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Report a death form | Plumbing Industry Pension Scheme
Report a death form
Report a death form
* Required field
Details of the person who has died
Title*
First name*
Surname*
National Insurance number*
Member number*
Address 1*
Address 2*
Address 3
Address 4
Postcode*
Date of birth*
Date of death*
Marital status*
Please select
Single
Married
Civil partnership
Allocated dependant
Divorced
Separated
Widowed
Spouse's Details (if applicable)
First name
Surname
Spouse's date of birth*
Address 1
Address 2
Address 3
Address 4
Postcode
Email address
Death certificate
Death certificate reference number (usually located in the top right corner) – if you don’t have this, please leave the field blank.
Details of the notifier
Are you an individual or an organisation?*
Please select
Individual
Organisation
Your name
Title*
First name*
Surname*
Your address
Address 1*
Address 2
Address 3
Address 4
Postcode*
Date of birth*
Telephone number*
Email address*
Relationship to the deceased*
Are you the person dealing with the estate?*
Please select
Yes
No
No estate to deal with
Company name
Company name*
Company reference number*
Company address
Address 1*
Address 2
Address 3
Address 4
Postcode*
Contact name
Title*
First name*
Surname*
*Captcha is required
Submit