Special Collection Form: Cessation of Employment Certificate (SC3)

• Published date: 26 April 2021
• Issuer: Department of Social Protection

SC3

PART 1

Department of Employment Affairs and Social Protection

Cessation of Employment Certificate

EMPLOYER: Parts 1 - 3 of this form should be issued to a special contrib utor (non-PAYE employee) on cessation of

employment. Please ensure that all Parts are completed.

If the employee entered your e mployment since the start of the Tax Year, you should show at 3(a) belo w

the reckonable earnings in respect of your employment only.

If you have been advised of reckonable earnings from previou s employment(s) since the start of the Tax

Year, you should include at 3(d) with the total earnings in your employment, shown at 3(a).

EMPLOYEE:  See notes on Part 3 of this form about claiming Jobseekers Benefit or taking up new employment.

NEW EMPLOYER:  See note on Part 2 of this form.

1 Employee’s Personal Details

Full Name:

PPS number:

Date of Birth:

Home Address:

2 Contribution Details

Social Insurance Contribution Class at commencement of employment

Number of weeks of insurable employment at this Class

Social Insurance Contribution Class if it changed during this employment

Number of weeks of insurable employment at this Class

3 Earnings Details

Currency

Amount

a) Gross reckonable earnings in your employment since start of

Tax Year

b) Total of employee’s share of PRSI contributions deducted

c) Total Social Insurance Contributions (Employer &

employee) paid on the amount listed at 3(a) above

d) Total gross reckonable earnings including earnings in other

employments since start of Tax Year

4 Employment Details

Date of commencement of employment (where it occurred after

start of Tax Year)

Date of cessation of employment

Employer’s Registered Number

DECLARATION

I declare that all the details I have given at Section 1 to 4 above are true and complete and that the above PRSI contributions have

been or will be remitted to the Department in accordance with Social Welfare Regulations.

Signed_________________________ Date________________

Employers Name____________________________________________

Address___________________________________________________

Day

Month

Year

Official Stamp