Firefighters’ Pension Scheme 2006 & 2015
Pensions for declared
partners form

Please read the below information and then complete this form in black ink if you wish to nominate your partner for dependant's benefits. The declaration should be signed by both you and your partner and should be witnessed by a third party. 
Once complete, please return the form to us using the Contact us section of our website at lppapensions.co.uk or post it to LPPA, PO Box 1383, Preston, PR2 0WR.   

Introduction
Benefits payable upon the death of a member of the Firefighters' Pension Scheme 2006/2015 include pensions for children, and for a surviving spouse or civil partner. The Scheme also provides benefits, similar to those for a surviving spouse or civil partner, for a partner with whom the firefighter has not entered marriage or formed a civil partnership but where:

•	An appropriate nomination and joint declaration has been made, and;

•	The Fire and Rescue Authority are satisfied that, at the date of the firefighter's death, the nominated partner was living with the firefighter in an exclusive, committed, long­term relationship (normally for at least two years) and that the conditions for making the nomination and joint declaration are still met.

Qualifying conditions
The conditions for nomination and joint declaration are that: 
•	Both the firefighter and nominated partner must be free to marry or enter into a civil partnership with each other in the United Kingdom (a guide to persons who are not allowed to marry or enter into a civil partnership can be obtained from LPPA); and;

•	Either the nominated partner must be financially dependent on the firefighter or the firefighter and nominated partner must be financially interdependent.
Please note: If you and/or your partner are currently married or have a civil partner then this type of nomination cannot be made. Upon your death, your spouse or civil partner would automatically receive a dependant's benefit under the provisions of the Firefighters' Pension Scheme 2006/2015. This would be the case until such time as the marriage or civil partnership is annulled or dissolved. It would not be until that time that you would be able to make a nomination for your partner.
There is no requirement that you and your partner should have been in an 'exclusive, committed, long-term relationship' at the date of making the nomination. This would not have to be demonstrated until date of death. At that time, the Fire and Rescue Authority would have to be satisfied that the relationship had existed for at least two years up to that date.

If the relationship has come to an end, please let us know as soon as possible so we can cancel your nomination.

What does my partner need to do after my death?
It is never easy to ask for information when a person dies, but the Authority has to do this to determine entitlement for benefits. You and your partner should be aware that this will happen. 

For example, the Authority may ask for confirmation that you lived in a shared household with shared household spending. Or your partner may be able to demonstrate that you had a bank account or mortgage in joint names. It may be that you and your partner have made wills, or have taken out life assurance, naming each other as the main beneficiary. 

This is the sort of evidence that the Authority would seek. There would be a right of appeal if the Authority decides not to pay a pension and your partner believes that he/she has entitlement.

1	About you (the scheme member)	
 
Your name		
Your date of birth 		
Your address (it is your responsibility to tell your pensions administrator if you subsequently change address)		

		
Your postcode		
Your daytime telephone number		
Your National Insurance number		

2	About your partner	

I nominate my partner named below to receive a nominated partner’s pension under the Firefighters’ Pension Scheme 2006/2015 scheme. 

Partner’s full name including title		
Partner’s date of birth		
Partner’s address (this should normally be the same as the address of the FPS 2006/2015 member)		

		
Partner’s postcode		
Partner’s National Insurance number		

Please note: You should not rely on this nomination alone to give your partner entitlement to a pension. Upon your death, your Fire and Rescue Authority will need to be satisfied that your relationship met the qualifying conditions to pay the pension.
 
3	Declaration	

•	We confirm the following:
o	We have lived together for ______ years, during which time our financial affairs have been interdependent (or the partner has been financially dependent on the FPS 2006/2015 member). 
o	We have an exclusive, committed, and long-term relationship with each other, and we intend to continue this indefinitely. 
o	We are not married to each other, and we have not formed a civil partnership with each other.
o	We are not related in a way that will prevent marriage or civil partnership. 
o	Neither of us is married or in a civil partnership with anyone else. 
o	Neither of us is currently nominated as the unmarried partner of anyone else. 
•	We will let LPPA know in writing if our relationship comes to an end. 
•	We understand that benefits will not be paid unless the partner provides satisfactory evidence that the declaration above is valid when the FPS 2006/2015 member dies. 

Scheme member’s signature (signed in the presence of the witness named below)		
Date		
Partner’s signature (signed in the presence of the witness named below)		
Date		

4	Witness	

Note: the witness is simply required to witness the signing of the form by the scheme member and partner in Part 3 above

Name of witness		
Address of witness		

		
Postcode		
Signature of witness		
Date