Opt Out Of The Teachers' Pension Scheme printable pdf download

Date of receipt:

Opt out of the Teachers’ Pension Scheme

This form should only be completed if you’re eligible to join the Teachers’ Pension Scheme (TPS) but decide you do not wish to be a member.

Please complete Part A . Your employer will need to complete Part B and return it to us. Once we receive your form we’ll then confirm the effective date of your opt-out.

If you have contracts with more than one employer and you wish to opt out of multiple contracts, you must opt out from each one separately as required.

Part A: To be completed by the applicant in all cases.

Section 1: Personal details

10. Mobile telephone number

Teacher’s reference number

11. Personal email address for all future correspondence

We will send details of your benefits to your email address

Surname

12. If you are opting out of ALL TPS contracts or have only ONE

Former surname (if any)

TPS contract please tick this box and go directly to Q.17

First name

13. Please enter the name of the Employer to which

this opt out relates (If your Employer is a Local

Authority, then please enter the LA name. Otherwise,

Title (please tick, or state if other)

please provide the full name of the establishment)

Mrs

Miss

Other

14. Do you have more than one TPS contract with the Employer

Date of birth (e.g. dd/mm/yy)

named above?

Yes

(Go to Q.15)

(Go to Q.17)

National Insurance number

15. If Yes, do you wish to opt out of ALL TPS contracts with this

Employer?

Contact address

Yes

(Go to Q.17)

(Go to Q.16)

16. If No, from which TPS contract do you wish to opt out?

Postcode

Home telephone number (inc. STD code)

If you are employed in teaching on a full time basis but also undertake some part-time teaching, your employer should not deduct contributions for your part-

time earnings, therefore, you don’t need to opt-out to avoid payment of contributions on your part-time earnings.

17. Reason for opt-out

(choose one option)

Personal financial reasons

2012-2013 contribution increases only

Scheme reforms other than 2012-2013 contribution increases

Joined other scheme

Leaving teaching

Other, please state

OPT OUT / December 2012