"Employer Request for Access to the Online C10 System" - Bahamas

This fillable "Employer Request for Access to the Online C10 System" is a document issued by the Bahamas National Insurance Board specifically for Bahamas residents.

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Download "Employer Request for Access to the Online C10 System" - Bahamas

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The National Insurance Board
Employer
Request for Access to
The Online C10 System
Name of Business: ________________________________________________________
Employer NI#:
_________________ Industry________________________________
(To be completed if business is sole proprietorship)
Self-Employed NI#:_____________S/E Name:__________________________________
Business Address: ________________________________________________________
Descriptive Address:_______________________________________________________
________________________________________________________________________
P. O. Box: _____ _______________City/Settlement:____________________________
Island.: _______________________________Business License #: __________________
Phone 1:
______________ Extn.: ___________Phone 2: ______________________
Fax Number: ______________________Cell Phone: ____________________________
Contact Person:
________________________Position__________________________
Email Address:
________________________________________________________
Alt. Email Address:_______________________________________________________
Preferred Method of Communication with NIB:
Email
Fax
Regular Mail
Terms of Access
1. Access to the National Insurance Board’s website has been granted to the above referenced
business for the sole purpose of entry and submission of online C10s.
2. All user-ids and passwords assigned are expected to be kept confidential by the indicated Contact
Person. You are required to immediately advise N.I.B. of any change in Contact Person.
3. Submission of data through this service is accepted as having been officially presented to The
National Insurance Board as a signed document.
4. The National Insurance Board reserves the right to terminate the assigned access at its sole
discretion at any time.
I agree to the terms detailed above.
Signed:
___________________________
Date: _____________________
Print Name:____________________________
Position:___________________
To expedite processing, the completed application may be scanned and e-mailed to inspectorate@nib-bahamas.com.
Please note that before access is granted, the original document must have been received at NIB’s Inspectorate
Department, P. O. Box N 7508, Nassau, Bahamas or it may be hand-delivered to your nearest NIB office.
The National Insurance Board
Employer
Request for Access to
The Online C10 System
Name of Business: ________________________________________________________
Employer NI#:
_________________ Industry________________________________
(To be completed if business is sole proprietorship)
Self-Employed NI#:_____________S/E Name:__________________________________
Business Address: ________________________________________________________
Descriptive Address:_______________________________________________________
________________________________________________________________________
P. O. Box: _____ _______________City/Settlement:____________________________
Island.: _______________________________Business License #: __________________
Phone 1:
______________ Extn.: ___________Phone 2: ______________________
Fax Number: ______________________Cell Phone: ____________________________
Contact Person:
________________________Position__________________________
Email Address:
________________________________________________________
Alt. Email Address:_______________________________________________________
Preferred Method of Communication with NIB:
Email
Fax
Regular Mail
Terms of Access
1. Access to the National Insurance Board’s website has been granted to the above referenced
business for the sole purpose of entry and submission of online C10s.
2. All user-ids and passwords assigned are expected to be kept confidential by the indicated Contact
Person. You are required to immediately advise N.I.B. of any change in Contact Person.
3. Submission of data through this service is accepted as having been officially presented to The
National Insurance Board as a signed document.
4. The National Insurance Board reserves the right to terminate the assigned access at its sole
discretion at any time.
I agree to the terms detailed above.
Signed:
___________________________
Date: _____________________
Print Name:____________________________
Position:___________________
To expedite processing, the completed application may be scanned and e-mailed to inspectorate@nib-bahamas.com.
Please note that before access is granted, the original document must have been received at NIB’s Inspectorate
Department, P. O. Box N 7508, Nassau, Bahamas or it may be hand-delivered to your nearest NIB office.