State Pension Claim Form - Department For Work & Pensions Page 17
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26Part 5
About National Insurance (NI) contributions - continued
Have you been employed in the
United Kingdom or the Isle of Man
or have you worked for a United Kingdom
or Isle of Man employer and paid
NI contributions as an employee in
No
Please go to Part 6.
the last 2 years before reaching
State Pension age?
Yes
Did you pay these contributions through an
No
employer?
Yes
Please tell us about any United Kingdom or Isle of Man employers you
have had while you were outside the United Kingdom or Isle of Man. If
you have had more than 2 employers, tell us about the others in Part 10.
Employer 1
Employer 2
Employer’s name and address
If you know the wages are dealt
with at a different address,
please give us that address,
including the postcode.
Staff payroll or other reference
number
If you do not know it, tell us the
job or department.
Date you started work for this
employer
Date you stopped work, if
appropriate
13
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