Form AFPS FORM 18
Introduction
Q1. You are entitled to one forecast in any 12-month period free of charge in compliance with current legislation. If you request any additional forecasts, a charge will be applies.
Introduction
Q1. PLEASE NOTE – THIS FORM MUST BE RETURNED BY POST. Requests received by e-mail will not be accepted.
General Instructions
Q2. Please ensure that you fully complete all Parts (A to I) of this form.
Part A – Your details
Q3a. Title – for example Mr, Mrs, Miss, Ms etc
Part A – Your details
Q3b. Surname
Part A – Your details
Q3c. Forename(s)
Part A – Your details
Q3d. National Insurance number
Part A – Your details
Q3e. Date of Birth (DD/MM/YYYY)
Part A – Your details
Q3f. Address forecast to be issued to
Part A – Your details
Q3g. Postcode
Part A – Your details
Q3h. Telephone number
Part A – Your details
Q3i. Email address
Part B – Member’s details
Q4a. Member’s full name
Part B – Member’s details
Q4b. Member’s date of birth (DD/MM/YYYY)
Part B – Member’s details
Q4c. Member’s Service Number (if known)
Part B – Member’s details
Q4d. Member’s National Insurance number (if known)
Part C – Forecast Date
Q5a. I wish to request a forecast of benefits at scheme payment date
Part C – Forecast Date
Q5b. If you are over age 55, the forecast will be provided as at current date
Part C – Forecast Date
Q5c. I wish to request a forecast based on an early claim of actuarially reduced benefits.
Guidance: (Date given must be between your 55th and 60th/65th birthday) (If no date is provided a current date will be used)
Part C – Forecast Date
Q5d. If you are over age 55, the forecast will be provided as at current date
Part D – Charges
Q6a. Additional request may be submitted for an administrative charge of £90 (£75 + VAT)
Part D – Charges
Q6b. Have you received a forecast within the last 12 months? Yes No
Options: Yes; No
Part D – Charges
Q6c. Do you wish to have an additional forecast? Yes No
Options: Yes; No
Part D – Charges
Q6d. Payment by bank transfer using the details below. Yes
Part D – Charges
Q6e. Account Title: MOD DBS MIL PERS UK Receipts
Part D – Charges
Q6f. Sort Code: 60 – 70 – 80
Part D – Charges
Q6g. Account Number: 10021116
Part D – Charges
Q6h. If paying from abroad please use the following: IBAN Number: GB87NWBK60708010021116
Part D – Charges
Q6i. SWIFT Code: NWBKGB2L
Part D – Charges
Q6j. Date
Part D – Charges
Q6k. If paying by bank transfer, please confirm the date the transfer was made
Part E – Data Protection
Q7a. How the MOD collects and uses personal information
Part F - Declaration
Q8a. I confirm that • The information I have given is accurate and complete to the best of my knowledge and belief.
Part F - Declaration
Q8b. I understand that • I must immediately tell the MOD of anything that may affect my entitlement to, or the amount of, payments made under any scheme administered by Veterans UK, including any change of address.
Part F - Declaration
Q8c. • If I knowingly give false information, I may be liable to prosecution.
Part F - Declaration
Q8d. Remember – You must sign this form yourself if you can, even if someone else has filled it in for you.
Part F - Declaration
Q8e. If a representative who acts as a Power of Attorney or Appointee for the claimant is signing this form, they must enclose evidence to show that they are the legal representative.
Part G – Consent for email correspondence
Q9a. I authorise Veterans UK of the MOD to use email whenever possible in its correspondence with me via my nominated email address shown on the front of this claim form. I accept that the information may include my personal details excluding bank account numbers, National Insurance number, medical details and any other information that could compromise my identity.
Part G – Consent for email correspondence
Q9b. I understand that correspondence transmitted by email may be open to abuse because it is transmitting over an unsecured network. I accepted that the MOD will not be liable for any loss, interception or unauthorised use of information transmitted this way. I am content for Veterans UK to correspond with me from the email address shown at the front of this claim form.
Part G – Consent for email correspondence
Q9c. Do you wish to correspond via email? Yes No
Options: Yes; No
Part I - Signature of Applicant
Q10a. Signature
Part I - Signature of Applicant
Q10b. Date