Employee Registration Form

Please complete all the required fields to register as a member.

1. PERSONAL PARTICULARS (Some fields optional)

Title (Optional)

Surname

Other Name(s)

Ghana Card No.

Date of Birth

SSNIT No.

Tel No.

Email (Optional)

Gender

Name of Employer

Date of Employment (Optional)

Postal Address

Residence Address

Nationality

Hometown

Region

GPS Address (Optional)

Other ID Card

ID Card No.

Occupation

Marital Status

Salary (GH₵) (Optional)

2. NEXT-OF-KIN DETAILS

Full Name

Gender

Relationship

Phone Number

Email (Optional)

3. BENEFICIARY NOMINATION (All fields optional)

Beneficiary 1

Full Name (Optional)

Relationship (Optional)

Date of Birth (Optional)

Email Address (Optional)

Phone Number (Optional)

Relationship to Member (Optional)

Residence Address (Optional)

% Share (Optional)

4. MEMBER DECLARATION

certify that all information provided on this form is true and accurate. I further confirm that, I am of sound mind on this day

in the nomination of persons as my dependents to receive death and survival benefits in the event that I am no more.

Member's Signature

Date (YY/MM/DD)

NB: It is important that all information supplied is complete and accurate in order that a correct member record is established.

FOR OFFICE USE ONLY

This section is restricted and will be completed by Standard Pensions Trust staff.

Comments

Processing Date

Approval Status

No. 42 Nii Nortey Nanchii Street

Dzorwulu Accra, Ghana

P. O. Box 8952 Accra-Ghana

+233 (0) 302 780 720 | +233 (0) 302 780 765 | +233 (0) 302 780 793 | +233 (0) 302 780 452

www.standardpensions.com

Corporate Trustee. Pension Fund Administrator