UNITED NATIONS JOINT STAFF PENSION FUND
INSTRUCTIONS FOR PAYMENT OF DISABILITY OR DEATH BENEFIT(S)
I M P O R T A N T
Please Enter Pension Number
PLEASE PRINT OR TYPE
Use this form to submit payment instructions ONLY for Disability or Death benefits payable under the
For other types of benefits, please obtain the appropriate form from the
Secretary of your Staff Pension Committee or the Pension Fund’s website: .
Check the appropriate box below for the type of benefit to which you are entitled under the UNJSPF
All sections of the form overleaf should be completed and the form should be signed by you as a
beneficiary of the UNJSPF. When completing the form, please bear in mind that your benefit must be
paid to a bank account in your name or to a joint account which includes your name. Only in
exceptional cases, where a beneficiary does not have a bank account and is unable to open one, can
payment be sent in care of a UN office. Payment cannot be remitted to a mailing address, nor can it be
made to third party. Your signature on the form must be duly authenticated or witnessed, either by an
officer of the United Nations or a local governmental authority. The full name, official title and signature
of the Official authenticating your signature and their stamp/seal of office must be affixed to this form.
If your signature is not authenticated or witnessed, your payment instructions will be returned which
will delay the processing of your benefit.
You are invited to provide Emergency contact details, for use by the UNJSPF ONLY when all efforts to
reach you through normal channels fail.
For assistance in filling out this form, please consult with the Secretary of your Staff Pension
Upon completion, submit both pages 1 & 2 to the Secretary of your Staff Pension Committee.
TYPE OF BENEFIT DUE UNDER THE UNJSPF REGULATIONS:
a) Disability benefit (Article 33)
b) Widow’s benefit (Article 34)
c) Widower’s benefit (Article 35)
d) Divorced surviving spouse's benefit (Article 35 bis)
e) Annuity for spouse married after separation (Article 35 ter)
Child’s benefit (Article 36)
g) Secondary dependant’s benefit (Article 37)
h) Residual settlement (Article 38)
Page 1 of 2