Employees - Declaration Form

In order to have your form processed you must fill in all of the required fields

Name of Claimant
National Insurance Number
National Registration Number
Email Address
Date of Original Claim (YYYY-MM-DD)
Agree Not Agree
I have not worked or received any remuneration since the date of
the original unemployment claim.
I am able and willing to do suitable work but I was unable to
find any.
I have not been out of the Island since the date of the Claim.
I acknowledge that if I make any false statement or give false
information for the purpose of obtaining the benefit, I may be
prosecuted and liable on conviction to a fine of one thousand
dollars ($1000.00) or imprisonment for six months or both.
I acknowledge that if I fail to submit a claim by the due date
provided by the National Insurance Office that I may lose the
If out of the Island during the claim for unemployment, please
indicate the period that you have been out of the Island..
Date you left the Island (YYYY-MM-DD) Date you returned to Island (YYYY-MM- DD)

Employment Details

If you are re-employed with any employer or start self-employment, you MUST complete the following section:
Name of Employer
Date of Re-employment (YYYY-MM-DD
Addres of Employer
Telephone Number of Employer

Related Links

TVET Council

International Labour Organisation

Barbados Workers’ Union

National Union of Public Workers

Barbados Union of Teachers