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Please download and answer all relevant sections of the form. You can submit completed Claims at the SSB Branch Office nearest you.

*Sickness Benefit Claims can be submitted online using your My Social Security Portal Account at: SSBPORTAL.ORG.BZ

Abbrev.	REGISTRATION
R1A	Employee Listing to be provided by Employer.
Card Pick Up	Card Pick Up Authority Form

Abbrev.	SHORT TERM BENEFITS
SB1, SM2 SB	Claim Form and Salary Record for Sickness Benefit.
MB, SM2 MB	Claim Form and Salary Record for Maternity Benefit.
MB5, SM2 MG	Claim Form and Salary Record for Maternity Grant.
FG1	Claim form for Funeral Grant.

Abbrev.	EMPLOYMENT INJURY
IB 1, IB 7	Claim form and Witness Report for Injury Benefit.
IB 8	Continuation of Injury Benefit.
IB 17	Application for Disability Benefit.
SVB1	Application for Survivors or Death Benefit.

Abbrev.	LONG TERM BENEFITS
INV 1	Application for Invalidity Benefit.
RB 1	Application for Retirement Benefit.
RB/DIS/INV P6	Pensioner's Life Declaration Form for Retirement, Disability or Invalidity Pensions.
NCP 1	Application for Non-Contributory Pensions.
NCP P6	Pensioner's Life Declaration Form for Non-Contributory Pensions.
SVB1	Application for Survivors' or Death Benefit.
SVB-DB P6	Pensioner's Life Declaration Form for Survivors’ or Death Pensions.

Abbrev.	CONTRIBUTIONS
Payroll Template	Payroll Sample for small to medium businesses to track weekly wages paid to employees.
ED1	Employment Declaration for Contribution History/Record.
DP7	Application to apply for Contributions Refund.
Emp_Access	Employer Access Request for Online Employer Services.

Abbrev.	MISCELLANEOUS
AP 1	Application to Appeal your claim.
AR 1	Accident Record form to be submitted by Employer.
BLA 1	Application for Business Loan (Investment Services).
DDA	Authorization form to update Bank or Credit Union Information.
Pension DA	Authorization form for Pensions.
NCP SA	Standing Authority form for Non-Contributory Pensions.