retirement Bond N
(If a public sector employee) State if Remitted to RSA: Yes - No
Amount of Accrued benefits N
(If a private sector employee) State if Remitted to RSA: Yes - No
Total Balance on RSA: N
Expected Contribution to