Application For Review Of A Notice Or Penalty - The Pensions Regulator Page 2

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Part 2. Applicant details
Name of applicant
Position in organisation
Address and postcode
Contact telephone number
Contact email address
Please confirm if you are willing for us to respond to this review
Yes/No
application, including acceptance of service of any Statutory Notice
Please delete as
that may result, by email.
applicable
Part 3. Representative details
Only complete this section if you wish a representative to act on your behalf
in relation to this review application. If completed, all correspondence and
documents, including notification of the decision and any associated Statutory
Notices will be sent directly to the representative.
Name of representative
Representative’s organisation
Address and postcode
2

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