State Pension Claim Form - Department For Work & Pensions Page 25
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26Part 11 Declaration
I understand that I must promptly tell The Pension Service, by phone or
When you return your claim form
in writing, of anything that may affect my entitlement to, or the amount
We will make enquiries for you so that we can consider your
of, my State Pension.
claim for pension or benefit. This can take around 8 weeks
from the date we get your claim.
I declare that the information I have given on this form is correct and
complete as far as I know and believe.
About your claim
It would help if you did not phone us to check on the progress
I understand that if I knowingly give false information, I may be liable to
we are making unless you want to report a change that would
prosecution or other action.
affect your claim - for example, bank details etc.
I understand that if I fail to promptly notify the Department of a change
in circumstances, I may be liable to prosecution or other action.
We will only acknowledge your claim if you are sending a
•
birth certificate
This is my claim for State Pension
•
Signature
marriage certificate
•
civil partnership certificate
Please sign the form here after printing
•
certificate of annulment
•
certificate of civil partnership dissolution
•
decree absolute
Date
•
decree of divorce
•
death certificate
Part 12 What to do now
1. Check that you have answered all the
4. When to claim - If you want to claim your
5. Send this form and any documents to:
questions on this form that apply to you.
State Pension now, please send this form
International Pension Centre
The Pension Service 11
to us without delay.
2. Check that you are sending us all the
You can get your State Pension paid more
Mail Handling Site A
documents we have asked for.
quickly if you:-
Wolverhampton
These could be your birth certificate, your
- answer all the questions on the form that
WV98 1LW
marriage certificate, your civil partnership
apply to you, and your husband, wife or
United Kingdom
certificate, your decree absolute or
civil partner if you have one
decree of divorce, your dissolution of civil
- send us all the documents we ask for.
partnership document, certificate of
If you cannot do this, please get in touch
annulment or death certificate.
with us, but your State Pension may be
3. Check that you have signed this form.
delayed or you could see a loss of your
State Pension.
21
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