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    NI 79 For NIS Refunds

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    lacatancopycentre

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    NI 79 For NIS Refunds

    Uploaded by

    lacatancopycentre
    10 views1 page

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    NI 79 for NIS Refunds

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    10 views1 page

    NI 79 For NIS Refunds

    Uploaded by

    lacatancopycentre

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    THE NATIONAL INSURANCE BOARD N.I.

    79

    APPLICATION FOR REFUND

    NAME OF EMPLOYER: ..................................................................................................................................................


    REGISTRATION NUMBER
    ADDRESS: ......................................................................................................................................................................

    SERVICE CENTRE AT WHICH APPLYING: ..................................................................................................................

    POSTAL ADDRESS PERIOD OF AMOUNT OF REASON FOR OVERSTAMPING STILL EMPLOYED


    NAME OF INSURED PERSON N.I. NUMBER OF INSURED PERSON OVERSTAMPING REFUND (State whether card attached) WITH YOU

    YES NO

    .........................................................................................
    N.B. IF REASON FOR OVERSTAMPING IS THAT EMPLOYEE IS OVER 65, ENSURE
    THAT A COPY OF HIS BIRTH CERTIFICATE IS ATTACHED. SIGNATURE OF EMPLOYER

    ............................................
    NIB/GS:10/87 DATE

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