Notification of the death of a customer

Sorry to hear of your loss, please complete this form to notify us of a death of a customer.

* Required

Information on the Deceased

Scheme Name

Scheme Number *

First Name *

Surname *

Full Address *

Postcode *

Date of Birth *

National Insurance Number *

Marital Status *

Date of Married/Civil Partnership *

Date of Divorce *

Registration of the Death

Date of Death *

Do you have a Death Certificate? *

Please Upload the Certificate here (Max 20MB)

Drag and drop or choose a file

Add file

Death Certificate Number *

Reference numbers can be found in the following locations:

England and Wales: 9 digit number (beginning with 5) located in the bottom left of the document

Scotland: 9 digit number located in right hand section at top of document

Northern Ireland: 8 digit number (preceded by a letter) located in top right corner

Please note that we will need to see a copy of the death certificate before we can provide you with any account information.

Your Details

First Name *

Surname *

Full Address *

Postcode *

Contact Number *

Relationship to the deceased *

Are you the next of kin? *

Next of Kin Name

Relationship to deceased

Date of Birth *

Contact Number *

Full address *

Full Address Including Postcode Please

How do you prefer to be contacted? *

Email address *

Does the Deceased have any Children? *

Enter Name *

Date of Birth *

Another Child

Enter Name *

Date of Birth *

Another child

Enter Name *

Date of Birth *

Another Child

Enter Name *

Date of Birth *

Are you aware of any other individual(s) (financial dependent/parents/siblings) who may be a beneficiary of the deceased? *

Name *

Full Address *

Date of Birth *

Another Beneficiary? *

Name *

Full Address *

Date of Birth *

Another Beneficiary?

Name *

Full Address *

Date of Birth *

What happens next?

We'll check the details you’ve provided and we’ll be in touch with you via your preferred contact method to confirm the next steps.

If you need to contact us please call us on:

03450 778 778

Monday to Friday, 9am – 5pm.

Or email to: dbretirements@landg.com