FORM EAS7(DCC contracts)(fill-in)

To: Devon Pension Services

Estuary House

Peninsula Park

Rydon Lane

EXETER, EX2 7XB

ESTIMATE OF RETIREMENT BENEFITS

Please provide an estimate of benefits as requested below:

DETAILS OF EMPLOYEE
NAME:- / N.I. NO:
DATE OF BIRTH: / PAY REF: / HOURS PER WEEK:
PENSIONABLE PAY
Please indicate the estimated pensionable pay for the year ending with the estimated date of retirement shown above £
(If part-time, quote part-time appropriate pensionable remuneration amount and the Pension Section will increase to whole-time figure for calculation purposes)
If hours have changed during the year, (total estimated remuneration still to be indicated above) or if whole-time pensionable pay has dropped in last 3 years, please complete this table:
Date from / Date to / Hours per week / Remuneration
LEAVING DETAILS
ESTIMATED DATE OF LEAVING:-
TYPE OF RETIREMENT (Tick appropriate box)
Redundancy / Interest of Efficiency / Age (60 or over)
Employers Consent / Waive actuarial reduction / NOYES / (choose as appropriate)
MARITAL/CIVIL PARTNERSHIP/NOMINATED PARTNER STATUS
(Tick the appropriate box)
Single / Married/Civil Partnership / Nominated Cohabiting Partner / Widow(er)/Surviving
Civil Partner / Divorced/Civil Partnership Dissolved
AWARD BY EMPLOYER OF ADDITIONAL MEMBERSHIP AND/OR PENSION
If the member is entitled to immediate payment of benefits then the employer may, in line with their policy, award additional membership and/or pension, please indicate below your decision
Member will not been awarded any additional membership and/or pension on leaving
(tick box if appropriate)
Member maybe awarded additional membership of (Maximum 10 years) / YEARS / DAYS
Member maybe awarded additional pension of (Maximum £5000 p.a.) / £ / p.a.
Please note the employer will be charged for any Actuarial work undertaking in connection with any award calculation
EMPLOYER DETAILS
Name of contact / Tel. No
Estimate to be returned to (name and address of employer):


March 2011