Your tax-free lump sum

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1 As this calculation is carried out as, any information provided in relation to employment after is irrelevant Who this form is for 0817 This form is for individuals who would like to take a cash lump sum from their plan Pension regulations will allow 25% of your total fund to be taken as a tax-free lump sum on retirement However you may be able to take more than 25% of the fund built up in your pension before 6th April 2006 tax-free This is dependent upon your service and salary history To allow us to calculate your tax-free lump sum entitlement please complete the following information Filling in this form Please use BLOCK CAPITALS to fill in this form and any additional instructions you give us Do not use correction fluid if you make a mistake If you need to correct a mistake, please initial any changes you make Please give as much information as you can Part 1 Employment information Member Member Date of Birth National Insurance No August 2017 Page 01 of 06

2 Part 2 We need the following details about this employment 1 Have you been a controlling director at any time? Yes No If yes, were you still a controlling director of this employment? Yes No If no, when did you stop being a controlling director? A controlling director is a director who, within 10 years of leaving service, owns 20% or more of the share capital of the This can be by themselves or with one or more associates 2 Date of leaving this employment (if applicable) 3 In the table below, please enter earnings details ending no later than, or the date of leaving this employment, whichever is earliest (we can consider up to 13 years earnings) If you were a controlling director we need at least three consecutive years salaries and any additional taxable benefits (P11D benefits ending no later than, or the date of leaving employment, whichever is earliest) If you were not a controlling director, we can use a single salary within the last five years of service together with at least three years of additional taxable benefits (P11D benefits ending no later than, or the date of leaving employment, whichever is earliest) Standard Life holds basic salary history for group schemes as provided at scheme renewal time This does not include benefits and expenses provided by your employer in addition to your basic salary These would be detailed on your P11D certificates Calculations can be based on our records but a fuller salary history may increase the percentage of your pension fund which can be taken as a tax-free lump sum We do not routinely gather salary history for Executive Pension s (EPP) If your plan is an EPP and you have not previously given us salary information, you will need to give us your salary information now Year ending Basic salary Other taxable benefits (no dividends) Page 02 of 06 August 2017

3 Part 3 Other pension plans Prior to did you have any other pension plans held outside Standard Life in respect of this employment? Yes If yes, you must complete Parts 3a and 3b No If no, go to Part 3e Please contact the other provider directly for the information we need Please note that if incomplete information is provided regarding other benefits you will be breaching HM Revenue and Customs (HMRC) rules and your entitlement may have to be recalculated Part 3a: Details of your other pension plans held outside Standard Life in respect of this employment Amounts payable, or amounts already paid on or before, from other pension plans with this employer plan plan Part 3b: Did you receive any benefits on or before from any of these pension plans? * Examples of the type of plan could be Occupational, Executive Pension, Section 32 Buy Out and Personal Pension If you have more plans please write the information on a separate sheet of paper Yes If yes, you must complete Part 3c No If no, you must complete Part 3d Part 3c: If yes, please complete the following: sum paid Yearly pension at Sum paid Yearly pension Part 3d: If no, we still need to take these into account in our calculations Please complete the following: Transfer value Sum that could have been paid ** Transfer value at sum that could have been paid ** Part 3e: Prior to did you have any other pension plans held outside of Standard Life in respect of previous employments? Yes If yes, go to Part 4 No If no, go to Part 5 ** Tax-free Lump Sum that could have been paid at 5 April this refers to the maximum Tax-free Lump Sum which would have been payable assuming no other benefits in respect of this employment Alternatively if you just provide the value of the other benefit at 5 April 2006 split between any Ordinary, Additional Voluntary Contributions and Protected Rights benefits then we can calculate this ourselves August 2017 Page 03 of 06

4 Part 4 Other pension plans from previous employments Do any of the following apply to the employment referred in in section 1 of this form? you left service with this employer before 6 April 2004 and your P60 earnings for the last complete tax year before you left were 25,000 or less; or you were still in service with this employer after 5 April 2004 and your P60 earnings for the 2004/05 tax year were 50,000 or less Please contact the other provider directly for the information we need Yes If yes, go to Part 5 No If no, you must complete Parts 4a and 4b Part 4a: Details of your other pension plans for previous employments Name of employer providing these benefits Employment start date plan Employment end date * Examples of the type of plan could be Occupational, Executive Pension, Section 32 Buy Out and Personal Pension Name of employer providing these benefits Employment start date plan Employment end date Part 4b: Did you receive any benefits on or before from any of these pension plans? If you have more plans please write the information on a separate sheet of paper Yes If yes, you must complete Part 4c No If no, you must complete secion Part 4d Part 4c: If yes, please complete the following: sum paid sum paid Yearly pension at Yearly pension Part 4d: If no, please complete the following: Transfer value sum that could have been paid at *** Transfer value at sum that could have been paid *** *** The tax-free lump sum is the amount you could have received if you actually retired at that date Page 04 of 06 August 2017

5 Part 5 Returning this form Please return the fully completed form to Standard Life Dundas House 20 Brandon Street Edinburgh EH3 5PP Or it to claims_opc@standardlifecom (please quote scheme and member in the subject field) Part 6 What happens next We ll update our records with the information you ve given us and tell you about the tax-free lump sum that could be paid from the funds built up before 6 April 2006 If we don t get this information, we will be unable to complete the calculations, therefore your taxfree lump sum from funds built up before 6 April 2006 could be limited to 25% It s important that you return this form so we can accurately calculate your tax-free lump sum at retirement If you have any questions about completing the form you can contact us on August 2017 Page 05 of 06

6 Standard Life Assurance Limited is registered in Scotland (SC286833) at Standard Life House, 30 Lothian Road, Edinburgh EH1 2DH Standard Life Assurance Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority wwwstandardlifecouk Standard Life Aberdeen, images reproduced under licence All rights reserved August 2017 Page 06 of 06

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