Payment Instruction Form

Lump sum or pension payment instruction

This form is for individuals claiming a lump sum or pension payment due to a beneficiary of the estate.

* Required

Payment number *

Deceased's full name *

Choice of spouse's pension or one-off lump sum payment *

I wish to take the benefit as a pension

I wish to take the benefit as a one-off lump sum

Please consider your claim options carefully as you will not be able to reverse this decision once the claim is finalised.

Beneficiary's details

Title *

Forenames *

Surname *

Date of birth *

Date of marriage *

Full address *

Post code *

Contact number *

Email address *

National Insurance Number *

Bank/building society details

Account holder name *

Name of bank/building society *

Sort code *

Account number *

Building society roll number

Only required if your bank has issued one to you.

Enclosures *

Please upload copies of any supporting documentation as requested in our recent letter i.e. Passport, Marriage Certificate, Death Certificate, Bank Statement.

Drag and drop or choose a file

Add file

Declaration

'I confirm that all the details provided above are correct and i'm happy for you to proceed accordingly.'

Data privacy

For information on how we use your data please read the Legal & General Privacy Notice at legalandgeneral.com/privacy-notice.

Spouse's confirmation *

I confirm that all the details provided above are correct and i'm happy for you to proceed accordingly.

Today's date *