State Pension Claim Form - Department For Work & Pensions Page 7
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26Part 1
About you - continued
Have you, your husband, wife or civil partner
ever claimed any of the following benefits in
or from the United Kingdom or the Isle of
Man? The United Kingdom is England,
No
Scotland, Wales and Northern Ireland.
Yes
Please tell us about this below.
•
State Pension
•
Graduated Retirement Benefit
•
Widow's Benefit
•
Bereavement Benefit
If you need more space use the
space in Part 10 at the end of this
Which benefit was claimed?
form.
Who claimed the benefit?
You
Your husband, wife or civil partner
If you are a married woman getting
State Pension you need only fill in
Parts 2, 4, 8 and 11 of this form.
No
Have you ever lived or worked in the
Please go to Part 2.
United Kingdom or the Isle of Man?
Please tell us about this below.
Yes
Please tell us any address(es) you had in
the United Kingdom or the Isle of Man and
the dates that you lived there. If you need
more space use the space in Part 10 at the
end of this form.
Address
From
From
Dates
To
To
3
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