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Questions asked on the Fire Retirement Form

Contents Have you checked that WYPF have the correct address on record? * ..... 2 Rank* ..... 2 Marital Status ..... 2 Split Pension applies? ..... 2 2015 Protected Pensionable Pay (Final Salary) applies? ..... 2 Last date of service * ..... 3 Pay retirement benefits from ..... 3 Type of Retirement * ..... 3 Extra contributions - Were there any contributions outstanding at the date of leaving? ..... 3 Please provide any strike information that has not yet been notified to WYPF..3 Please provide strike information based on strike only in the last 12 months up to the last day of employment/active membership ..... 3 Additional Pension Benefits* ..... 3 Please provide annual rates of pay for the last 12 months in all cases: Any pay treated as temporary for pension purposes should be excluded but pensionable elements such as FDA included. CPD is also excluded ..... 4 Was pay higher in any of the earlier 2 years? ..... 4 Is/was the firefighter a retained member of one of the final salary schemes (1992, 2006, RDS Modified) * ..... 4 Member made RDS modified election? ..... 4 CARE Pay - for leavers from 1 April 2015 who are members of the 2015 scheme, you will need to provide pensionable pay received including APP treated as having been received ..... 4 Is member in 2015 scheme? ..... 5 Assumed Pensionable Pay (APP) ..... 5 Do you need to send revised CPP/APP for any previous financial year? ..... 5 Additional Information ..... 5

Fields marked with a * are compulsory

Questions asked on the Fire Retirement Form

Have you checked that WYPF have the correct address on record? *

• Yes – Move onto next question
• No – Further question below
• Please cancel this transaction and check the member address. If it is incorrect, please correct it before attempting this transaction again.

Rank*

• Firefighter Trainee
• Firefighter Development
• Firefighter Competent
• Crew Manager Development
• Crew Manager Competent
• Watch Manager Development
• Watch Manager Competent A
• Watch Manager Competent B
• Group Manager Development
• Group Manager Competent A
• Group Manager Competent B
• Station Manager Development
• Station Manager Competent A
• Station Manager Competent B
• Area Manager Development
• Area Manager Competent A
• Area Manager Competent B
• Assistant Chief Fire Officer
• Deputy Chief Fire Officer
• Chief Fire Officer

Marital Status

• Civil Partnership
• Cohabiting Partner
• Married
• Not Married
• Unknown

Split Pension applies?

No – Move onto next question

Yes – Further question below

• Have you notified WYPF
• Yes – Move on to next question
• No
• Complete FPS Split Pension Notification form via the portal

2015 Protected Pensionable Pay (Final Salary) applies?

• No – Move onto next question
• Yes – Further question below
• Have you notified WYPF
• Yes – Move on to next question
• No
• Complete FPS 2015 Protected Pensionable pay form via the portal

Last date of service * Drop down calendar (dd/mm/yyyy)

Pay retirement benefits from Drop down calendar (dd/mm/yyyy)

Type of Retirement *

• Early (50/25) Maximum Lump Sum
• Early (50/25) Restricted Lump Sum
• Employer Initiated Retirement
• Ordinary (30 Years)
• Partial Retirement (2015 Scheme only) - Permanent Lower Tier III Health PLUS Injury on Duty
• Permanent Ill Health (Lower Tier)
• Permanent Ill Health (Upper Tier)
• Degree of disablement *
• Permanent Lower Tier Ill Health PLUS Injury on Duty
• Permanent Upper Tier Ill Health PLUS Injury on Duty
• Voluntary (Age 55)
• Degree of disablement*

• Permanent Upper Tier III Health PLUS Injury on Duty

• Degree of disablement *

Extra contributions - Were there any contributions outstanding at the date of leaving?

No – Move onto next question

Yes – Further question below

• Please give details of the outstanding contributions here £
• How are these arrears being recovered?

Please provide any strike information that has not yet been notified to WYPF.

• Date of strike (dd/mm/yyyy)
• Hours on strike
• Add another?
• Total number of days strike
• Strike contributions being repaid?
• No/Yes
• No/Yes

Please provide strike information based on strike only in the last 12 months up to the last day of employment/active membership.

• Total number of hours strike
• Pay lost due to strike £

Additional Pension Benefits*

• Was member in receipt of Long Service Increment (LSI) at 30 June 2007?
• Is member in receipt of CPD?
• No/Yes
• No
• Yes - Total pension contributions relating to the CPD payment (Employee, Employer & Notional III Health percentages) from 1 July to date of leaving £

• Is there any other pay deemed pensionable via an APB (from 01/07/2013) i.e. Temporary Promotion? *
• No
• Yes - Total pension contributions relating to the 'Temporary payment' (Employee, Employer & Notional III Health percentages) from 1 July to date of leaving

Please provide annual rates of pay for the last 12 months in all cases:

Any pay treated as temporary for pension purposes should be excluded but pensionable elements such as FDA included. CPD is also excluded.

Date from (dd/mm/yyyy) Annual Pay £ Date from (dd/mm/yyyy) Annual Pay £ Date from (dd/mm/yyyy) Annual Pay £

Was pay higher in any of the earlier 2 years?

• No – Move onto next question
• Yes –
• Date from (dd/mm/yyyy) Annual pay £
• Date from (dd/mm/yyyy) Annual pay £
• Date from (dd/mm/yyyy) Annual pay £

Is/was the firefighter a retained member of one of the final salary schemes (1992, 2006, RDS Modified) *

• No – Move onto next question
• Yes –
• Actual pensionable pay for the previous complete financial year £
• Actual pensionable pay from 1 April to retirement date

Member made RDS modified election?

• No - Move onto next question
• Yes –
• Repaying by periodical payment? No/Yes
• No – Move onto next question
• Yes –
• Date of first payment(dd/mm/yyyy)
• Amount of monthly payment £
• Is the member continuing to make these periodic contributions after leaving? Yes/No

CARE Pay - for leavers from 1 April 2015 who are members of the 2015 scheme, you will need to provide pensionable pay received including APP treated as having been received.

Is member in 2015 scheme?

• No – Move onto next question
• Yes – CPP for current financial year i.e. from 1st April until date of leaving: £

Assumed Pensionable Pay (APP)

Assumed Pensionable Pay (APP) applies where member has had a period of reduced pay OR no pay but has repaid pension contributions.

• No – Move onto next question
• Yes –
• APP for the current financial year (1st April to date of leaving)£
• Do you need to send revised CPP/APP for any previous financial year?
• Yes/No

Do you need to send revised CPP/APP for any previous financial year?

• No – Move onto next question
• Yes –
• APP for any previous financial year
• Year
• Year
• Year
• Year APP £

Additional Information

Submit/Cancel