Form Completed by: Payroll/ HR For Employer Signature: Date: / / (*delete as appropriate) (**see guidance notes) Please read the notes. Send in additional copies of the form, for each employment, as more detailed information becomes available. Please do not hold up this notice while waiting for the certificate or the IRMP opinion concerning reduced contractual hours. Concerning the reduction to contractual hours Suggestion for IRMP statement concerning the reduction in hours my opinion (name of the member) ‘In ….. …. had reduced contractual hours or partly as a result of the condition that caused or contributed to the member’s death’, ‘wholly Name signed …… …………… …… Official stamp Guidance notes follow on page 3 Guidance Notes Annual Rate of Assumed Pensionable Pay ((AAPP)(Regulations 21(4) &(5) ‘AAPP’ and 39(9)(a)) Work out this for each employment, using the pay’ from ‘pensionable the 3 months ending in the pay period before the date of death: take out any lump
Form Completed by: Payroll/ HR For Employer Signature: Date: / / (*delete as appropriate) (**see guidance notes) Please read the notes. Send in additional copies of the form, for each employment, as more detailed information becomes available. Please do not hold up this notice while waiting for the certificate or the IRMP opinion concerning reduced contractual hours. Concerning the reduction to contractual hours Suggestion for IRMP statement concerning the reduction in hours ‘In my opinion ….. …. (name of the member) had reduced contractual hours ‘wholly or partly as a result of the condition that caused or contributed to the member’s death’, Name …… …………… signed …… Official stamp Guidance notes follow on page 3 Guidance Notes ‘AAPP’ Annual Rate of Assumed Pensionable Pay ((AAPP)(Regulations 21(4) &(5) and 39(9)(a)) Work out this for each employment, using the ‘pensionable pay’ from the 3 months ending in the pay period before the date of death: take out any lump
DeathinServiceNotification.docx