Bereavement detailed notification of death

Please complete this form to provide information on the deceased and their Personal Representative or next of kin.

* Indicates required information

Details of the deceased

Title*

First name*

Surname*

Search for address of desceased*

Date of birth*

Date of death*

Is there a Will? *

Yes

Not sure

Any account numbers (if known)

Details of the Personal Representative This could be the executor, administrator or legal representative dealing with the estate. If the Personal Representative is unknown, please provide details for the next of kin. If there is more than one Personal Representative, please include additional details in the additional information box.

Title*

First name*

Surname*

Search for address of personal representative*

Relationship to the deceased

Email address

Phone number*

Any additional information you think may be useful