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Beneficiary Details Name and Address Relationship if any Please use additional sheets if necessary Date of Birth if under 18 Total Share of Benefit I certify that I have read the notes overleaf and that the above details are correct to the best of my knowledge Member s signatureDate Send completed form to City of London Pensions Office PO Box 270 Guildhall London EC2P 2EJ pensions cityoflondon.gov.uk. Appendix 1 4 Death Grant Expression of Wish For Members of the Local Government Pension...
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