Transfer details. Application form. Applicant s details. Transferring scheme s details

Transcription

1 Transfer details Application form This form is to be completed by the Administrator/Practitioner/ Trustee of the transferring scheme, arrangement or contract. We have used the term transferring scheme throughout this document. Please complete all relevant sections of this application form and send it to: Zurich Retirement Services, Pointon York House, Welland Business Park, Valley Way, Market Harborough, LE16 7PS. The Zurich Self Invested Personal Pension (SIPP) and Protected Rights Transfer Plan are written under the Zurich Personal Pension (No 3Z) Scheme (the Scheme). Zurich Assurance Ltd. (Zurich) set up the Scheme and has appointed Zurich Pension Trustees Limited as the Trustee to look after the member s interests. It has also appointed Capita Life & Pensions Regulated Services Limited (Capita) as Scheme Administrator and Operator of the Scheme. Applicant s details Title Mr Mrs Miss Ms Other (please specify) Surname Forename(s) Gender Male Female Date of birth D D M M Y Y Y Y National insurance number Zurich Plan number, if known Transferring scheme s details Name of transferring scheme Address of scheme administrator/practitioner/trustee (please delete as applicable) Country (if not within the UK) Contact s name Contact s role Telephone number Arrangement number(s) This is a scheme registered (or deemed to be registered for section 226 Retirement annuity contracts) with HMRC under Chapter 2, Part 4 of the Finance Act Yes No If Yes, what is the PSTR number? Applicant s membership/plan number

2 Type of transferring scheme Please tick the category into which the current transferring scheme falls and complete the relevant section below. UK non-occupational registered pension scheme UK occupational registered pension scheme Recognised overseas pension scheme Zurich can t accept transfers from any other type of scheme or from Open Market Options into the applicant s Zurich Plan. Assets to be transferred What has the member asked you to transfer into the Zurich scheme? Cash UK commercial property Other assets (Please tick one or more, boxes) If you have ticked the Other assets box, please provide a list of assets to be transferred in specie. We will need to check whether we can accept the asset(s). If you have ticked the UK commercial property box please complete the separate property purchase/transfer in application. We will need to check whether we can accept the property(ies). Transfer payment details Total transfer payment to a SIPP Total amount of former Protected Rights included in the above amount Does this transfer represent the member s total pension benefits within the current transferring scheme? Yes No If no, is this: a) A split transfer? Yes No or b) A partial transfer? Yes No A split transfer is where all of the pension benefits within the current transferring scheme are to be transferred to at least two receiving UK registered pension schemes or qualifying recognised overseas pension schemes. A partial transfer is where some of the pension benefits within the current transferring scheme are to be retained within that scheme and the remainder are to be transferred to one, or more, UK registered pension schemes or qualifying recognised overseas pension schemes. Are you aware if the member is subject to the Money Purchase Annual Allowance Yes No If you have answered Yes to the above question please confirm the date upon which the member became subject to the Money Purchase Annual Allowance D D M M Y Y Y Y Please complete the information requested below if the transfer is fully or partly from a drawdown pension Please separate the total transfer value into the following elements: Transfer to a SIPP Transfer to a Protected Rights Transfer Plan 1) Uncrystallised (unvested) fund Box 1 2) Vested fund providing drawdown pension which commenced before 06/04/2006 3) Dependant s drawdown pension fund for the applicant which commenced before 06/04/2006 4) Crystallised fund providing drawdown pension which commenced after 05/04/2006 5) Dependant s drawdown pension fund for the applicant which commenced after 05/04/2006 6) Total transfer value Box 2 Box 3 Box 4 Box 5 Box 6 2

3 Transfer payment details (continued) Does all or part of the transfer directly or indirectly arise from vested rights under an approved occupational pension scheme or buyout contract where on or after 27 July 2004 but before 6 April 2006 the member had elected to take a tax-free lump sum, while deferring receipt of the pension? Yes No If Yes and this does not apply to all the transfer value, please state the amount to which it applies Are any benefits being transferred in excess of the lifetime allowance? Yes No If Yes, how much is in excess of the lifetime allowance? Divorce or civil partnership dissolution Pension credit amount Amount of Disqualifying Pension Scheme Credit (DPS credit) Is any part of the funds being transferred subject to an earmarking order, a pension Yes No sharing order, in process of being earmarked or in the process of being shared? (copy enclosed) Is any part of the transfer as a result of a pension share on a pension in payment? Yes No If Yes, amount of transfer payment from which no further tax-free lump sum can be taken Please provide a copy of: i) The relevant court order (or where no order has yet been made, any current draft order) including the amount/proportion subject to the earmarking order or pension sharing details (if applicable) and ii) The decree absolute, where this has been granted Block Transfer Details from a registered Pension Scheme To qualify as a block transfer, the transferring members must not have been a member of the receiving scheme for more than 12 months and, when they come to take their benefits, they must take all of their benefits at once. Is this part of a block transfer from a registered Pension Scheme (i.e. in a single transaction for two or more members)? Yes No If Yes a) Protected tax free lump sum amount: b) Fund value as at 05/04/2006: c) Transfer value in respect of this Block Transfer: d) Does the Transfer value include post A-Day contributions? Yes No Does the member have the right to take benefits before age 55 under this transferring arrangement? Yes No If Yes, from what age does this right apply and to what part of the transfer value does the right relate? Age Part of transfer value Bankruptcy Is any part of the transfer value currently subject to a bankruptcy order? Yes No If Yes, please supply the trustee in bankruptcy s contact details here and provide a copy of the bankruptcy order Name 3

4 Drawdown pension information If some or all of the benefits being transferred are providing a drawdown pension, please complete the information below using separate sheets of paper for each drawdown pension. Please note those benefits can only be transferred to another drawdown pension contract. Are the benefits in drawdown providing a drawdown pension? Yes No Please tick to indicate when drawdown pension commenced before 6/4/2006 after 5/4/2006 Please indicate which type of drawdown is being transferred Capped drawdown Flexi-access drawdown Amount of transfer payment used to provide a drawdown pension under transferring arrangement Original net value of drawdown pension fund (after taking tax-free lump sum) If capped drawdown please also answer the next two questions Current maximum gross capped drawdown income in pension year How much gross capped drawdown income has been paid out in pension year to date? If the member is transferring either capped or flexi-access drawdown please confirm the start date of the reference period for capped drawdown or start date of drawdown for flexi-access drawdown Date of the start of the reference period/drawdown start date D D M M Y Y Y Y Has any of the member s drawdown pension been used to purchase a short term annuity? (Short term annuities cannot be transferred into the Zurich SIPP or the Zurich Protected Rights Transfer Plan) Yes No If Yes What payments have been made? What future payments are to be made? When is the short term annuity to cease? D D M M Y Y Y Y Dependants/Successor/Nominee Drawdown Please exclude any transfer lump sum death benefit payment which the applicant received before 06/04/2007 from another deceased individual s remaining drawdown pension which the applicant has subsequently crystallised when answering the following question: Is this arrangement a Dependant/successor/nominee drawdown pension (i.e are survivor benefits received which originated from a deceased individual s UK registered pension fund)? Yes No If Yes all of the fund or Yes some of the fund, please provide the following information in respect of the deceased individual so that we can ensure that the applicant s fund is administered correctly in the event that the applicant dies with any remaining drawdown pension: Address Country (if not within the UK) Age at death Relationship to applicant Date of death D D M M Y Y Y Y Nationality Gender Male Female 4

5 Dependants/Successor/Nominee Drawdown (continued) Which category of drawdown fund is making the transfer Dependants Successor Nominee Has successor been nominated Yes No If Yes, please supply the name and address of the nominee Address Country (if not within the UK) If the transfer value relates to a successor s flexi-access drawdown fund please confirm the age at death of the immediately preceding dependant, nominee or successor D D M M Y Y Y Y If the transferring fund is a dependant s, nominee s or successor s flexi-access drawdown fund please confirm whether drawdown payments are subject to income tax under s579cza (6) of the Income Tax (Earnings and Pensions) Act 2003 Yes No In addition, please use the space below to provide the names and full contact details of any: a) Other dependant(s) of the deceased individual and b) Any nominee(s) of the deceased individual and c) Personal representative(s) of the deceased individual Drawdown pension benefits, crystallisations and arrangements These notes apply if the applicant is transferring from a drawdown pension. For each separate drawdown pension arrangement within the total transfer value, please complete the relevant crystallisation details using separate sheets of paper if necessary. We require this information to ensure that if: a) The applicant s net crystallised drawdown pension fund (i.e. those after any tax-free lump sum has been paid) is used to purchase an annuity or b) The applicant s uncrystallised benefits are transferred into a qualifying recognised overseas pension scheme before their seventy-fifth birthday, these subsequent benefit crystallisation events are administered correctly. If the applicant has crystallised any elements of their fund to provide drawdown pension benefits on more than one occasion after 05/04/2006 and the subsequent crystallisations have been added into the original drawdown pension, please only provide details relating to the combined ORIGINAL net drawdown pension funds at each crystallisation. Please state the percentage of the standard lifetime allowance (SLA) crystallised for each arrangement to 2 decimal places.. % For instance, 50% should be input as (However, if the applicant has not crystallised any pension benefits, please just input 0 ). Applicant s crystallisations relating to the transferring scheme In respect of the transfer value payment to Zurich, please state the applicant s combined percentage of the standard lifetime allowance (SLA) crystallised within either: a) The transferring scheme or b) Any previous UK registered pension scheme, or any recognised overseas pension scheme if the client has received any UK income tax relief after 05/04/2006 whilst a member of that overseas scheme, which transferred benefits (directly or indirectly) into the transferring scheme on, or after, 06/04/2006. (For either a split transfer or a partial transfer, the SLA percentage should be proportionately split between the schemes concerned. Therefore, in this situation, please state the SLA percentage consumed relating purely to the element of the applicant s pension fund which is to be transferred to Zurich). Please state the percentage of the standard lifetime allowance (SLA) crystallised to 2 decimal places.. % For instance, 50% should be input as (However, if the applicant has not crystallised any pension benefits, please just input 0 ). 5

6 Protection details received Member has primary/enhanced/fixed protection 2012/fixed protection 2014/ individual protection 2014 and this will be retained on transfer Yes No Not known Member has primary/enhanced/fixed protection 2012/fixed protection 2014/ individual protection 2014 and this will be lost on transfer Yes No Not known Money laundering prevention requirements current transferring scheme Before we can accept a transfer payment, we must carry out necessary money laundering prevention checks. Is the current transferring scheme a UK occupational registered pension scheme which is either a small self-administered scheme (SSAS) or an executive pension plan (EPP) (or would have been referred to as such before 06/04/2006)? Yes No If No, please go to the Declaration by Scheme Trustee/Administrator/Practitioner/Provider section. If Yes, we must carry out additional money laundering prevention checks before we can accept a transfer value payment. Consequently, please provide details of the sponsoring employer and trustee(s) below. In some situations, Zurich may need to contact your scheme again to obtain further information. Principal employer relating to the SSAS/EPP Employer s name Employer s address Details of Trustee(s) Corporate Trustee or Master Trust arrangements A) The Trustee is the principal employer (please tick if appropriate) or complete the following B) Name of Trustee Address Individual Trustees 6

7 Individual Trustees (continued) Please continue on a separate sheet, if necessary. 7

8 Declaration by transferring scheme trustee/administrator/practitioner I confirm that I will adhere to any HMRC information requirements. I confirm that where the transferring member invokes any regulatory or statutory right to cancel their proposed transfer into their Zurich Plan(s), the transferring scheme will reinstate the member to the extent of the value returned. I hereby declare that the information given in this form is to the best of my knowledge and belief correct and complete. Warning: I am aware that making false statements can be a serious offence and that severe penalties (including criminal prosecution) can result from this. Please do not send the transfer value payment with this form. We will request payment from you when we confirm that we can accept the proposed transfer. Any payment received prior to our confirmation of acceptance will be returned. Name of authorised official Capacity For and on behalf of Telephone number Signature of authorised official Date D D M M Y Y Y Y Checklist for enclosures Items that may be required: Court order Bankruptcy order Decree absolute In specie list of assets Property purchase/transfer in application Please let us know if you would like a copy of this in large print or braille, or on audiotape or CD. Capita Life & Pensions Regulated Services Limited is authorised and regulated by the Financial Conduct Authority. Registered in England No Registered Office: 71 Victoria Street, Westminster, London SW1H 0XA. Zurich Assurance Ltd, authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Registered in England and Wales under company number Registered Office: The Grange, Bishops Cleeve, Cheltenham, GL52 8XX. Telephone: We may record or monitor calls to improve our service. DP (11/15) RRD