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MDA email template — NIS Life Certificate
Email Templates / MDA Emails
MDA Submission Email — NIS Life Certificate
This email is sent to the NIS when a claimant submits their NIS Life Certificate confirming they are still alive. It shows the submission details and the full form data.
Preview:
You have received a NIS Life Certificate submission
Service:
NIS Life Certificate
Submission ID:
[Reference ID]
Submission date:
[dd/mm/yyyy]
Submission time:
[hh:mm]
Applicant phone number:
[246-xxx-xxxx]
Applicant email:
[email]
Here is the data from this request:
Declaration
I [Applicant's name] confirm that my information is true and correct. I understand that false details may lead to my application being rejected or legal action and that the Government of Barbados will keep my information confidential.
Name
[Claimant's full name]
Date
[dd/mm/yyyy]
Claimant details
National Insurance number
[NIS number]
National Registration Number (NRN)
[NRN]
Last name
[Last name]
First name
[First name]
Middle name(s)
[Middle name(s)]
Address
[Address]
District
[District]
Parish
[Parish]
Postal code
[Postal code]
Email address
[Email address]
Telephone number
[Telephone number]
Mobile number
[Mobile number]
Date of birth
[dd/mm/yyyy]
Benefit details
Which benefit do you receive?
[Benefit type]
Have you remarried or cohabitated this period?
[Yes / No — if Survivors Benefit]
Date of marriage or cohabitation
[dd/mm/yyyy — if remarried/cohabitated]
Witness details
Date the claimant was confirmed alive
[dd/mm/yyyy]
Witness full name
[Witness name]
Witness profession or title
[Witness profession]
Date signed
[dd/mm/yyyy]
Due date: [To be filled by officer]
Officer assigned: [To be filled by officer]
Reference: [To be filled by officer]
You have received a NIS Life Certificate submission
Service:
NIS Life Certificate
Submission ID:
[Reference ID]
Submission date:
[dd/mm/yyyy]
Submission time:
[hh:mm]
Applicant phone number:
[246-xxx-xxxx]
Applicant email:
[email]
Here is the data from this request:
Declaration
I [Applicant's name] confirm that my information is true and correct. I understand that false details may lead to my application being rejected or legal action and that the Government of Barbados will keep my information confidential.
