Quotation to Purchase Service under the Notional Service Purchase Scheme - Application by a Teacher

• Published date: 24 October 2019
• Issuer: Department of Education

Aonad na bPinsean

An Roinn Oideachais agus Scileanna

Corr na Madadh

Baile Átha Luain

Co. na hIarmhí

N37 X659

Pension Unit

Department of Education and Skills

Cornamaddy

Athlone

Co. Westmeath

N37 X659

Email: pensions@education.gov.ie www.education.ie Form NSQ 1 – 1st Jan. 2018

APPLICATION FOR A QUOTATION TO PURCHASE SERVICE UNDER

THE NOTIONAL SERVICE PURCHASE SCHEME.

Circular 129/06 should be read before completing this form.

Please complete this form in full using block letters:

- Do not leave any gaps from the date which you started your working.

- Unpaid absences include such absence as career breaks, unpaid maternity

leave, unpaid sick leave, strike days, any unpaid personal leave.

- Teaching status includes permanent, temporary, substitute, part time, EPT,

RPT, job sharing or CID teaching service.

- Applications for quotations must be received at least 6 weeks before your

next birthday

Please note that there are a number of circumstances which exists whereby notional

service cannot be purchased. This include:

- If you are not currently employed

- If you are in the Single pension scheme

- If you are currently on sick leave

If you are in casual or intermittent employment.

This list is to be used as a guide only and is not exhaustive.

Note: Members who are seeking to purchase notional service and also wish to avail of

a career break must have their application and contract completed in full prior to the

start of their career break

Please tick (√) box to indicate which sector in which you are employed:

Primary Post Primary Special Needs Assistant

PART 1 - YOUR DETAILS BLOCK CAPITALS ONLY PLEASE.

Surname: _______________________________ First Name: __________________

PPSN: _________________________ Date of Birth: __________________

Telephone Contact: ____________________________

Email address: ________________________________

Postal Address: _______________________________

On what date do you intend to retire: ______________________