Who is this for? Please use this form to send your completed Scheme Pays nomination form securely to the pensions team. You should complete all the member details on the form and provide any additional details below. Your details * Denotes required fields Your name Title*MrMrsMissMsDrProfTitle* - This is a required field Forename(s)* - This is a required field Surname* - This is a required field Date of birth* Day* of birth - This is a required fieldDD01020304050607080910111213141516171819202122232425262728293031 Month* of birth - This is a required fieldMM010203040506070809101112 Year* of birth - This is a required fieldYYYY20082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920191919181917191619151914 Other information National Insurance number* - This is a required field For example QQ123456C Email address* - This is a required field What would you like to do? Please attach supporting documents Note that there is a 4MB file size limit per file and only JPG and PDF files can be attached. Please select the file number 1 Choose file number 1 | Delete file number 1 Please select the file number 2 Choose file number 2 | Delete file number 2 Additional Information 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. I confirm I understand that the data I provide will be used as outlined in the data protection statement. Today's Date: Date: 22-10-2024 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. Back to Home