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GESOPS Retirement Withdrawal Form A

1) The document is an occupational pension claim form for the Ghana Education Service (GES) Pension Scheme. 2) It requests information such as the applicant's name, date of birth, ID details, GES staff ID, SSNIT number, email, institution, claim type, and date of exit. 3) Bank account details are also required, and the applicant must declare the information is true before signing and dating the form.

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GODWIN OWUSU YEBOAH
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174 views1 page

GESOPS Retirement Withdrawal Form A

1) The document is an occupational pension claim form for the Ghana Education Service (GES) Pension Scheme. 2) It requests information such as the applicant's name, date of birth, ID details, GES staff ID, SSNIT number, email, institution, claim type, and date of exit. 3) Bank account details are also required, and the applicant must declare the information is true before signing and dating the form.

Uploaded by

GODWIN OWUSU YEBOAH
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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GES

OCCUPATIONAL CLAIM FORM


PENSION Instructions:
SCHEME Please fill in BLOCK LETTERS and return the hard copy to your local GES office along with your retirement
notice / letter of introduction from GES and a copy of any valid National ID card.

DETAILS OF APPLICANT
Name of Applicant:
Date of Birth [DD/MM/YYYY]: Gender: Male Female
ID Type: ID Number:
GES Staff ID: Phone Number:
SSNIT Number:
Email:
Name of Instituition:
Claim Type: Normal Retirement Early Retirement Total Incapacity Survivor’s Benefit Transfer (i.e. to another trustee)
Withdrawal Permanent emigration from Ghana
Date of Exit:
BANK ACCOUNT DETAILS

Name of Bank: Branch:


Account Name:
Account Number:

DECLARATION

I authorize the Trustee Board to transfer my Pension Benefits to the Bank Account indicated on this form. I certify that the instruction and
information provided herein are true and correct and that neither the Board of Trustees nor GLICO Pensions Trustee Ltd. will be held liable
for any errors or omissions that result from the usage of the information for its intended purpose.
Namer of Applicant:

Signature: Date [DD/MM/YYYY]:

FOR OFFICE USE ONLY


(TO BE COMPLETED BY SUPERVISOR ,GHANA EDUCATION SERVICE)

Name Of Supervisor:

Signature:
Official Stamp

Date:
Day Month Year

TO BE COMPLETED BY FUND ADMINISTRATOR (GLICO PENSIONS TRUSTEE LTD)

Name Of Receiving Officer:

Signature:
Official Stamp

Date:
Day Month Year

GLICO PENSIONS TRUSTEE LTD


P. O. Box 4251 , Adabraka – Accra
Tel: + 233 30 224 6140/ +233 30 224 6142/ +233 50 126 0870 / +233 50 163 4204

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