FORM
F38
NATIONAL UNION OF RAIL, MARITIME & TRANSPORT WORKERS
Application for Death Grant
TO BE COMPLETED BY THE BRANCH SECRETARY/ORGANISER* Branch
Surname of Deceased
N.I. Number
Membership Number
Forenames of Deceased
Age Last Birthday Cause of Death
Date Joined Union
Retired
Was the member retired or still employed at date of death?
Employed
NOTE: If the deceased left children under 22 years of age and still in full-time education, a claim for Orphan Benefit should be submitted on Form F.39 I certify the foregoing particulars are true to the best of my knowledge, and that the member was in benefit at the time of death Dated
Signed...................................................................... Branch Secretary/Organiser
TO BE COMPLETED BY THE CLAIMANT I
being the nearest relative or Legal Representative
of
(Deceased), hereby claim any Death Benefit due from the National Union of Rail, Maritime & Transport Workers.
Name Address
Signed................................................................... Status
Post Code
Dated
To enable us to get payment to you as quickly as possible, we can transfer payment directly into your bank account.This saves time between our posting a cheque and your receiving it, the delay in cheque clearance and the possibility of the cheque being lost in the post or otherwise mislaid. We will, of course, send written confirmation of the transfer. It must be your own bank account; we cannot take responsibility for payment on your behalf into someone else’s account. For payment by this method, please complete the following details:
Name of bank
Branch
Account Number
Sort Code -
-
FOR H.O. USE
DOCUMENTS TO BE ATTACHED:
Checked by
Contribution card (if paying to Branch) Death Certificate Will or Probate
Benefit Authorised ÂŁ Cheque No
by BACS Ref
Birth certificate of any children for whom Orphan Benefit is being claimed.
* For details of your branch secretary please access your member login at www.rmt.org.uk