Form

Bereavement benefits claim form

Use this form to claim bereavement benefits if your husband, wife or civil partner died before 6 April 2017.

• From: Department for Work and Pensions
• Published: 1 October 2013
• Last updated: 14 June 2022 — See all updates

Applies to England, Scotland and Wales

Documents

Bereavement benefits claim form you can print and fill in with a pen

Ref: BB1-print

PDF, 166 KB, 16 pages

Bereavement benefits guidance booklet

PDF, 129 KB, 8 pages

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

Published 1 October 2013
Last updated 14 June 2022 + show all updates

1. 14 June 2022

   English and Welsh claim form documents have been updated. Guidance booklets added in English and Welsh.

2. 1 October 2013

   First published.