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Title *

Name *

First

Last

In case you are filling in the form on the behalf of someone else, please complete this part of the form with the member's details.

Date of Birth

We use your date of birth as a security measure to validate your identification details against the information we have on our records.

Postcode *

Email *

Email

Confirm Email

Please sign me up for email and online communication

Opt into digital

When opting into digital we prioritise email and online communication when sending you information. This ensures that we respond to you faster, your post will not get lost and it can move with you when you change your address.

Mobile (or landline) number *

Membership Reference:

To enable us to confirm your identity, it would help to have your membership reference. This can be found on your welcome letter from Premier.

National Insurance number

To enable us to confirm your identity, it would help to have your National Insurance number. Providing this may ensure that we can process your request without contacting you to further confirm your identity.

Scheme Name (or employer)

In the absence of a membership reference number, a scheme name or the name of your relevant employer will help us identify you on our systems.

What would you like to do today? *

Please confirm the date for your quote

This is the date from which you would like to start receiving your pension.

Are you an IFA or requesting the quotation on behalf of someone else? *

I am requesting this for myself
I am an Independent Financial Advisor

Name *

First

Last

Email *

Email

Confirm Email

Address *

Line 1

Line 2

City / County

Post Code / ZIP code

Country *

FCA registration number *

Please upload a scanned copy or photograph of your Letter of Authority

Previous address *

Line 1

Line 2

City / County

Post Code / Zip Code

Country *

Date Moved to New Address *

New address *

Line 1

Line 2

City / County

Country *

Proof of ID

Please provide a scanned copy or photograph of a your driving license or passport.

Proof of New Address

Please provide a scanned copy or photograph of a utility bill with your name on it, at the new address.

Marital Status Changed to *

Date of change *

New Title *

New Name *

First

Last

Proof of Change

You will need to provide a scanned copy or photograph of the marriage, civil partnership, divorce, or death certificate to verify your information.

Proof of Name Change

You will need to provide a scanned copy or photograph of the relevant certificate (marriage, civil partnership, divorce, deed poll) and a copy of one form of photographic ID in your new name.

Name *

First

Last

We are sorry to hear about your loss. Please give us the contact details of the person who is dealing with the member’s affairs who we can contact if we have questions about Spouse's benefits, Death benefits or over payments.

Mobile (or landline) number *

Email *

Address *

Line 1

Line 2

City / County

Post Code / Zip Code

Relationship with the deceased?

For example, spouse, partner, solicitor, friend, etc.

Date of Death

Further information

The deceased has left a will
A death certificate has been issued
The death was overseas

Please upload a scanned copy or photograph of the death certificate, if issued.

Due to security reasons we will need to send you a form to complete to change your bank account details. *

Send me the form by email
Send me the form by post

Please tell us what you need *

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