Payment Instruction Form

Spouse trivial lump sum without recoveries

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

* Required

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

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.

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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

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