Forms

A form for declaring a change in marital or economic status (to be filled out once a year)

A form to be filled out by a woman who was awarded a judgment for maintenance in cases of termination or renewal of the request for maintenance pay.

This form may not be sent by mail.

This form is meant for single-parent families or families receiving a subsistence benefit who request a study grant. 

Declaration of woman on early pension whose husband is an Israeli resident

This form explains how it is determined who is the worker's primary employer and who is his secondary employer, based on the worker's declaration on form 101 (worker information form). The worker's employers must deduct insurance contributions from the worker's salary in accordance with this determination.

A form for monthly reporting on members of kibbutz/collective settlement

A form for reporting on changes in kibbutzim or collective settlements (property, exports, transfers from one type to another)

This form is meant for carrying out coordination of insurance contributions by:

·         the secondary employer for a worker who works as a salaried employee in two workplaces

·         the person paying a pension to a person who is both a pension recipient and a salaried employee in the same workplace, or to a person receiving a pension from two sources

on condition that the income from the primary employer or from the primary pension payer is under 60% of the average wage NIS 5,171 (as of 01.01.2012) .

This form is meant for reporting on workers employed during election periods.

This form is meant for workers defined as salaried employees under "classification of insured order" of the National Insurance Institute, such as: lecturers, artists and tour guides.

Employer's announcement of the closing of a file.

This form is meant for  salaried employees/those on early pension from a number of sources, whose monthly income from one or more sources is higher than the income ceiling for payment of insurance contributions NIS 41,850 (as of 01.01.2012) .

The form is meant for salaried employees/those on early pension from a number of sources, whose income from one source or from several sources is higher than the income ceiling for collection of insurance contributions NIS 41,850 (as of 01.01.2012) and who wish to receive a future authorization based on insurance contribution coordination.

The form is meant for employers who have a debt to the NII and they wish to submit a request to cancel or reduce the fine.

The form on which all the employee's wages and deductions every month are itemized – including additional payments and deductions related to his monthly wages liable for insurance contributions. This form can be attained from all employers and pension payers.

Form for authorizing the debiting of a bank account for employers who have a representative connected to the National Insurance Institute’s Client Representation System, for the purpose of implementing a payments agreement for employers

Consent of claimant that the National Insurance Institute can receive all relevant information for determining eligibility and can release information that the NII has on the claimant

This form is for people in the client representation system on the internet - to add/delete office employees as users of the system (this form has to be filed with the addendum of confidentiality NII/66).

This form is for representatives, accountants or tax consultants who would like to inform the NII that they are canceling representation of clients.

This form is for representatives interested in representing people with the NII.

The form is meant for spouses who wish to be recognized as common-law spouses

The form should be filled out for every foreign resident (including volunteers) for whom insurance contributions were calculated.

The form is to be filled out by persons who have a 1A visa or a 5A visa, and who wish to be recognized as residents by the National Insurance Institute (subject to completing a waiting period).

This form is for an insured person requesting to correct the tax advances for the year

The form is to be filled out by persons who have a 2A visa, or a 4A visa as persons accompanying those with a 2A visa, and who wish to be recognized as residents by the National Insurance Institute (subject to completing a waiting period).

The form is to be filled out by persons who have a residency visa, including A5, and who the National Insurance Institute has requested to fill out this form.

The form is meant for payment of current national insurance contributions by means of credit card. The form should be filled out and transferred to the collection department in the local NII branch closest to one's place of residence.

Declaration of an insured who began working as a salaried employee after being in the status of "not working".

Claims form for payment of maternity allowance to a father entitled to maternity leave

The form is for Israeli citizens who would like to be examined for the purpose of determining a percentage of mobile disability.

The form is for those who have limited mobility and are applying for mobility related benefits.

Request for survivor’s benefit for the widow and orphans of an Israeli resident who was not insured (because he/she took up residence in Israel after having reached retirement age).

This form for the obtaining of an employer’s authorization for a discharged soldier who is submitting a claim for a grant for vital work and who is employed as a personal caretaker and assistant

Employer’s claim to return reservist’s benefit after it was paid to the employee.

Meant for submitting personal claim for reservist’s benefit by people who are not employees. IDF Confirmation, form number 3010 must be enclosed.

This form should be filled by the employer if  it was not filled in the original personal claim form for reservist’s benefit.

Application for compensation for families of terrorist act victims.

Claim form for compensation for the families of those killed in terrorist acts.

Claim to combine disabilities to a work disabled person, for whom  a number of disability degrees was determined due to a number of work injuries, and regarding whom the accumulative character of the disabilities has substantially hurt his earning capacity.

Claim form for a work disabled person for whom a medical committee determined a temporary disability degree and who cannot perform any work, has no income from work or business, is not eligible for sick days and  requests to be recognized as a "disabled person in need".