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Ministry of Finance & Planning
Public Employees' Pension Administration System
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Application for Family Benefit Refund
Applicant Details
Taxpayer Registration Number *
Given/First Name *
Middle Name
Surname/Last Name *
Date of Birth *
Gender *
Last Ministry *
Last Employer *
Last Classification *
Service End Date *
Reason For Leaving Service *
Applicant Address
Address Line 1 *
Address Line 2
Country *
Parish/State/Province *
Postal Code/Zip Code
Primary Phone No. (Mobile) *
Alternate Phone No.
Email ID *
Reason for Request *
Employment Record * (Please list down the details of your employment history with Government of Jamaica in descending order.)
Name of EmployerStart Date of EmploymentEnd Date of EmploymentClassificationType Of Employment 
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Please provide dependent details as on service end date
Full NameDate Of BirthRelationshipAddressPhone Number 
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Please specify your bank account details for remittance
Name of Bank *
Bank Account No *
Branch *
Type of Account *
Transit number
Comments (if any)
Upload relevant attachment(s) *
File Type File Name Action
  Sample Bank Account Details Attachment
Allowed File Types are : , .jpg , .jpeg , .png , .xls , .xlsx , .doc , .docx , .gif , .ppt , .pptx
Allowed File Size is : 5242880 Bytes
Please type the text as shown in the image *