Widow’s, Widower’s or Surviving Civil Partner’s (Non-Contributory) Pension Application Form (WP1)

• Published date: 16 April 2021
• Issuer: Department of Social Protection

How to complete this application form?

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

There are examples on the back of this page that can be used as a guide to ll in this form. Please:

• write with a black ballpoint pen, use capital letters and place an X in the relevant boxes;

• complete Part 5 if you wish to apply for Fuel Allowance;

• read and sign the declaration in Part 9; and

• read the checklist in Part 10.

How do I apply?

Send this completed form to:

Widow’s, Widower’s or Surviving Civil Partner’s Non-contributory Pension Section

Social Welfare Services

Department of Social Protection

College Road

Sligo

F91 T384

How do I qualify?

To qualify for Widow’s, Widower’s or Surviving Civil Partner’s (Non-contributory) Pension you must:

• be a widow, widower or surviving civil partner;

• be under 66 years of age;

• have no dependent children;

• not be cohabiting with another person; and

• be habitually resident in the State.

If you:

• are 66 years of age or over you may apply for the State Pension (Non-contributory).

• have dependent children you may apply for the One-Parent Family Payment or Jobseeker’s Transitional

Payment.

What is Widow’s, Widower’s or Surviving Civil Partner’s (Non-contributary) pension?

Widow’s, Widower’s or Surviving Civil Partner’s (Non-contributory) Pension is a means tested payment

payable to a widow, widower or surviving civil partner who does not qualify for the Widow’s, Widower’s or

Surviving Civil Partner’s (Contributory) Pension. It is payable to persons under age 66 with no dependent

children.

How can I get help and further information?

If you need any help to complete this form, please contact the Widow’s, Widower’s or Surviving Civil

Partner’s (Non-contributory) Pension section by email at wwscpncp@welfare.ie or by calling

0818 200 400 or 071 915 7100.

Your local Intreo Centre, Social Welfare Oce or any Citizens Information Centre can also help. You can

nd the name and address of your local Intreo Centre or Social Welfare Oce at

www.gov.ie/intreocentres.

For more information, visit www.gov.ie/wncp.

Application form for

Widow’s, Widower’s or Surviving Civil

Partner’s (Non-contributory) Pension

Social Welfare Services

WP 1

Data Classification R

How to fill in this form

SAMPLE

1234567T

M U R P H Y

M A U R E E N

M C D E R M O T T

Landline

Mobile

M M U R P H Y @ W E L F A R E . I E

1. PPS Number:

3. Surname:

7. Date of birth:

4. First names:

Mr Mrs Ms Other

2. Title insert an X or specify:

6. Birth surname:

5. Your first names as appears

on your birth certificate:

10. Telephone numbers:

11. Email address:

X

M A R Y

8 . Mother’s birth surname:

0 861234567

0 184779783

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

9. Address:

County D O N E G A L

F 9 2 P C 0 2

Eircode

2 8 0 2 1 9 8 0

D D M M Y Y Y Y

K E L L Y

Part 1 Your details

To help us process this form please write letters and numbers clearly and use one box for each.

Please see examples below.