Please do not tack the documents together Pension forecast application form Pension forecast application I would like to receive a forecast for an old-age pension an invalidity pension a survivors pension that would fall due in the event of my death 1. Applicant details 1.1 1.2 All first names 1.3 1.4 Social Security Number 1.5 Sex male female 1.6 Marital status single married registered partnership widowed registered partnership dissolved by death divorced legally dissolved registered partnership legally separated legally separated registered partnership For applicants who are married or in a registered partnership, a separate pension forecast request form must be filled out for each spouse/registered partner. Both forms must be sent together to the same compensation office. 1.7 Address Street, number Postcode, town Phone / Mobile E-mail 318_282_v2-1 / 7
1.8 Nationality Nationality Swiss citizenship Place of origin / canton 2. Details on spouse/registered partner 2.1 2.2 All first names 2.3 2.4 Social Security Number 2.5 Nationality Nationality Swiss citizenship Place of origin / canton 3. Children Entitlement to educational credits The insured may claim for educational credits for the years during which they had parental custody of one or more children aged under 16. For married parents, the educational credit will be divided equally between them during the calendar years in which their marriage subsisted. Divorced parents whose child/children was/were 16 or under when the official divorce decree was issued must provide a copy of said decree. Unmarried parents must provide confirmation of joint parental custody, as well as a copy of the agreement on the allocation of educational credits. Where applicable, decisions by the Child and Adult Protection Authority (KESB) should also be submitted, together with any later written agreements that deviate from earlier agreements on the allocation of educational credits. If the applicant fails to submit any written proof regarding the allocation of educational credits to the compensation office, all such credits will be granted in full to the mother as of 1 January 2015. 3.1 Do you have you biological (born in or out of wedlock), adopted, foster or step-children? Please provide details of all your children, including children who are over the age of 16, are adults or deceased. yes no Note: click + to add lines 318_282_v2-2 / 7
Status, first name, date of birth Status, first name, date of birth Status, first name, date of birth Status, first name, date of birth 318_282_v2-3 / 7
4. Former marriage(s) or registered partnership(s) The term former marriage(s) or registered partnerships refer to marriages or registered partnerships that have ended due to death, divorce (marriage) or legal dissolution (registered partnership). Divorced individuals may demand that all income earned during the marriage is divided equally between the former spouses and paid into their respective individual accounts. If the compensation fund establishes that the income has yet to be split, it will send the applicant (and his/her former spouse) the following application form «income-splitting upon divorce». The pension forecast will be calculated only once the income-splitting process is complete. Note: click + to add lines 4.1 First former marriage(s) or registered partnership(s) Date of marriage/registration day, month, year widowed registered partnership dissolved by death divorced registered partnership legally dissolved Details of former spouse/registered partner All first names Social Security Number 4.2 Second former marriage(s) or registered partnership(s) Date of marriage/registration day, month, year widowed registered partnership dissolved by death divorced registered partnership legally dissolved Details of former spouse/registered partner All first names Social Security Number 318_282_v2-4 / 7
5. Place of residence and employment abroad The AVS enforcement agencies require detailed information on the length of residence and employment abroad for foreign nationals and for individuals who did not have Swiss citizenship at the time of their employment in Switzerland. 5.1 Have you ever lived abroad? from to State 5.2 Have you ever been gainfully employed outside Switzerland? from to State 5.3 Have you plans to immigrate in the future? from State 5.4 Shall you continue to contribute to the AVS insurance scheme while living abroad? Note: On voluntary insurance cover options, please see information sheet 10.02 Voluntary old-age, survivors and invalidity insurance. 5.5 Foreign nationals must also provide the following: Have you resided in Switzerland at irregular intervals? from to 318_282_v2-5 / 7
6. Current or past receipt of AVS/AI benefits Has a Swiss AVS or AI pension or Swiss AVS or AI helplessness allowance been paid out? To you? To your partner? For children? 7. Income from gainful employment An old-age pension forecast refers to the estimation or extrapolation of future annual income. In the absence of information on future income trends, the compensation fund will base its calculation of the pension forecast on the last annual income detailed in the individual account of the applicant, and adjust it accordingly based on average future wage trends until the applicant reaches retirement age. If it is not possible to carry out such a calculation due to changing income trends or because the applicant has taken up employment only recently, more details will be required. 7.1 Details on earned income Current rate of employment % Is your rate of employment likely to change in the near future? a) As of when? b) What will the new rate be? % Do you plan to return to work in the near future? a) As of when? b) How high will your annual income be following your return to work? How is your earned income likely to change by the time you reach retirement age? CHF higher same lower Enclosed: Unemployed applicants must enclose a copy of their last unemployment benefits statement. 7.2 Other comments 7.3 Current or last employer Name Address Start of employment End of employment (where applicable) 318_282_v2-6 / 7
8. Flexible retirement 8.1 Would you like to make an advanced pension withdrawal? If yes, for how many years? 1 year 2 years 8.2 Would you like to defer pension withdrawal? yes no If yes, for how many years? 1 year 2 years 3 years 4 years 5 years Note: You can find additional information in the Information sheet 3.04 Flexible retirement. 9. Legal force and signature Your pension forecast will be calculated based on your current circumstances (marital status, income etc.) and in accordance with the applicable legal conditions. Any changes in your personal circumstances or to the legal conditions (retirement age, eligibility criteria, calculation rules, contribution requirement etc) may have a material bearing on pension entitlement and on pension rates. The precise rate of the AVS or AI pension rate to which you will be entitled can only be calculated when the insured risk (old-age, death or invalidity) materialises. I, the undersigned, confirm that I have read and agree to the above conditions, and declare that the information I have provided herein is accurate. Place and date Signature of the applicant or representative Please do not tack the documents together. Enclosed: Copy of the declaration on joint parental custody, as well as a copy of the agreement on the allocation of educational credits for unmarried parents Copy of the decision by the Child and Adult Protection Authority (KESB) on the allocation of educational credits Parental agreements on the allocation of educational credits Copy of the last unemployment benefits statement Original power of attorney issued to applicant s representative 318_282_v2-7 / 7