Form
Bereavement benefits claim form
Use this form to claim bereavement benefits if your husband, wife or civil partner died before 6 April 2017.
Applies to England, Scotland and Wales
Documents
Details
If your husband, wife or civil partner died on or after 6 April 2017
You may be able to claim Bereavement Support Payment.
You may not have to fill in a form. There are other ways to claim.
If you need this form in a different format
Contact the Bereavement Service helpline to ask for:
- a printed copy of the form
- a different format, such as large print, braille or audio CD
Updates to this page
Published 1 October 2013
Last updated 14 June 2022
show all updates
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English and Welsh claim form documents have been updated. Guidance booklets added in English and Welsh.
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First published.