Claim for Bereavement Allowance form (SA366)

Use this form if you are claiming for Bereavement Allowance.

You should read the information you need to know about your claim for Bereavement Allowance before you start your claim.

This PDF is fillable. Download this form and complete it on your device, or print it and complete it by hand.

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 23 May 2019