Please use this form to notify Derbyshire Pension Fund of any previous public service pension scheme membership that you have so the fund can work out whether you will be affected by the McCloud judgment.

You only need to fill in the form if you were a member of a public service pension scheme before you joined the Local Government Pension Scheme (LGPS) in Derbyshire Pension Fund.

Not everyone will need to complete the form.

You do not need to complete the form if any of the following apply to you:

  • Your only public service pension scheme membership is in the LGPS through Derbyshire Pension Fund.
  • you were a member of a public service pension scheme before you joined the LGPS in Derbyshire Pension Fund, and that membership has been transferred to Derbyshire Pension Fund.
  • you first joined a public service pension scheme after 31 March 2012
  • you left the LGPS or reached age 65 before 1 April 2014.
  • you joined the LGPS with Derbyshire Pension Fund after 31 March 2022.
  • you joined the LGPS with Derbyshire Pension Fund before 1 April 2012 and did not have a gap in membership of over five years.

What is a public service pension scheme?

A public service pension scheme is a UK pension scheme for:

  • civil servants
  • the judiciary
  • the armed forces
  • local government workers
  • health service workers
  • teachers
  • fire and rescue workers
  • police officers

Consent

By submitting this form, you consent to Derbyshire Pension Fund:

  • using the information you provide to contact you on pension related matters
  • contacting my previous public service pension scheme(s) to confirm my membership

We will not share your email address or telephone number with any third parties.

You can access our Privacy notice to find out what information we hold about you and:

  • how we use it
  • your rights
  • the safeguards in place to protect it.
  • Previous membership details

    In the following ‘More information’ box, please provide details of your previous public sector scheme membership. Please include:

    - the scheme name

    - date from

    - date to

    - whether you have been refunded the contributions in respect of the membership

    - whether you have transferred your membership to another pension scheme

  • Declaration

    By submitting this form, I understand that:

    - Derbyshire Pension Fund will investigate whether I am eligible for a review of my pension under the McCloud remedy

    - Completing this form does not guarantee I will get additional pension

  • Declaration for a deceased member

  • If yes, please provide the following information: