State Pension Claim Form - Department For Work & Pensions Page 7
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26About you - continued
Part 1
Have you, your husband, wife or civil partner
ever claimed any of the following benefits in
the United Kingdom? The United Kingdom is
No
England, Scotland, Wales and Northern
Please tell us about this below.
Yes
Ireland.
•
State Pension
•
Graduated Retirement Benefit
•
Widow's Benefit
•
If you need more space use the
Bereavement Benefit
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.
Please go to Part 2.
No
Have you ever lived or worked in the
Please tell us about this below.
United Kingdom?
Yes
Please tell us any address(es) you had in
the United Kingdom 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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