Payment Instruction Form

Spouse trivial lump sum without recoveries

This form is for individuals claiming a lump sum instead of a spouse’s pension.

Payment number

Deceased's full name

Spouse's details (The surviving beneficiary)

Title

Forenames

Surname

Date of birth

Full address

Post code

Contact number

Email address

National Insurance Number

Bank/building society details

Name of bank / building society

Account holder name

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

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Declaration

Spouse's confirmation

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

Today's date

Data privacy

For information on how we use your data please read the L&G Privacy Notice.

If you have any questions about completing this form please contact us on:

0345 0263858

Monday to Friday 9am to 5pm.
Calls may be monitored and recorded.