The templates on this page are for people who are getting divorced or separated. They only apply to members of the HSE Pension Scheme.
If you are in the Single Public Service Pension Scheme, contact your local pensions office.
If you are in a Voluntary Hospital or Nominated Health Agency scheme, email NFLP@hse.ie to get the correct templates.
Templates
Divorce proceedings
Notice to Trustees (HSE Scheme - divorce - current employee)
Draft Pension Adjustment Order (HSE Scheme - divorce - current employee)
Judicial separation proceedings
Notice to Trustees (HSE Scheme - judicial separation - current employee)
Draft Pension Adjustment Order (HSE Scheme - judicial separation - current employee)
Next steps
Notice to Trustees (NTT)
Send the completed, signed, and dated Notice to Trustees by registered post. Keep the registered post receipt as proof that it was sent.
Draft Pension Adjustment Order (DPAO)
The Draft Pension Adjustment Order must be sent to the National Family Law Pensions Unit before it goes to Court.
You can email or post the completed draft for review.
The Trustees will confirm in writing if it can be implemented.
Send the Trustees’ letter and the approved Pension Adjustment Order to the Court.
Once the Court certifies the Pension Adjustment Order, the Trustees will implement it.
Email: NFLP@hse.ie
Phone: 071 982 0542
Phone: 071 982 0442
National Family Law Pensions Unit,
HR Shared Services,
National HR, HSE,
Aras Sláinte Chluainín,
Manorhamilton,
Co Leitrim,
F91 AP57
Disclaimer
The templates on this website are for guidance only and do not replace legal advice.