Fillable Printable The Pension Service Claim Form - England
Fillable Printable The Pension Service Claim Form - England
The Pension Service Claim Form - England
Help using this PDF claim form
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or a newer version.
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•
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•
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If you are having technical difficulties:
• downloading the form
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• printing the form
Please contact the DWP Online helpdesk.
Phone: 0345 604 3349
Minicom (textphone): 0345 604 0523
Email: [email protected]
Opening hours
Monday to Friday: 8.00am - 6.00pm
Closed on all Public and Bank Holidays.
For help and advice on the information you need to put on the form or about
the benefit you want to claim, contact the office that deals with the benefit.
InternationalPensionCentre
ThePensionService11
MailHandlingSiteA
Wolverhampton
WV981LW
UnitedKingdom
InternationalPensions
DirectPayment
NotestohelpyoufillinPart9ofIPCBR1GOV
WhatisInternationalPensionsDirectPayment?
InternationalPensionsDirectPaymentistheDepartmentforWorkandPensions’wayofpayingyourpensionorbenefitdirecttoanaccountofyourchoice
outsidetheUnitedKingdom.
Theadvantages
Gettingyourmoneypaidinthiswayhasmanyadvantages:
•
itissecure
•
itisconvenient
•
youwillbenefitfromcompetitiveexchangeratesbasedonbulkbuyingofcurrency
•
therearenopostaldelays
•
therearenochequeclearancedelays
•
itislessexpensiveforustoarrange,whichsavestaxpayers’money.
Howdoesitwork?
The£sterlingvalueofyourmoneywillbeconvertedtolocalcurrencyandpaiddirectlytoyouraccount.Yourpensionorbenefitwillbepaidinarrears.
Youcanchoosetobepaidattheendof4or13weeks
Ifyouchoosetobepaidevery4weeks
Themoneywillbepaidintoanaccountforyouintheweekfollowingeach4weekperiod.Yourfirstpaymentmightcoveraperiodof2to5weeks,but
afterthisallpaymentswillcovera4weekperiod.
Ifyouchoosetobepaidevery13weeks
Themoneywillbepaidintoanaccountforyouintheweekfollowingeach13weekperiod.Yourfirstpaymentmightcoveraperiodof2to14weeks,but
afterthisallpaymentswillcovera13weekperiod.
ButifyouareonlygoingtogetasmallStatePensionorbenefityouwillbepaidonceayear.
IPCBR1GOVBankingNotes12/13
1
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Youcanworkoutwhatexchangeratehasbeenusedforeachpaymentbydividingtheamountbythe£sterlingvalueofyourmoney.
Abouttheaccountyouwanttouse
•
Youcanuseanaccountinyourname,orajointaccount.
•
Youcanusesomeoneelse’saccountif:
–thetermsandconditionsoftheiraccountallowthis,and
–theyagreetoletyouusetheiraccount,and
–youaresuretheywilluseyourmoneyinthewayyoutellthem.
•
Ifyouareanappointeeoralegalrepresentativeactingonbehalfofthecustomer,theaccountshouldbeinyournameonly.
Findingouthowmuchwehavepaidintotheaccount
Wewilltellyouwhenwewillmakethefirstpaymentandhowmuchitwillbeforin£sterling.Youcancheckyourpaymentsonaccountstatements.The
statementsmayshowyourNationalInsurancenumbernexttoanypaymentswehavemade.Ifyouthinkapaymentiswrong,getintouchwithus
straightaway.
Changesinpensionorbenefit
Wewilltellyouwhenthemoneyyougetfromusgoesup.Theamountofmoneywesendyoumaychangebecauseofcurrencyexchangerates.
Ifwepayyoutoomuchmoney
Ifwepayyoutoomuchmoneywehavetherighttotakebackanymoneywepaythatyouarenotentitledto.Thismaybebecauseofthewaythe
paymentsystemworks.Forexample,youmaygiveussomeinformationwhichmeansyouareentitledtolessmoney.Sometimeswemaynotbeableto
changetheamountwehavealreadypaidyou.Thismeanswewillhavepaidyoumoneythatyouarenotentitledto.Wewillcontactyoubeforewetake
backanymoney.
Importantadditionalinformation
Youmusttellusstraightawaywhenyourbankoraccountdetailschange.Ifyoudonot,yourpaymentsmaybedelayed.
Ifyourequirefurtherinformation,pleasecontactuson+441912187777.
Youmayfinditusefultokeepthesenotes.
NotestohelpyoufillinPart9ofIPCBR1GOV-continued
2
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StatePensionclaimform
IPCBR1GOV12/13
Part1Aboutyou
1
Benefityoucangetbecauseofthisclaimcanbepaidmorequicklyifyou:
•
answerallthequestionsontheformthatapplytoyou,andyourhusband,wifeorcivilpartnerifyouhaveone
•
sendusallthedocumentsweaskforwiththisform.
Ifyoucannotdothis,getintouchwithus,butbenefityoucangetbecauseofthisclaimmaybedelayed.
Surnameorfamilyname
Allothernames,infull
Title
Allothersurnamesorfamilynamesyouhavebeen
knownbyorareusingnowPleaseincludemaidenname
allformermarriednamesandallchangesoffamilynam
Yourpermanentaddress
PhonenumberAddyournationalandlocalareacode
Whatisthisnumber?Pleasetick
,
e.
No
Yes
PleasetellusyourNationalInsurance(NI)Number
YoucanfindyourNInumberonyourNInumbercard,
lettersfromsocialsecurityorpayslips.Butdonotdelay
sendinginthisformifyoucannotfindthenumber.
IfyoudonotknowyourNInumber,haveyouever
hadoneorusedoneatanytime?
LettersNumbers
Letter
HomeWorkMobileFax
IPCBR1GOV_122013interactivev0.0:IPCBR0001.qxd 11/03/2015 12:28 Page3
Part1Aboutyou-continued
Natureofevidence
Forofficialuseonly
Verifiedby
Checkedby
Certificatereturnedby
on
//
2
Dateofbirth
Pleasesendusyourbirthcertificate
Weneedtheoriginalcertificate.Ifyoudonotwishtosendyouroriginalcertificateaphotocopymaybe
acceptablebutonlyifthephotocopyhasbeenstampedandsignedbyanyofthefollowing
acivilservant
oradoctororsurgeonregisteredunderthelawsofthecountrywherethedeclarationismade
oraministerofreligion
orabarrister,solicitororadvocateauthorisedtopracticeinthecountrywherethedeclarationismade
oranotarypublicoranypersonallowedtoadministeroathsinthecountrywherethedeclarationismade
oranofficerofabankauthorisedtosigndocumentsonthecustomer’sbehalf
oramagistrate
Ifyoudonothaveyourbirthcertificate,andareunabletosenditquickly,donotdelaysendinginthisclaim
form.
Youmustremembertosendusallthedocumentsweaskfor.Ifyoudonot,benefityoucangetbecause
ofthisclaimmaybedelayed.
Otherdocumentsonwhichyourdateofbirthisrecordedmaybeacceptable.
Areyousendingyourbirthcertificatewiththisform?
No
Yes
Wewillsendthecertificatebacktoyou
assoonaswecan.
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Part1Aboutyou-continued
Haveyoueverlivedorworkedinthe
UnitedKingdomortheIsleofMan?
PleasegotoPart2.
Pleasetellusaboutthisbelow.
No
Yes
Haveyou,yourhusband,wifeorcivilpartner
everclaimedanyofthefollowingbenefitsin
orfromtheUnitedKingdomortheIsleof
Man?TheUnitedKingdomisEngland,
Scotland,WalesandNorthernIreland.
•
StatePension
•
GraduatedRetirementBenefit
•
Widow'sBenefit
•
BereavementBenefit
Whichbenefitwasclaimed?
Whoclaimedthebenefit?
Ifyouareamarriedwomangetting
StatePensionyouneedonlyfillin
Parts2,4,8and11ofthisform.
No
Yes
Pleasetellusaboutthisbelow.
YouYourhusband,wifeorcivilpartner
3
Pleasetellusanyaddress(es)youhadin
theUnitedKingdomortheIsleofManand
thedatesthatyoulivedthere.Ifyouneed
morespaceusethespaceinPart10atthe
endofthisform.
Address
Dates
From
To
From
To
Ifyouneedmorespaceusethe
spaceinPart10attheendofthis
form.
IPCBR1GOV_122013interactivev0.0:IPCBR0001.qxd 11/03/2015 12:28 Page5
Part1Aboutyou-continued
Pleasetellusaboutanytimeyouspentin
theUnitedKingdomortheIsleofMan.
Includeanyholidays.Ifyouneedmore
spaceusethespaceinPart10attheend
ofthisform.
FromTo
FromTo
FromTo
FromTo
4
HaveyoueverbeeninHMForces?
Pleasetellus
thedateyouenlisted
thedateyouweredischarged
whereyouweredischarged
theRegimentorcorpsyouwerein
yourservicenumber
yourrank
Whichservicewereyouin?
ArmyNavy
RAF
No
Yes
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Part1Aboutyou-continued
Didyouworkforanemployerinthe
UnitedKingdomortheIsleofMan?
Employer’snameandaddress
Ifyouknowthewagesaredealt
withatadifferentaddress,please
giveusthataddress,including
thepostcode.
Thedateyoustartedworkfor
thisemployer
Thedateyoustoppedworkfor
thisemployerifyouhavestopped
workingforthem
Payroll,stafforother
referencenumber
No
Yes
Pleasetellusaboutanyemployersyouhavehad.Ifyouhave
hadmorethan2employers,tellusabouttheminPart10.
Employer1Employer2
PleasegotoPart2.
5
Doyouhaveanycontributionorinsurance
recordcardsornoticesthatshowyouwere
employedintheUnitedKingdom?
No
Yes
Pleasesendustheoriginaldocuments,
notphotocopies.
IPCBR1GOV_122013interactivev0.0:IPCBR0001.qxd 11/03/2015 12:28 Page7
Part2
Aboutyourhusband,wifeorcivilpartner
Forofficialuseonly
Husband'sstatusbefore
marriage
Detailsofwifeimmediately
beforemarriage(status)
Detailsofwifeimmediately
beforemarriage(Surname)
Detailsofwifeimmediately
beforemarriage
eg.maidenname
No
Yes
6
Whatisyourcurrentmaritalor
civilpartnershipstatus?
Ifmarriedmorethanoncegivedetails
ofpreviousmarriagesinPart10
SinglePleasegotoPart4
Marriedorcivilpartner
Divorcedorcivilpartnershipdissolved
Widowedorsurvivingcivilpartner
Marriageorcivilpartnershipannulled
Separated
Tellusaboutyourhusband,wifeorcivilpartner
Theirsurnameorfamilyname
Theirothernames
Anyothernamesbywhichtheyhave
beenknown
TheirNationalInsurance(NI)numberif
youknowit
IfyoudonotknowtheirNInumberdid
theyeverworkorliveintheUnitedKingdom?
Theiraddress,ifdifferentfromyours
Theirdateofbirth
Dateofmarriageorcivilpartnershipformation
Dateofdivorce,annulmentor
civilpartnershipdissolution
Thedatetheydied,ifyouarewidowedora
survivingcivilpartner
LettersNumbers
Letter
IPCBR1GOV_122013 interactive v0.0b admin boxes:IPCBR0001.qxd13/03/201516:18Page 8
Part2
Aboutyourhusband,wifeorcivilpartner-continued
Certificatereturnedby
Natureofevidence
Verifiedby
on
//
Checkedby
Certificatereturnedby
Natureofevidence
Verifiedby
on
//
Checkedby
Certificatereturnedby
Natureofevidence
Verifiedby
on
//
Checkedby
Forofficialuseonly
1.Ifyouaremarriedoracivilpartnerpleasesendus
yourmarriagecertificateorcivilpartnership
certificate.
2.Ifyouarewidowedorasurvivingcivilpartnerplease
sendusyourlatehusband’s,latewife’sor
latecivilpartner’sdeathcertificateandyour
marriagecertificateorcivilpartnershipcertificate.
IfyouaregettingUnitedKingdomWidow’sBenefitor
BereavementBenefitthereisnoneedtosendthese
certificatesaswealreadyhavethesedetails.
3.Ifyouaredivorcedorapersonwhosecivil
partnershiphasbeendissolvedpleasesendusyour
decreeabsoluteorconfirmationofdissolutionofcivil
partnershipandyourmarriagecertificateorcivil
partnershipcertificate.InScotlandadecreeabsoluteis
calledadecreeofdivorce.
4.Ifyourmarriageorcivilpartnershipwasannulled
pleasesendusthecertificateofannulmentandyour
marriagecertificateorcivilpartnershipcertificate.
Areyousendingyourmarriageor
civilpartnershipcertificatewiththisform?
No
Yes
Wewillsendthecertificatebackassoonas
wecan.Pleasefillintherestofthisform.
YouneednotfillinPart3.
Areyousendingyourdecreeabsolute,decreeofdivorce,
certificateofannulmentorconfirmationofdissolution
ofcivilpartnershipwiththisform?
No
Yes
Wewillsendthecertificatebackassoonas
wecan.Pleasefillintherestofthisform.
YouneednotfillinPart3.
Areyousendingyourlatehusband’s,latewife’sor
latecivilpartner’sdeathcertificatewiththisform?
No
Yes
Wewillsendthecertificatebackassoonas
wecan.Pleasefillintherestofthisform.
YouneednotfillinPart3.
Youmustremembertosendusallthedocumentsweaskfor.Ifyoudonot,benefityoucangetbecauseofthisclaim
maybedelayed.Otherdocumentsonwhichdatesarerecordedmaybeacceptable.
Ifyoudonotwishtosendyouroriginalcertificatesphotocopiesmaybeacceptable-pleaseseethenotesonpage2
ofthisform.
PleasefillintherestofthisformincludingPart3
PleasefillintherestofthisformincludingPart3
PleasefillintherestofthisformincludingPart3
7
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