TRANSFER APPLICATION FORM.

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1 PERSONAL PENSION SCHEME NO.1 TRANSFER APPLICATION FORM. This application is to be used only for transferring other pensions to an existing Personal Pension Scheme No.1 plan. This application can only be used when: The value of the transfer is at least 300. The transfer does not contain pension credits arising from a divorce. The pension pot being transferred has not been used for income drawdown. There are no earmarking or outstanding pension sharing orders applicable to the transfer value. The pension pot being transferred is not subject to any bankruptcy order. Please note: We will not normally accept a transfer from a Defined Benefit/Final Salary Scheme without the approval and advice of an Independent Financial Adviser. If the plan you want to transfer to us has valuable guarantees or protection, you may lose these on transferring to your PPNo.1. Please speak to a financial adviser before you decide to transfer. When completing this application form please ensure you answer all appropriate questions and note the following: We will contact you if we need further information. Use BLOCK CAPITALS throughout. To help you, important information has been highlighted using the i symbol. If this application is to be completed by someone else on your behalf, you must read all of the answers carefully before signing the declaration. If any answer is incorrect, please correct and initial any alterations. Please do not use correcting fluid. GLOSSARY Pension Credit: Pension pot(s) that have been transferred from a former spouse/ registered civil partner. Selected Retirement Date: The date you have chosen to access your pension pot. To protect you and us from financial crime, we may be required to verify the identity of new and sometimes existing customers. This may be achieved by using reference agencies to search sources of information relating to you (an identity search). This will not affect your credit rating. If this fails, we may need to approach you to obtain documentary evidence to confirm your identity. Following the pension transfer, we ll send you a notice of your rights to cancel. You will then have 30 days to change your mind. Before reading and signing the declaration, you should ensure that you read your Key Features, Illustration (if applicable) and the Investment Options brochure (if applicable). If you re unsure of anything, please ask your adviser for further information. If you don t have an adviser, visit to find a financial adviser near you.

2 1 ABOUT YOU 1.1 What is your full name? Title Mr Mrs Miss Ms Other Surname First name(s) 1.2 What is your permanent residential address? Phone number address Time at this address Please give your previous address if you have moved within the last three months. Previous address Years Months 1.3 What is your National Insurance number? 1.4 Is your existing Legal & General Personal Pension Scheme No.1 plan an individual plan, or part of a group scheme provided by your employer or an affinity group? (please tick one box) Individual Group 1.5 What is the arrangement number of your existing Legal & General Personal Pension Scheme No.1 plan? UP Transfer Application Form Page 2/8

3 2 TRANSFER DETAILS 2.1 Where is the transfer coming from? Please complete the following details relating to your transferring scheme(s) or contract(s). Transfer Payment 1 Transfer Payment 2 Name of scheme trustees or administrator Their address Plan number Pension scheme name HM Revenue & Customs Pension Scheme Tax Reference number (PSTR) Transfer value Is the transfer value given above the full value of the plan you re transferring? Yes No Yes No If there are more than two transfer payments please photocopy this page, sign and date it and attach it to this form. Once we have received your application, we will contact the scheme(s) you are transferring from for more detailed information about the transfer payment(s). Legal & General is a participating provider in the Options service from Origo and this application form includes the Common Transfer Declaration. Please go to to find out if the transferring scheme also participates in this service. Transfer Application Form Page 3/8

4 2 TRANSFER DETAILS continued 2.2 Where do you want your transfer payment(s) to be invested? You may choose the specific funds you wish to invest in OR a lifestyle profile. If you choose the specific funds you wish to invest in, this instruction will only apply to the new transfer payments that you are making with this application form. If you want to change the funds the rest of your pension is invested in, please let us know. If you choose a lifestyle profile this will be applied to the whole of your pension pot value and not just the transfer payments that you are making with this application form. Please see our Investment Options brochure for details of the full range of funds and lifestyle profiles available. If you wish to invest in with profits, the term to your Selected Retirement Date must be at least five years. If you do not complete this section, we will invest your transfer payments using your existing investment instructions. Name of fund Fund Code Transfer Value OR Name of lifestyle profile Total 100 Total 100 Transfer Application Form Page 4/8

5 3 DEATH BENEFITS 3.1 If you die before you take all of your pension pot, who do you want the benefits to go to? If you want to nominate more than one person, please show what percentage each should receive. You should complete this section if you wish to nominate a beneficiary or set up a trust, or if you wish to change your current nomination. By completing this section you will replace any previous nomination you have made. BENEFICIARY 1 Full name Relationship to me Percentage of lump sum BENEFICIARY 2 Full name Relationship to me Percentage of lump sum BENEFICIARY 3 Full name Relationship to me Percentage of lump sum OR To trustees to be held on trust. Please enclose the original trust documentation, which we will return to you by recorded post. The way benefits can be paid will depend on a number of factors. Legal & General will pay any death benefits at its discretion taking into account the range of potential beneficiaries as detailed in your Member s Booklet. If you make a nomination, Legal & General will not be bound by this form but will take this into account when deciding who to pay the benefit to. Under current rules, if you die before age 75, any benefits paid to your beneficiaries will normally be tax free, although the value of your pension pot will be tested against your remaining lifetime allowance which could result in a tax charge. If you re aged 75 or over when you die any benefits paid to your beneficiaries will be taxed as earned income and there is no lifetime allowance test. In some circumstances there could be an additional inheritance tax liability. Transfer Application Form Page 5/8

6 4 DECLARATION AUTHORITY FOR A TRANSFER PAYMENT(S) TO BE MADE INTO YOUR EXISTING LEGAL & GENERAL PERSONAL PENSION SCHEME NO.1 PLAN The transfer payment(s) detailed in this application form will be applied in accordance with the terms of your existing Legal & General Personal Pension Scheme No.1 plan. This agreement discharges the previous scheme trustee/administrator of any liability upon completion of the transfer. There may be certain circumstances, depending on the type of scheme or the assets held within it, where the previous scheme trustee/administrator will require completion of additional forms before the transfer can proceed. A I confirm that to the best of my knowledge and belief the details contained in this application are correct and complete. B B1 APPLIES TO THE PREVIOUS SCHEME TRUSTEE/ADMINISTRATOR I authorise and instruct you to transfer funds from the plan(s) as listed in section 2.1 directly to Legal & General. Where you have asked me to give you any original policy document(s) in return for the transfer of funds and I am unable to do so, I promise to accept responsibility for any claims, losses and expenses of any nature that you may incur as a result of having made the transfer(s) listed in section 2.1. I authorise you to release all necessary information to Legal & General to enable the transfer of funds to Legal & General. Where applicable, I authorise you to obtain from and release to the financial adviser named in this application any additional information that may be required to enable the transfer of funds. If an employer is paying contributions to any of the plans as listed in section 2.1, I authorise you to release to that employer any information in connection with the transfer of funds from the relevant plan(s). Until this application is accepted and complete, Legal & General s responsibility is limited to the return of the total payment(s) to the previous scheme trustees/administrator. Where the payment(s) made to Legal & General represent(s) all of the funds under the plan(s) listed in section 2.1, then payment made as requested will discharge the previous scheme trustees/administrator of all claims and responsibilities in respect of the plan(s) listed. Where the payment(s) made to Legal & General represent(s) part of the funds under the plan(s) listed in section 2.1, then the previous scheme trustees/ administrator will be discharged of all claims and responsibilities only in respect of the part of the plan(s) represented by the payment(s). B2 APPLIES TO THE PREVIOUS SCHEME TRUSTEES/ADMINISTRATOR AND LEGAL & GENERAL I promise to accept responsibility in respect of any claims, losses and expenses that Legal & General and the previous scheme trustees/administrators may incur as a result of any incorrect information provided by me in the application form or of any failure on my part to comply with any aspect of the application. B3 APPLIES TO LEGAL & GENERAL I authorise and request Legal & General to contact my previous scheme trustees or the administrators of my Personal Pension Scheme or Retirement Annuity Contract, and to obtain on my behalf necessary information concerning my pension benefits. I authorise Legal & General to accept the transfer payment and understand that on receipt of the transfer payment, Legal & General will apply this sum to my Personal Pension Scheme No.1 plan and that on acceptance of the transfer payment by Legal & General, the trustees or administrators liability to me in respect of the previous scheme benefit ceases. The banking of the transfer payment by Legal & General does not constitute acceptance by Legal & General of the transfer payment. The transfer payment will only be accepted once Legal & General has received all the necessary information from the trustees or administrator of my previous scheme. I understand that as the transfer is being paid to my existing plan, the selected retirement date for the benefits resulting from my transfer payment will be the same as under my existing plan. Where I am a member of a Group Pension Plan the details of the transfer may be passed to the servicing agent of the Group Pension Plan. This is irrespective of whether or not the servicing agent provided advice for this transfer. C ACCESS You have the right to ask for a copy of your information in return for payment of a small fee. To obtain a copy of your information, you should write to Legal & General, City Park, The Droveway, Hove BN3 7PY. You can ask Legal & General for a copy of your completed application form for up to 30 days after it has been set up on our records and we will send you a letter confirming the details that we have taken from this form. You can ask Legal & General for a copy of the Member s Booklet and Member s Guide containing the terms and conditions of this contract at any time. Applicant Signature Signature Date (DDMMYYYY) Please note we cannot accept this application unless it is both signed and dated. Please send any correspondence and completed transfer form to: Legal & General City Park The Droveway Hove East Sussex BN3 7PY Transfer Application Form Page 6/8

7 5 FOR ADVISER USE ONLY 5.1 Verification of identity Each party must provide evidence of their identity. This can no longer be evidenced by a Confirmation of Verification of Identity Certificate. Please send us two items of identity for each applicant, one item as proof of name, and the second as proof of address. We recommend that you send us photocopies of anything that cannot be replaced or would cost money to replace and will return any original documents by recorded delivery. Check the expiry dates on all documents to make sure they re still valid. A Confirming your identity leaflet containing a list of acceptable documentation can be found in Legal & General s Adviser Centre. 5.2 Declaration The applicant is applying on their own behalf and not as a nominee, trustee or in a fiduciary capacity for any other person. Full name of firm (if different from section 5.1 on page 7) Principal s Financial Services Register firm reference number Appointed representative s Financial Services Register firm reference number (if applicable) Financial Services Register individual s reference number Legal & General agency number Signature Date (DDMMYYYY) Job title address 5.3 Basis of advice declaration 1. Was advice given? Yes No If no: a. Commission style/terms (please tick relevant box) Initial Fund based Level and fund based b. Commission sacrifice? If Yes, please state percentage Yes No amount of overall commission 2. The following documents have been completed and are attached: Client illustration Ceding scheme warranty/discharge forms (please tick relevant box(es)) Nil commission 3. All documents will be issued to you, the adviser, unless indicated here (excluding cancellation rights which will be sent direct to the client). Name Client Other (please give details below) Transfer Application Form Page 7/8

8 Legal & General Assurance Society Limited Registered in England and Wales No Registered office: One Coleman Street, London EC2R 5AA Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. W /17 NON ASD

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