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Forms and Documents McCloud information form

McCloud information form

Before you complete the form

I have fully read and understand the information detailed on the McCloud page about completing the McCloud Information Form:

Yes

Prior to joining the LGPS with Essex Pension Fund, I had been in a Public Service Pension Scheme for (select all that apply):

civil servants

the judiciary

the armed forces

local government workers

health service workers

teachers

fire and rescue workers

members of the police

none of the above

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Please make sure that you have read the McCloud information carefully before you complete this form.

Your details

First name*

Surname*

Email address

Date of birth*

National Insurance number*

Payroll number

Start date*

Previous pension scheme membership

Scheme name**

Reference

Date from:

Date to:

Contributions refunded?

On behalf

If you are completing this form on behalf of a member who has died:

First name

Surname

Email address

Date of birth*

Relationship to member

*Required field

**Please include the name of the relevant LGPS Pension Fund, Fire and Rescue Authority or Police Authority.

Essex County Council (as the Administering Authority of the Fund) is a data controller under the General Data Protection Regulations. The Fund holds and manages your personal data in line with statutory requirements to provide you with pension administration services. Find out more in our privacy policy.

Seax House, County Hall,
Chelmsford, Essex,
CM1 1QH

0333 013 8384

pensionenquiries@essex.gov.uk

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