Who is this for? You can use this form if you are: an active, deferred or pensioner member of the Plan a dependant or beneficiary of an active, deferred or pensioner member of the Plan a prospective member of the Plan anyone who has been in any of the above categories in the six months before making an application under the procedure, anyone who claims to be in one of the above categories and the complaint relates to this claim, or the representative of anyone in the above categories This form should not be used if: any proceedings have already begun in a court or tribunal, or the Pensions Ombudsman has started an investigation into a complaint made or a dispute referred to them IDRP Policy I confirm that I have read the IDRP policyI confirm that I have read the IDRP policy* - This is a required field Please use the dropdown to select if you are the member or prospective member or whether you are completing the form as one of the other eligible groups noted above. If you are completing the form as a third party on behalf of the member or a beneficiary, we will need a letter of authority to release information to you. This can be uploaded when you complete the form. If you are a member or prospective member and would like the reply to go to another party, please select I am someone else where you will be able to enter their details. Please choose an option*I am the member or a prospective memberI am someone elsePlease choose an option*Please choose whether you are the member or are submitting the complaint on their behalf - This is a required field The Money and Pensions Service is available to assist members and beneficiaries in connection with any difficulty with the scheme, you can read more at: https://www.moneyhelper.org.uk - This link opens in a new browser window The Trustee's IDRP Committee will consider your complaint on behalf of the Trustee and will write to you telling you of its decision within four months of receiving your complaint or within 21 days of reaching a decision. If a response cannot be sent within these timeframes, you will be given an explanation for the delay and an expected date for the Trustee’s decision. Your details * Denotes required fields Your personal details Title*MrMrsMissMsDrProfTitle* - This is a required field Forename(s)* - This is a required field Surname* - This is a required field Address Select countryUnited KingdomAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaÅland IslandsBhutanBolivia (Plurinational State of)Bonaire, Sint Eustatius & SabaBosnia & HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Democratic Republic of)CongoCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island & McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension & Tristan da CunhaSaint Kitts & NevisSaint LuciaSaint Martin (French part)Saint Pierre & MiquelonSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard & Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan (Province of China)TajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis & FutunaWestern SaharaYemenZambiaZimbabweCountry* - This is a required field Start typing your address Look up address Address line 1* - This is a required field Address line 2 Town County/State/Province/Region Postcode/Zip code Date of birth* Day* of birth - This is a required fieldDD01020304050607080910111213141516171819202122232425262728293031 Month* of birth - This is a required fieldMM010203040506070809101112 Year* of birth - This is a required fieldYYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920191919181917191619151914191319121911191019091908190719061905190419031902190119001899189818971896189518941893189218911890188918881887188618851884 NI Number National Insurance number* For example QQ123456C Other information Email address* - This is a required field Relationship to the member* - This is a required field Relationship to the member* - This is a required fieldPlease choose an optionSpouse, civil partner or other dependantMember's representativeDependant's representative If you have not already provided a letter of authority, please attach a copy of this below. Note that there is a 4MB file size limit per file and only JPG and PDF files can be attached. Please select the file number 1 Choose file | Delete file Please select who the response should be sent to* - This is a required field: The member or beneficiaryMe as their representativeTo both of us Member or dependant’s details * Denotes required fields Member’s personal details Title*MrMrsMissMsDrProfMember’s Title* - This is a required field Member’s Forename(s)* - This is a required field Member’s Surname* - This is a required field Address Select countryUnited KingdomAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaÅland IslandsBhutanBolivia (Plurinational State of)Bonaire, Sint Eustatius & SabaBosnia & HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Democratic Republic of)CongoCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island & McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension & Tristan da CunhaSaint Kitts & NevisSaint LuciaSaint Martin (French part)Saint Pierre & MiquelonSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard & Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan (Province of China)TajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis & FutunaWestern SaharaYemenZambiaZimbabweMember or dependant’s Country Start typing the Member or dependant’s address Look up member / dependant’s address Member or dependant’s Address line 1* - This is a required field Member or dependant’s Address line 2 Member or dependant’s Town Member or dependant’s County/State/Province/Region Member or dependant’s Postcode/Zip code Member or dependant’s date of birth* Member or dependant’s Day* of birth - This is a required fieldDD01020304050607080910111213141516171819202122232425262728293031 Member or dependant’s Month* of birth - This is a required fieldMM010203040506070809101112 Member or dependant’s Year* of birth - This is a required fieldYYYY202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920191919181917191619151914191319121911191019091908190719061905190419031902190119001899189818971896189518941893189218911890188918881887188618851884 Member or dependant’s NI Number Member or dependant’s National Insurance number* - This is a required field For example QQ123456C What would you like to do? * Denotes required fields Please give full details of your complaint and why you would like it to be considered by the Trustee. If you have already made a complaint about this matter to the pensions team, please provide any additional information or details that were not included in your original complaint. If you prefer to upload a document with details of your complaint, you can upload this below. If you do not have any additional information to add to your document, please enter “See attached” in the boxes below. Please enter details of your complaint - This is a required field 10,000 character limit If you have received a response to your complaint from the pensions team, please confirm why this response did not address your complaint. 10,000 character limit Please confirm how you would like to see your complaint resolved. - This is a required field 10,000 character limit Please attach any additional documents that you would like to submit to support your complaint. You do not need to re-send any documents already provided. Note that there is a 4MB file size limit per file and only JPG and PDF files can be attached. Please select the file number 2 Choose file number 2 | Delete file number 2 Please select the file number 3 Choose file number 3 | Delete file number 3 Please select the file number 4 Choose file number 4 | Delete file number 4 Your declaration Please tick the box below to confirm that you understand and acknowledge the statements. I would like my complaint to be considered by the Trustee and a decision to be made. Data protection The Trustee, as the controller under the applicable data protection legislation in the UK, uses certain personal information about you to (amongst other reasons) communicate with you and administer your benefits in the Plan. Your information is shared with the Plan’s administrators, other providers of services to us, and public bodies such as HM Revenue & Customs. For more detailed information on how we use and disclose your information, the protections we apply, the legal bases we rely on and your data protection rights, please see our privacy notice at www.pearson-pensions.com/privacy-notice/ - This link opens in a new browser window. If you would like a copy of our privacy notice to be sent to you, please contact the pensions helpline. I confirm I understand that the data I provide will be used as outlined in the data protection statement. Today's Date: Date: 21-11-2024 Thank you You will receive a confirmation email shortly. Your complaint will be passed to the Trustee to consider. Back to Home
