Invalidity Pension Application Form (INV1)

• Published date: 01 April 2021
• Issuer: Department of Social Protection

You need a Personal Public Service Number (PPS Number) before you apply.

How to complete this application form.

• Please tear off this page and use as a guide to filling in this form.

• Please answer all questions. Incomplete forms will be returned and this may

delay your application.

• Please use BLACK ball point pen.

• Please use BLOCK LETTERS and place an X in the relevant boxes.

If you do not have a spouse, civil partner or cohabitant:

Please fill in Parts 1 to 4 and Part 7 as they apply to you. When the form is

completed, read Part 8 and sign declaration in Part 1.

If you have a spouse, civil partner or cohabitant:

Please fill in Parts 1 to 7 as they apply to you. You must complete Part 6 fully if

you wish to claim an increase for your spouse, civil partner or cohabitant or if

you wish to claim an increase for a qualified child. When the form is completed,

read Part 8 and sign declaration in Part 1.

Your spouse, civil partner or cohabitant must also sign the declaration in Part 1 if

you are claiming an increase for them and/or your child(ren).

If you need any help to complete this form, please contact your local Intreo

Centre, Social Welfare Office, Citizens Information Centre or

Invalidity Pension Section.

Telephone: (043) 334 0000 or 0818 92 77 70

If you are calling from outside of Ireland please call

+ 353 43 334 0000

For more information, log on to www.gov.ie

Application form for

Invalidity Pension

Data Classification R

Social Welfare Services

INV 1

How to fill this form

To help us in processing your application:

• Print letters and numbers clearly.

• Use one box for each character (letter or number).

Please see example below.

1 2 3 4 5 6 7 T

M U R P H Y

M A U R E E N

M C D E R M O T T

1 N E W S T R E E T

O L D T O W N

D O N E G A L T O W N

L A N D L I N E

M O B I L E

2 8 0 2 1 9 7 0

O N E C H A R A C T E R P E R

B O X

1. Your PPS Number:

3. Surname:

7. Your date of birth:

4. First name(s):

D D M M Y Y Y Y

Mr. Mrs. Ms. Other

2. Title: (insert an ‘X’ or

specify)

6. Birth surname:

5. Your first name(s) as

appears on your birth

certificate:

10.Your telephone number:

11.Your email address:

Contact Details

9. Your address:

X

M A R Y

8 . Your mother’s birth

surname: K E L L Y

O N E N U M B E R P E R B O X

O N E N U M B E R P E R B O X

County D O N E G A L Post Code

SAMPLE