If you would like someone from a local Pension Service to arrange to visit you to help you to make a claim for Pension Credit please complete the enclosed form.

The information on this form will be emailed directly to your local Pension Service. Please ensure when using this form that your National Insurance number is correct as this is what will be used by the Pension Service to identify your contact details. If you do not know your National Insurance Number there is an option to use your date of birth instead.

For added security your National Insurance number will not be visible on your computer. To ensure that you have input the number correctly you are asked to enter it twice.

What area of Scotland do you live in?


What is your name?

What is your email address? (optional)


Do you know your National Insurance Number. Yes    No

What is your National Insurance Number?


Please confirm your National Insurance Number:


What is your date of birth? (Please use format dd/mm/yyyy)


Claim request:


Additional message:


Declaration:
I confirm that I am the person named above and I have provided a correct National Insurance Number or Date of Birth.
I am not the person named above but I have their consent and I have provided their correct NINO or DOB.
I am not the person named above and do not have their consent

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