Appendix 2 to

Annex A to

BGNSI 12.10

Dated 09 Jan 20

REPORTING DEATH OF A	SELECT	PENSIONER

GVAC/DVAC/AWC/GWAC, UK/RECORDS OFFICE LOCATION:	SELECT HERE

Head of Veteran Services	Reference: TYPE your REF

British Gurkhas Pokhara

BFPO 4

Telephone: 061 567280

Email: BGN-RecordsOfficeGroupMailbox@mod.gov.uk	Date: SELECT DATE

Details of the death is as shown below:

Army No:	ENTER A/NO	Rank:	SELECT RANK

Name:	Enter Name	Unit:	SELECT UNIT

Date of Death:	SELECT DATE	Cause of Death:	ENTER CAUSE

Name of OFP holder :	ENTER NAME	Pension Code (if applicable):	ENTER CODE

Death Reported by:	enter name	Relationship:	enter RELATION

Family Details of the Pensioner/Non-Pensioner:

Relationship	Name	DOB	Marital Status	DOM	Remarks
1st Wife	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
2nd Wife	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
3rd Wife	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
1st Son	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
2nd Son	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
3rd Son	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
4th Son	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
5th Son	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
1st Daughter	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
2nd Daughter	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
3rd Daughter	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
4th Daughter	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT
5th Daughter	FIRST name	SELECT	SELECT	SELECT	ENTER TEXT

Note: Full details of children must be given and if they are born from different mother; name of mothers should be annotated in the remarks column. If they are married, spouses’ names should also be listed against the names of children.

Name(s) of eligible family member(s) for CLICK HERE including NPP numbers:

NAME	NPP/ADHAR CARD NUMBER	PREFERRED PPO
ENTER NAME	ENTER NPP NUMBER	SELECT GVAC
ENTER NAME	ENTER NPP NUMBER	SELECT GVAC
ENTER NAME	ENTER NPP NUMBER	SELECT GVAC
ENTER NAME	ENTER NPP NUMBER	SELECT GVAC

Current Pension Office:	SELECT GVAC

Present Home Address of the pensioner/Non-Pensioner/LTA claimant(s):

Village/House No:	ENTER VILLAGE	Ward No/Street:	WARD/STREET
GP/NP/Town:	ENTER GP/NP/TOWN	Post Office/Code:	POST OFFICE
Dist/County:	ENTER DISTRICT	Province/State:	ENTER ANCHAL
Tel:	ENTER TEL NUMBER	Email:	ENTER EMAIL

Death certificate from the Village Council or Local Registrar of relevant County (if in the UK) is attached to this report.

Any other information/recommendation for grant of family pension or LTA:

Click here to enter text

AWC/ GWAC, UK/ GVAC/ DVAC RECORDS OFFICE Stamp

Signature of SELECT :	Date:	SELECT DATE

Rank:	SELECT RANK	Name:	Enter Officer’s name

Note: Death of a Service/Family Pensioner is to be notified to the nearest GVAC Office immediately by phone or email to prevent overpayment.