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    1. Who is this for?

      This form is for the member to return their member declaration.

      Please complete your details on the next page and then attach your completed Member Declaration form. If you have any other queries about your pension, please contact us to submit your additional request to the pensions team.

    2. Your details

      * Denotes required fields

      Your name

      Address

      Look up address

      Date of birth*

      Other information

    3. What would you like to do?

      Please attach your completed Member Declaration form

      Please select the file number 1
      | Delete file number 1

      Note that there is a 5MB file size limit per file and only JPG, Word and PDF files can be attached.

    4. Your declaration

      Data protection

      Please tick the box below to confirm that you understand and acknowledge the statements.

      The Trustee, as the controller under the applicable data protection legislation in the UK, uses certain personal information about you to (amongst other reasons) communicate with you and administer your benefits in the Plan. Your information is shared with the Plan’s administrators, other providers of services to us, and public bodies such as HM Revenue & Customs. For more detailed information on how we use and disclose your information, the protections we apply, the legal bases we rely on and your data protection rights, please see our privacy notice at www.pearson-pensions.com/privacy-notice/ - This link opens in a new browser window. If you would like a copy of our privacy notice to be sent to you, please contact the pensions helpline.

      Date: 19-03-2024

    Thank you

    You will receive a confirmation email shortly.

    Your form will be processed by the pensions team. Please contact them directly if you have any queries.

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