REQUEST FOR WITHDRAWAL OR SURRENDER

Transcription

1 REQUEST FOR WITHDRAWAL OR SURRENDER For use with the Flexible Investment Account You should request all Policy Transactions should be requested through your Online Service Account. We will only allow you to use this form to request a partial or total surrender in exceptional circumstances. If you do not request the surrender through your Online Service Account, we may refuse to accept your request. You should be aware that by submitting this form to us an Offline Asset Dealing Charge will apply to each transaction to buy and each transaction to sell assets. This will be in addition to any Asset Dealing Charge, other Portfolio Fund Charges, Third Party Agent Charges and any other charges that may apply. All references to Old Mutual International means Old Mutual International Isle of Man Limited Singapore Branch. Please return the completed form to: Old Mutual International office situated at Level 25, North Tower, One Raffles Quay, Singapore BEFORE COMPLETING AND SUBMITTING THIS FORM YOU SHOULD: Speak to your financial adviser representative to ensure you are following the most suitable course of action for your circumstances Refer to your policy terms and literature Read the guidance notes on taking money from your policy, available on or by contacting us Be fully aware of the possible tax consequences that may apply on taking money from your Flexible Investment Account this is particularly important for UK residents If totally surrendering your Flexible Investment Account or totally surrendering individual policies, request an approximate calculation of the value as an outstanding establishment charge may apply. To help you, we have used an arrow u to highlight certain facts and to let you know that you can find further information and explanations in the guidance notes available on our website or by contacting us. Important information There are a number of alternatives to surrendering part or all of your policy and, before making a decision, you may wish to consider reviewing the investments you hold or read the document are you sure surrendering is the best option?, available on our website. This could give you the opportunity to achieve one or more of the following: better performance less risk stable returns. It is important to review your policies regularly because: the investment market can change quickly your attitude to risk may change. Completing the form To complete this form: use CAPITAL LETTERS only use blue or black ink specify choices as appropriate complete all relevant sections; refer to the guidance notes where relevant do not use correction fluid; any amendments should be crossed out and initialled by all policyholders. 1 of 8

2 A DETAILS OF THE POLICY FROM WHICH PAYMENT WILL BE MADE u Please see the guidance notes on how to complete this section. Policy number (for example ) Type of investor (3) Individual Trustee Corporate DETAILS OF INDIVIDUAL POLICYHOLDER(S), INCLUDING INDIVIDUAL TRUSTEES If there are any further policyholders, please photocopy this page, attach the details with this form and tick here. (3) Title (3) Policyholder 1 Mr Mrs Miss Other Policyholder 2 (if any) Mr Mrs Miss Other Full forename(s) Surname DETAILS OF CORPORATE POLICYHOLDER Company name POLICYHOLDER(S), ADDRESS (INDIVIDUAL, TRUSTEE AND CORPORATE) Residential address (where you are currently living) Daytime telephone number including dialling code address Fax number FINANCIAL ADVISER REPRESENTATIVE DETAILS Financial adviser representative company Financial adviser representative contact number Financial adviser representative name Financial adviser representative address Who is to be contacted in case of queries (3) Policyholder Financial Adviser Representative THIRD PARTY/PLEDGE INTEREST DETAILS If third party/pledge interest exists, please ensure that we have an up to date signatory list. If this has not already been provided, please also include ID and proof of residency of two directors which must be certified as true. Full name(s) of Pledgee(s) Address(es) of Pledgee(s) DETAILS OF NOMINATION (IF APPLICABLE) Is the policy subject to a nomination (3) Yes No If yes, please indicate the type of nomination (3) Irrevocable Trust Nomination Revocable Nomination Date of nomination Your surrender request will only be paid in accordance with the nomination if the nomination was registered and accepted by Old Mutual International. It is not possible to accept and register any nomination received after the death of the policyholder. 2 of 8

3 B TYPE OF SURRENDER Please indicate below which type of surrender you would like (Please tick one option only): (3) Total surrender of all policies Total surrender of individual policies Enter a range, for example 1 to 5, or choose a value for which Old Mutual International will calculate the appropriate number of policies for surrender.we will surrender whole policies as close to the value needed, and then we will partially surrender the remaining policies to achieve your requested amount. Range to OR Value If you do not have the cash available in your policy, you must sell your asset to fund the requested surrender, please provide as much information as possible in the following section, for example, number of units or value. Part surrenders across all policies, including Regular Withdrawals Payment currency Total surrender of one or more policies and part surrenders will be paid in the Policy Currency unless you request it to be paid in one or more of the other available currencies. Regular Withdrawals will only be paid in the Policy Currency. Payment currency (3) SG$ US$ HK$ AU$ Other (Please state) Please tick here if you have taken professional advice on the best way of cashing in your policy, taking your present tax status into account. (3) sale of specific asset(s) to fund total surrender of individual policies u See guidance notes for more information. Please state in the space below which specific asset(s) held in your policy should fund your requested surrender. Please clearly indicate below the percentage or value of each asset to be sold. If you wish to add more investments to be sold, please attach a photocopy of this page, attach the details with this form and tick here. (3) Asset name/fund name Sedol/ISIN number Percentage or cash value (Please indicate) u See guidance notes for more information. sale of assets to fund part surrender, across all policies including regular withdrawals u See guidance notes for more information. Regular Withdrawals will be paid in your Policy Currency. Please indicate the amount or percentage of your premium(s) to be withdrawn each year (the minimum level of payment is SG$1,600 a month or currency equivalent). If you do not want to include all of your Premiums you will need to work out how much you want and insert an amount in the Amount (per annum) box below. Amount (per annum) OR Percentage of total Lump Sum and Regular Premiums % Please choose the frequency of the withdrawal (3) Monthly Quarterly Half-yearly Annually Date of first withdrawal (The date must be at least 10 working days from the date you signed this form) You must select an Asset to be sold to pay for the part surrender benefits and regular withdrawals which may be a Nominated Asset or where you do not select a Nominated Asset or it is no longer available the Asset with the highest value at the time will be sold. Nominated Asset(s) Sedol/ISIN number Percentage or cash value (Please indicate) 3 of 8

4 C PAYMENT DETAILS u Please see the payment details section of the guidance notes before completing this part of the form. Please make sure this section is completed in clear BLOCK CAPITALS. If your payment is to be sent by telegraphic transfer a bank charge will apply. All payments must be paid to the Policyholders own account. bank details of payee Bank name Bank address Country Payee name Payee account number/ IBAN Sort code (applicable to UK accounts only) Branch code for non-uk payments ABA number SWIFT/BIC code (SWIFT code needed for bank accounts outside Europe; BIC code needed for European accounts with an IBAN) Currency of the bank account payment being made to Additional information that may be required by the bank For Old Mutual International use only Policy number 4 of 8

5 D AUTHORITY OF POLICYHOLDER(S) REQUESTING THE PAYMENT u SIGNATORIES Please note all policyholders, including additional trustees and/or assignees where applicable, must sign below. The Lead policyholder is unable to authorise the transaction on behalf of all policyholders. Please indicate the capacity in which you are acting. Each of the undersigned signatories hereby: 1. authorises and requests Old Mutual International to carry out the transaction detailed in Section B in accordance with the Flexible Investment Account Policy Terms. 2. confirms that the amount to be received is the value of the Allocated Units less any Portfolio Fund Charges, for example the outstanding Establishment Charge, Asset Dealing Charge and Offline Asset Dealing Charge, and Third Party Agent and other charges. 3. confirms that all the information contained in this form is true and correct and that I am entitled to the legal and/or beneficial interest in the policy unless the policy is subject to a trust or nomination and the beneficiaries are entitled to receive payment in accordance with the provisions. 4. confirms that there is no Bankruptcy Order against the policyholder or beneficiary (if applicable) nor are they an undischarged bankrupt or deemed to be insolvent under any relevant insolvency legislation. 5. undertakes to indemnify Old Mutual International against any claims or demands made by any other person or party as a result of the payment requested in Section B. 6. agrees that payment of the the partial or total surrender proceeds shall constitute full discharge of the liability of Old Mutual International. 7. confirms that by partially/totally surrendering my policy I have read and understood the guidance notes attached to this form, have sought and considered financial advice in regards to the potential tax consequences and have referred to your policy terms and literature. 8. understands that Old Mutual International may terminate my Online Service agreement if all of my policies come to an end by totally surrendering all policies within my contract. uold Mutual International does not offer legal, tax or financial advice and we can accept no responsibility for any action taken or refrained from on the basis of information provided by us. Any information provided is based on our understanding of the current law and practice and is subject to change inthe future. Signatory 1 Signed Date Full name Capacity (3) Individual Trustee Authorised signatory Third party/pledgee Signatory 2 Signed Date Full name Capacity (3) Individual Trustee Authorised signatory Third party/pledgee Signatory 3 Signed Date Full name Capacity (3) Individual Trustee Authorised signatory Third party/pledgee Signatory 4 Signed Date Full name Capacity (3) Individual Trustee Authorised signatory Third party/pledgee E CHECKLIST Fully completed form (This must be the original signed version of the form). Current photo ID plus proof of residential address certified by financial adviser representative, if suitable certifier, otherwise notary public/solicitor (This is only required if these details have changed since you last carried out a Policy Transaction or if the Policy has been assigned to you and you have not already provided us with this information) Proof of address must be no more than three months old, ID must be valid and in date (mobile phone bills are not acceptable) 5 of 8

6 F FEEDBACK QUESTIONS FOR TOTAL SURRENDER OF ALL POLICIES ONLY At Old Mutual International we are keen to improve our products and services. To help with this, we would value your feedback. Could you please spend a few moments completing the questions below to help us understand why you have decided to cash in your Old Mutual International policy. 1. Did you seek advice from a financial adviser representative? Yes No 2. What is the main reason for deciding to cash in your policy? Poor fund performance Premiums/charges too high or not what you expected Poor customer service experience To invest in a different product with Old Mutual International Product not what you expected (eg lack of flexibility) Monies required for another purpose (eg to buy a house) No specific reason Product acheived my financial needs/expectation Purchase an alternative product with another provider 3. If you intend to invest the payment from this surrender with another product provider, please confirm with whom. 4. Can you confirm if you are a UK resident for tax purposes? (3) If so, what type of taxpayer are you? (3) (tick on right for answer) This information is purely for marketing purposes. Non taxpayer Basic rate Higher rate Thank you for completing these questions. Additional rate Calls may be monitored and recorded for training purposes and to avoid misunderstandings. Old Mutual International is the registered business name of Old Mutual International Isle of Man Limited Singapore Branch. Old Mutual International Isle of Man Limited Singapore Branch, 50 Collyer Quay, OUE Bayfront, #05-07, Singapore, Phone: Fax: Registered in Singapore Number T08FC7158E. Authorised by the Monetary Authority of Singapore to conduct life assurance business in Singapore. Member of the Life Insurance Association of Singapore. Member of the Singapore Finance Dispute Resolution Scheme. Old Mutual International Isle of Man Limited is registered on the Isle of Man under number 24916C. Registered Office/Head Office: King Edward Bay House, King Edward Road, Onchan, Isle of Man, IM99 1NU, British Isles. Licensed by the Isle of Man Financial Services Authority. Old Mutual International Isle of Man Limited is a member of the Association of International Life Offices. Old Mutual International is registered in the Isle of Man as a business name of Old Mutual International Isle of Man Limited. PDF8375/INT /June of 8

7 GUIDANCE NOTES important information on policy proceeds and payment When surrendering or making one-off withdrawals, it s important to consider that: You may have to pay tax if you withdraw or surrender from your policy. Therefore we strongly recommend you consult with your financial adviser representative before completing this form. Old Mutual International may deduct Portfolio Fund Charges, such as any oustanding Establishment Charge, Offline Asset Dealing Charge or Asset Dealing Charge, and Third Party Agent and other charges. Therefore we strongly recommend you ask for an approximate calculation of the surrender value before completing this form. You may incur set up costs if you move your investments to a new provider. How can we send you the policy proceeds? Total surrender of one or more policies and part surrenders will be paid in the policy currency unless you request it to be paid in one or more of the other available currencies. Regular withdrawals will only be paid in the Policy Currency. No third party payments are allowed. Payments will be paid to all policyholders, jointly, unless you request for the payment to be split equally amongst all policyholders. To ensure that transactions and policies remain economically viable, we stipulate a minimum value of a portfolio fund which is currently SG$20,000/US$15,000/ 15,000/HK$120,000/ 10,000/AU$20,000 or other currency equivalent. If at any time the portfolio fund value falls below the greater of this amount or 125% of any outstanding Establishment Charge then we reserve the right to automatically surrender your policy or cluster of policies unless you offer to pay us an additional premium, subject to our acceptance. If we choose to exercise this right we will confirm this to you through your Online Service Account. When you are ready to request a payment, what should you do? Please return the original completed form to: Old Mutual International office situated as Level 25, North Tower, One Raffles Quay, Singapore A DETAILS OF THE POLICY FROM WHICH PAYMENT WILL BE MADE In this section you should enter the policy number from which you wish the payment to be made. Please confirm whether this is a request from an individual, trustee or corporate policyholder by ticking the relevant field. If the policyholder is a trustee please fill out the name of the trust and the date that it was created. If the policy is in the name of a corporate investor please enter the corporate name in the space provided. If the policyholder is an indvidual(s) please enter full name in the space provided. You then need to give the address details of policyholder(s). FINANCIAL ADVISER REPRESENTATIVE DETAILS Please complete the company name, individual name, contact number, fax number and address of your financial adviser representative. THIRD PARTY/PLEDGEE DETAILS Please give the name of any third party to whom the policy has been pledged/assigned or with whom the policy schedules may have been deposited or otherwise charged as security or where a nomination has been noted on the policy. If this applies please also ensure that section D is also signed by the third party. B TYPE OF SURRENDER In this section please choose the currency in which you would like your payment to be received (if you choose a currency which is not the currency of your policy, currency conversion charges may apply). Please choose the type of surrender that you require from the options: Total surrender of all policies This is the sale of all investments into the policy currency (unless you advise us otherwise) and the surrender of all policies. Total surrender of individual policies This is the full surrender of a specific policies. Please indicate which asset(s) you want us to sell in order to fund your requested surrender. Part surrenders across all policies This is to request a specific amount by cashing in an equal amount across all policies. Regular withdrawals The minimum monthly payment is SG$1,600 (or equivalent). We will send your payment by telegraphic transfer which will incur a bank charge. Percentages withdrawn will be based on the premium(s) received prior to this request. If you require the percentage to include any additional funds received in the future, we will require revised instructions to this effect at that time. Please note that the sale of each investment may be subject to an Offline Asset Dealing Charge and an Asset Dealing Charge and sometimes also third-party charges. Sale of asset(s) to fund a partial surrender, including regular withdrawals. You must choose an asset to be sold to pay for the partial surrender benefit which may be a Nominated Asset or where you do not have a Nominated Asset or it is no longer available the asset with the highest value at the time will be sold. In all circumstances we suggest that you seek financial and tax advice before submitting any request for payment to ensure you are aware of any tax consequences as a result of the encashment from your policy. 7 of 8

8 C PAYMENT DETAILS Payments will only be made to a bank account in the policyholder s name; we will not accept requests to make payments to third parties. In exceptional circumstances payments can be made to financial institutions, financial advisers/solicitors/accountants which are recognised by the UK Financial Conduct Authority (FCA), and who have the appropriate authorisation to handle client money. Please discuss such requests with Old Mutual International before submitting your form. Payment will be sent to your bank account by bank transfer and bank charges will be incurred. For joint policies, payment will be made to both policyholders, either in full to a joint bank account or split equally to bank accounts in each of the policyholders names (please use section C to provide the second policyholder s bank details if applicable). All payments on corporate owned policies will be made payable to the company. All payments to banks within Europe and the Middle East require a BIC/SWIFT and an IBAN. Please ensure that these fields are filled in as it may delay your payment without this information. If proceeds are to be split equally between joint policyholders, please ensure that the tick box is filled and give details of the second policyholder in the area provided. D AUTHORITY OF POLICYHOLDER(S) REQUESTING THE PAYMENT All policyholders, including additional trustees and/or assignees where applicable, must sign this section. Please also indicate the capacity in which you are acting. These signatures authorise and request Old Mutual International to effect the transaction(s) detailed on this form. By signing this form you confirm that you have read and understood the policy terms and guidance notes on making a payment from the policy. E CHECKLIST This is to ensure that you have included all the information needed for us to process your request. Please tick the corresponding fields to make certain that the necessary documents have been supplied. F FEEDBACK QUESTIONS In order for us to continuously improve our products and services we appreciate any feedback that we receive. Please answer these questions and if you have any other comments or suggestions, you can contact us at the address at the beginning of these guidance notes, or use the addresses provided. If there are any further questions then please visit Calls may be monitored and recorded for training purposes and to avoid misunderstandings. Old Mutual International is the registered business name of Old Mutual International Isle of Man Limited Singapore Branch. Old Mutual International Isle of Man Limited Singapore Branch, 50 Collyer Quay, OUE Bayfront, #05-07, Singapore, Phone: Fax: Registered in Singapore Number T08FC7158E. Authorised by the Monetary Authority of Singapore to conduct life assurance business in Singapore. Member of the Life Insurance Association of Singapore. Member of the Singapore Finance Dispute Resolution Scheme. Old Mutual International Isle of Man Limited is registered on the Isle of Man under number 24916C.. Registered Office/Head Office: King Edward Bay House, King Edward Road, Onchan, Isle of Man, IM99 1NU, British Isles. Licensed by the Isle of Man Financial Services Authority. Old Mutual International Isle of Man Limited is a member of the Association of International Life Offices. Old Mutual International is registered in the Isle of Man as a business name of Old Mutual International Isle of Man Limited. PDF8375/INT /June of 8