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Nottinghamshire UNISON
39-41 Loughborough Road
West Bridgford
Nottingham
NG2 7LJ
Members Death Benefit Beneficiary
I wish to inform you that I have nominated the following person to be my death benefit beneficiary.
Members Name: UNISON Membership Number
Members Work Address: Members Home Address:
Name and address of Death Benefit Beneficiary
Name:
Address:
Members signature Dated
Please return to:
UNISON East Midlands Regional Centre
Vivian Avenue
Sherwood Rise
Nottingham
NG5 1AF Or email: eastmidlands@unison.co.uk
Tel: 0115 9810405 Fax: 0115 9815697 Email: branch.office@nottsunison.org.uk
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