Under Regulation 47 of the National Insurance and Social Security (Benefit) Regulations PARTICULARS are to be completed by Employer and given to Employee on date of termination.

Termination of Services – Where an employer terminates the employment of an employee or where the employee leaves the employment, the employer MUST give a Termination of Services/Lay-off Certificate to the employee and send a copy to the National Insurance Office within one week of the date of termination. An employee who wishes to claim Unemployment Benefit MUST submit the Certificate with his/her claim. A termination of Services/Lay-off Certificate must be given to the employee even if/she was only employed for a day or part thereof.

Penalty – Failure to provide the Employee with Termination of Services/Lay-off Certificate within one week of termination will result in a penalty.

Regulation 47(5) of the Benefit Regulations provides that the penalty is $1,000 for failing to comply with the requirements, where the contravention continues or the failure continues after conviction,, the penalty is $1,000 together with a further $200 for each day on which the offence is continued.

Termination refers to permanent separation i.e. the employee no longer works with the business. Self-termination refers to an employee who has resigned from the job while employee terminations refers to an employee who has been terminated by his/her employer.

Example 1 Date of Termination

Employer terminates John Brown on May 31^st and pays him monies due, including holiday pay and payment in lieu of notice. In this case, date of termination is May 31^st. (No NIS should be deducted from payment in lieu of notice). All wages MUST be reported in the week of termination for weekly paid employees and in the month of termination for monthly paid employees.

Example 2 Date of Termination

On May 31^st employer gives John Brown one month’s notice of termination, including salary for the month of June as well as holiday pay and other monies due. (John Brown is still employed but would not be required to report for work during June). In this case, June 30^th is the date of termination. If the period notice is longer or shorter, the end of the period date is the date of termination.

All wages MUST be reported in the week of termination for weekly paid employees and in the month of termination for monthly paid employees.

PERSONAL DETAILS OF EMPLOYEE
National Insurance Number*
National Registration Number*
Name
First Middle Last
Address
District
Parish
Zip/Postal Code
Tel. No.
Cell No.
Email
EMPLOYER DETAILS
Name of Employer
Employer's Registration No.*
Address
District
Parish
Zip/Postal Code
Tel. No.
Fax No.
EMPLOYMENT DETAILS
Occupation
Position within Organisation
Date Employment Commenced
Date Format: DD slash MM slash YYYY
Date of Termination
Date Format: DD slash MM slash YYYY
Last date at work
Date Format: DD slash MM slash YYYY
Last date for which employee will be paid
Date Format: DD slash MM slash YYYY
State reason for unemployment
Was employee Laid off?
- Yes
- No
Date of Lay off
Date Format: DD slash MM slash YYYY
Expected date of re-employment
Date Format: DD slash MM slash YYYY
OTHER DETAILS
Is the employee receiving or entitled to pension from employer?
- Yes
- No
Start date of pension
Date Format: DD slash MM slash YYYY
Was holiday pay given to employee who was laid off?
- Yes
- No
From
Date Format: DD slash MM slash YYYY
To
Date Format: DD slash MM slash YYYY
Amount of holiday pay?
Was the employee dismissed because of his/her own misconduct?
- Yes
- No
Explain
Did the employee voluntarily leave your employment?
- Yes
- No
Has the employee become unemployed because of stoppage of work attributable to a labour dispute at your workplace?
- Yes
- No
Is/Was the employee participating in a strike?
- Yes
- No
Any other relevant details?
I declare that the information given on this form is true to the best of my knowledge and belief.
Signature of Employer*
Date signed*
Date Format: DD slash MM slash YYYY
WARNING: ANY PERSON WHO MAKES A FALSE STATEMENT IS PUNISHABLE BY A FINE OR TERM OF IMPRISONMENT OR BOTH.