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Statement of Service Request Form for Teaching Staff ESP9t

• About this form
• When to use this form
• What you will need to complete the form

• Download the form (Excel, 36.35 KB)

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About this form

This form requests a teacher's statement of service, in other words their employment service record.

When to use this form

Use this form when a teacher requests a statement of service or a copy of their employment service record.

What you will need to complete the form

You will need the teacher's:

• MOE number
• personal details
• IRD number
• cheque for $56.25, made out to the name of your pay centre (if they want a full statement of service).