Pension Protection Fund (PPF) authority form           		
Your personal details	
Full name of member:	 

Name of former pension scheme:			
	
Member’s address 	

Post code:		
	
Member’s date of birth 			
	
Member’s National Insurance Number	

Details of authorised person/company to release information to : 	
Name of authorised person or company. Please print name 	Mr/Mrs/Miss/Ms
(delete as applicable)		
	
Address 	

Post code:		
	
Relationship to member 

Landline telephone number 			
	
Mobile telephone number 			
	
Email address 			

I, (insert name here)____________________________________, authorise the PPF to release information requested by the above named party.

This authority form will be valid for 12 months from the date of my signature.
	
Your signature:	

	Date:	/       /		

Return to PPF Member Services, Pension Protection Fund, PO Box 254, Wymondham, NR18 8DN 

For more information on how we use your data, please go to www.ppf.co.uk/members