Notes on Completion of Form
GENERAL
1 All sections of the form must be competed in full. "None" or "Not applicable" should be entered where appropriate, but blank spaces or "to be advised" or similar responses may result in the form being rejected as incomplete.
2 The form is also available in electronic format from the website www.pensionsboard.ie.
3 This form should be submitted to: The Pensions Authority, Verschoyle House, 28/30 Lower Mount Street, Dublin 2 or electronically, subject to such requirements as the said Board may stipulate.
Note 1: In the case of a public sector scheme, this form should be completed by the scheme administrator instead of the registered administrator.
Note 2: The form should be signed by the person completing it, who will normally be a member of the staff of the registered administrator or the administrator in the case of a public sector scheme.
For further information visit "www.pensionsboard.ie".