NI Forms - Trinidad and Tobago

NI forms for the range of NIS benefits and other National Insurance Business transactions in Trinidad and Tobago, CARICOM countries and Canada.


 Registration - Employers and Employees

NI 1 - Register as an Employer
NI 4 - Register as an Employed Person
NI 33 - Request for Replacement National Insurance Cards
NI 165 - Insured Person Data Update Questionnaire
NI 165 - Pension Ready Insured Person Data Update Questionnaire
NI 182 - Change of Particulars of the Insured Person
NI 184 - Statement of Contributions Paid/Due
NI 184A - Benefit Payment Authorisation
NI 187 - Statement of National Insurance Contributions Due/In Arrears
Termination Certificate

  Employment Injury Benefits

NI 19 - Employment Injury Benefit Application
NI 19A - Employment Injury Benefit Follow-Up Medical Certificate
NI 34A - Medical Report - Child Allowance
NI 114 - Medical Expenses Claim
NI 117 - Death Benefit Claim
NI 119 - Disablement Benefit Claim

  Invalidity Benefit

NI 38 - Invalidity Benefit Application

  Maternity Benefit and Special Maternity Grant

NI 12   - Maternity Benefit Application
NI 12A - Multiple Births
NI 13   - Special Maternity Grant Claim

  Sickness Benefit

NI 15   - Sickness Benefit Application
NI 15A - Sickness Benefit Follow-Up Medical Certificate

  Retirement Benefit / Grant

NI 82   - Retirement Benefit Application

  Funeral Grant

NI 8 - Funeral Grant Claim

  Survivors Benefits

NI 51 - Survivor Benefit Application

  Voluntary Insurance

NI 6 - Certificate of Voluntary Insurance Application
NI 11 - Voluntary Contributor Record Card


NI 42 - Nomination of Spouse
NI 79 - Application for Refund
NI 183 - Request for Statement of Contribution
NI 99 - Complaint Form
NI 65 - Life Certificate


Use of National Insurance Forms
Whenever  you perform National Insurance functions under the National Insurance Act or Regulations, you must accurately complete the specific National Insurance forms that are designed so that you can give all the information required.

All of these forms are available FREE of charge at any National Insurance Service Centre or are downloadable.



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National Insurance Board of Trinidad and Tobago (NIBTT)