Fillable Printable State Pension Forecast Form
Fillable Printable State Pension Forecast Form
State Pension Forecast Form
State Pension
Forecast
BR19 11/10
Who can get a
State Pension forecast
You can get a State Pension forecast if you are
more than 30 days away from State Pension age
when we process your application. It will take an
average of 10 working days to prepare your
forecast from the date we receive your
application form.
Completing the form
If you need any help, please phone us on
0845 3000 168 (if you live in the UK) or +44 191
218 3600 (if you live outside the UK), or write to
us at:
State Pension Forecasting Team
The Pension Service
Tyneview Park
Whitley Road
Newcastle upon Tyne
NE98 1BA
United Kingdom
Other ways to get a State
Pension forecast
If you live in the UK you can get a forecast:
•
online by visiting the website
www.direct.gov.uk/pensionforecast and
following the State Pension Forecasting links.
•
by calling the State Pension Forecasting Team
and we will take your application over the
phone. Our phone number is 0845 3000 168.
Our opening hours are Monday to Friday 8am
to 8pm and Saturday 9am to 1pm. For security
and quality purposes your call may be
monitored and recorded.
If you have speech or hearing difficulties you can
contact us using a textphone on 0845 3000 169.
Or you can use Text Relay by dialling 18001 0845
3000 168.
If you live outside the UK
You can call the State Pension Forecasting team
by dialling +44 191 2183600. Lines are open 8am
to 5pm Monday to Friday
What your State Pension
forecast will tell you
Your forecast will give you, using today’s prices,
estimates of the basic and additional State
Pension (and Graduated Retirement Benefit if
appropriate) that you may get at State Pension
age, based on:
•
your National Insurance (NI) contributions so
far, and
•
what we expect your future NI contributions to
be.
If you have a spouse or civil partner, it does not
include any State Pension for them.
Your forecast will also tell you if there is anything
you can do to improve your basic State Pension. If
you have little or no basic State Pension and you
have a spouse or civil partner, you may be able to
get a basic State Pension based on their NI
contributions.
If you are divorced or your civil partnership has
been dissolved
•
We will not contact your former spouse or civil
partner and any information you give us about
them in Part 8 will only be used to trace their
NI contribution record.
•
Your forecast will also tell you the amount of
any additional State Pension gained or lost as
the result of a share order issued by the Court
during your divorce or dissolution proceedings
Sending your forecast to
someone else
Our records are strictly confidential and we
cannot send your forecast to someone else unless
they are authorised to act on your behalf
(for example, they have Power of Attorney) or we
have your permission in writing. If your
representative is authorised to act on your behalf
we need to see proof of that authority before we
can send your forecast to them. If you would like
us to send your forecast to someone else, please
tick the box in Part 9 and fill in Part 10.
Tracing a lost occupational
or personal pension
The Pension Tracing Service
It’s easy to lose contact with a previous employer
and their pension scheme if, for example, you
have changed jobs several times. If you think you
have one or more old company or personal
pensions, but you don’t know the full details,
contact the Pension Tracing Service. If you can
give details of the company who you worked for,
or the provider you had your pension(s) with, the
Pension Tracing Service may be able to give you
the scheme’s contact details. You do not have to
pay for this service.
Once you have the contact details, you can ask
the pension provider to check whether you have a
pension with them.
You can contact the Pension Tracing Service by:
•
phoning 0845 600 2537 (lines are open from
8am to 6pm Monday to Friday). If you are
calling from abroad, the phone number is +44
191 2154491
•
textphone on 0845 3000 169. Or you can use
Text Relay by dialling 18001 0845 600 2537.
•
going to the website at
www.direct.gov.uk/pensions
•
writing to:
The Pension Tracing Service
Tyneview Park
Whitley Road
Newcastle upon Tyne
NE98 1BA
United Kingdom
Claiming State Pension
You cannot use this form to claim your
State Pension.
To find out how to claim your State Pension go to
www.direct.gov.uk/pensions
However, further information will be sent to you
with your forecast.
How we collect and use
information
The information we collect about you and how we
use it depends mainly on the reason for your
business with us. But we may use it for any of the
Department’s purposes, which include:
•
social security benefits and allowances
•
child support
•
employment and training
•
private pensions policy, and
•
retirement planning.
We may get information from others to check the
information you give to us and to improve our
services. We may give information to other
organisations as the law allows, for example to
protect against crime.
To find out more about how we use information,
visit our website www.dwp.gov.uk/privacy-policy
or contact any of our offices.
State Pension
Forecast
Application for a State Pension forecast
BR19 11/10
Part 1 About you
Please tell us about yourself. Use BLOCK CAPITALS.
Date of birth
Surname or family name
Other names
Address
All other surnames or family
names you have been known
by or are using now.
National Insurance (NI) number
Mr/Mrs/Miss/Ms
Postcode
Correspondence address
if different
Postcode
Letters Numbers Letter
Part 2 Marital status
Please tick the description that applies to you and give dates if possible.
If you are no longer married or in a civil partnership we will ask you for
more information later in the form.
Single
Married
Date of marriage
Civil partner
Date of formation of civil
partnership
Divorced
Date of divorce
Civil partnership dissolved
Date of dissolution
Widowed
Date you were widowed
Surviving civil partner
Date your civil partner died
Application for a State Pension forecast continued
Part 3 Contact details
Home phone number
Part 4 What you are doing now
By letter to the
address given in Part 1
By phone.
Please give number below
Code Number
Daytime phone number,
if different
Code Number Ext
We can send your forecast in
English or Welsh. Which
language do you prefer?
We can only send you a forecast
in Welsh if you live in Wales.
English
Welsh
We can send you information
in braille or large print.
Please tick the box if you
prefer one of these choices.
Braille
Large print
a Working for an employer
b Working for an employer and
getting Working Tax Credit
d Self-employed and getting
Working Tax Credit
c Self-employed
If we need to contact you
before we send you your
forecast, how would you prefer
us to get in touch with you?
What is this number? Work Mobile Textphone
Please tick all the boxes that describe what you are doing now.
e Not working
f Getting Statutory Sick Pay
j Getting Carer’s Allowance
previously known as Invalid Care Allowance
k Getting Severe Disablement Allowance
h Getting Incapacity Benefit
g Registered for Jobseeker’s Allowance
Marriage annulled
Date of annulment
Part 2 Marital status continued
Please send your certificate of annulment
Civil partnership annulled
Date of annulment
Please send your certificate of annulment
About NI contributions
If you have ticked any of the boxes a to d shown above, we need to
know about the NI contributions you are paying.
If you can improve your basic State Pension by paying Class 3 voluntary
NI contributions, we will tell you about this in your forecast.
i Getting Employment and Support
Allowance
Application for a State Pension forecast continued
Part 4 What you are doing now continued
Part 5 Living outside the United Kingdom (UK)
We use United Kingdom (UK) to mean England, Scotland, Wales and
Northern Ireland.
If you have not lived outside the UK please go to Part 6.
If you have lived outside the UK at any time since the age of 16,
please tell us where you have been. Do not include holidays or
periods served in HM forces.
If you are working for an
employer, please tell us your
current earnings before tax and
National Insurance.
£
Each week
Each month
Each year
Australia – please give dates
Canada
New Zealand
Any other country
Which countries?
Please tick the boxes that apply to you.
from to
About NI contributions – continued
Paying full-rate NI contributions
Paying married woman’s or
widow’s reduced-rate
NI contributions
Paying Class 2 self-employed NI contributions
Not paying NI contributions
Paying Class 3 voluntary NI contributions
Please tick all the boxes that apply to you.
If you are currently living outside
the UK, please provide details of
the country you are living in and
when you went to live there:
Country
From
Application for a State Pension forecast continued
Please also tell us if
Part 7 Extra information
We can also tell you what may happen to your State Pension in
different situations. If you want extra information in your forecast,
please tick the things you want to know about. If not, go to Part 8.
You were getting
bereavement benefits
which have now stopped
You have voluntarily given up
your entitlement to
Widow’s Benefit
You are currently disqualified
from getting Widow’s Benefit
If you put off claiming your
State Pension
Please tell us the date when
you may want to start
claiming your State Pension
If you stop work before you
reach State Pension age
If you currently live in the UK
but may go to live outside
the UK
If you are married or a civil
partner but are about to get
divorced or dissolve your civil
partnership
If your annual earnings change
Do not include pension income
Please tell us the date you
may stop working
Please tell us the country you
may go to
Please tell us what they
might change to
£
Please tell us your expected
date of divorce or dissolution
Part 6 Widowed or a surviving civil partner?
Widow’s Benefit or
bereavement benefits
War Widow’s Pension
War Widower’s Pension
Industrial Death Benefit How much Industrial Death Benefit do you get each week?
If this does not apply to you, please go to Part 7.
If you are currently widowed or a surviving civil partner
please tick the boxes that apply to you.
Are you getting or did you get
£
Application for a State Pension forecast continued
Part 9 What to do now
Where do you want your forecast sent?
To me at the address I have
given in Part 1
Please go to Part 11.
Please see the section below before
going to Part 10.
To my representative
Please go to Part 10.
Please provide proof of your authority,
for example, power of attorney.
I am a Personal Acting Body.
Send the forecast to me
In addition, if you have indicated above that you want your forecast to go
to your representative, tick the box below if you want this representative
to also have permission to handle any follow-up enquiries relating to the
State Pension forecast issued. This authorisation relates to enquiries made
to the Future Pension Centre only.
Please note that we can only provide information to your representative for
the period that your forecast is held on our computer records. If you request
another forecast in the future, you would need to provide further
authorisation for us to provide/discuss that forecast with your representative.
Part 8 Former marital or civil partner status
Their date of birth
Date you married or formed
a civil partnership
Their full name
Their last known address
Your ex or late spouse or civil
partner’s National Insurance
(NI) number
Postcode
Letters Numbers Letter
Only fill in this part if
•
you are widowed or a surviving civil partner
•
you are divorced or your civil partnership has
been dissolved
•
you are about to be divorced or have your civil
partnership dissolved, or
•
your marriage or civil partnership has been
annulled.
If this does not apply to you, or it does but you
would like us to provide you with a forecast based
on your own NI contributions only, please go to
Part 9.
Do not fill in this part if you have since
remarried or formed a new civil partnership.
Please give as much information as you can to
help us trace your last spouse or civil partner’s
NI contribution record.
Please tick the box that applies to you.
Please go to Part 10.I want my representative to
handle any follow-up
enquiries that relate to my
State Pension forecast
Application for a State Pension forecast continued
Part 10 Your representative
Surname or family name
Other names
Address
Organisation’s name
if this applies
Mr/Mrs/Miss/Ms
Postcode
Daytime phone number
Code Number Ext
Fax number
Code Number
Reference number if you know it
Part 11 Signature
Please sign and date this form.
Date
Signature
Please give details of your representative.
If you are a Personal Acting Body, please give your name and address.
Please go to Part 11.
BR19_112010_006_001
Where to send the form
Please send the form to the address below.
State Pension Forecasting Team
The Pension Service
Tyneview Park
Whitley Road
Newcastle upon Tyne
NE98 1BA.
