Trustee Investment Plan and Personal Pension Investment Plan

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1 Trustee Investment Plan and Personal Pension Investment Plan Application form Part 1 Request and Undertaking When purchasing a Trustee Investment Plan or a Personal Pension Investment Plan, the trustees of the scheme contract with Standard Life Assurance Limited (SLAL) which issues an insurance policy to them. Standard Life Investments Limited (SLI) carries out certain investment management and administrative functions for SLAL. By the Trustees/ Managers of ( the scheme ) established on or by Trust Deed Date (DD/MM/YYYY) To Standard Life Assurance Limited We, the trustees of the scheme, want you to issue us with a policy in your Trustee Investment Plan/ Personal Pension Investment Plan series in your customary form, as evidence of the insurance contract made by us with you in connection with the Scheme. We certify that the Scheme is or is to be a registered pension scheme (as defined in the Finance Act 2004). The Pension Scheme Tax Reference Number is We undertake to give you the information you require in order to meet your obligations under the contract and to pay, as they fall due, all monies payable under the contract. Scheme Anniversary Date (DD/MM) This is the date on which you will receive your annual statement Please provide a copy of the Trust Deed confirming the establishment date of the scheme and if applicable, a copy of the most recent Deed of Appointment/Removal confirming the current Trustees. When we refer to Standard Life we mean Standard Life Assurance Limited. Do not use correction fluid if you make a mistake. If you need to correct a mistake, please initial any changes you make. We will provide you with the policy terms and conditions relating to the contract. The policy terms (and a copy of this completed form) can be made available on request. Part 2 Details of the Scheme To be able to provide you with the correct terms and conditions we need to know the scheme type. Occupational Defined Contribution Occupational Small Self-Administered Full name of principal employer or SIPP manager Employer or SIPP manager contact name Address Building number Occupational Defined Benefit Self-Invested Personal Pension Street City/Town County Telephone number address August 2017 Page 01 of 08

2 Part 2 Details of the Scheme (continued) If this policy relates to an individual member of a SIPP we will normally record the name of the SIPP Scheme and also details of the member. Please provide the following details. SIPP Scheme SIPP Member s SIPP Member s Reference Number Part 3 Authorised Signatories SIPP Managers Please send a copy of the arrangements you have in place for authorised signatories with this application. Occupational Schemes This part of the form should only be completed where you want to nominate someone other than the full Trustee panel to sign for future instructions under this contract. If no instruction is given here we will require all the Trustees to sign. If you already have arrangements in place for authorised signatories that you would like us to follow, please send a copy with the application. Otherwise, complete the following. We wish you to proceed with any future instructions under this contract on the signed instruction from of the persons authorised here. (s) Position Position Position OR, we wish you to proceed with any future instructions under this contract on the signed instruction from Trustees. Page 02 of 08 August 2017

3 Part 4 Investment Funds Please refer to the document Investment Choices and Charges (TIP20) for details of the funds available including the fund name and fund code. A Initial Investment Deposit. This should be applied as follows: Please indicate the percentages or monetary amounts to be invested. Fund Code Fund Percentage (%) Amount ( ) Cheques are no longer accepted as a payment method. Our bank details for payment by CHAPS or BACS can be found at the end of this application. Total % B Future Investment Deposit Please tick one of the following boxes: 1. Until further notice, the investment content of future deposits should be applied as above. 2. Until further notice, we will advise how the investment content of future deposits should be applied. Please note that the first option is only available where the initial deposit has been invested as a percentage. August 2017 Page 03 of 08

4 Part 5 Unit Statements We will send statements to the contact names stated in Part 2 and Part 7 of this form, unless advised otherwise. If there is a requirement for the statements to be sent directly to another recipient, please ensure all details are entered below. Contact Company Company address Building number Street City/Town County address Contact Company Company address Building number Street City/Town County address Page 04 of 08 August 2017

5 Part 6 Payment Details Complete the details below so that payments can be made directly to a designated bank account. We, the trustees of the scheme, hereby instruct Standard Life to arrange for payment to be paid direct to the bank or building society account, as detailed below. It is not mandatory to supply these details however it will allow us to transfer funds at a later stage without further confirmation. Account Bank/Building Society Address (In full) Bank or Building Society Account No. Branch Sort Code Part 7 Financial Adviser Details Please provide the financial adviser s full name and address and a contact name for unit statements and other general correspondence. Contact Company If you are receiving advice from a financial adviser, you should remember that the adviser is acting on your behalf not only by giving you advice, but also regarding the completion of this form. Company address Building number Street City/Town County FCA firm reference number Intermediary Reference Number address Part 8 Adviser Remuneration This section must be completed in order for us to process your application. Until further notice, the financial adviser whose details appear above should be paid the following: A Initial Investment Deposit % Non Funded Initial remuneration (maximum 5%) and/or B Fund Based Renewal Remuneration % of the value of the fund on each anniversary date of this policy (maximum 0.5%). Please indicate the level of advice that was given. Was advice given? Full advice No advice (eg, execution only) Enter the percentages, if any, agreed between you and your adviser. Where Non Funded Initial remuneration is completed, units equal to the percentage taken will be cancelled after investment. Where Fund Based Renewal remuneration is completed, units equal to the percentage(s) taken will be deducted from the fund. Where a personal recommendation is made to retail clients relating to this product, no remuneration is payable. August 2017 Page 05 of 08

6 Part 9 Data Protection Declaration We and/or our group of companies will collect personal information about you, the trustees of the scheme (or your directors or other company officer if you are a corporate trustee) in order to consider your application and, if your application is successful, to provide our services to you and manage our relationship and our business and services. We will collect your name and address, as trustee (or as director or company officer of a corporate trustee), and will hold a copy of the deed constituting the trust for the scheme. If your application does not proceed, the information may be held on our records for up to 7 years before it is deleted. We may disclose the information collected to your professional advisers, to other Standard Life Aberdeen group companies, to our third party service providers and, where we consider it appropriate and lawful to do so, to other organisations. Any personal information collected may be held or disclosed in countries outside the European Economic Area which may not have the same standard of data protection laws. Where this occurs, we will take appropriate steps to adequately protect it. If any of the trustees (director or company officer) would like to like to request a copy of the personal data we hold, please write to the Data Protection Co-ordinator at our Head Office. We may charge a fee for providing this information. Declaration We have read the Data Protection Notice and agree that the personal information may be used for the purposes described. We confirm to having the authority to make this declaration, and should we be signing on behalf of any other person, in any capacity, we will ensure they have had the opportunity to read the Data Protection Notice and agree to the use of personal information as described. We, the trustees of the scheme, confirm that we have read and understood Parts 1 to 9 of this application form and the accompanying notes. Part 10 s We, the trustees of the scheme: (a) Request that the benefits described in or arising from payments specified in the application be provided to us under the TIP or PPIP and in consideration of its acceptance we undertake to be bound by the provisions which govern the TIP or PPIP policy; and (b) Declare according to those declarations highlighted above. Date (DD/MM/YYYY) Important: Please note that the date must be completed in order for us to process your application. Where the Scheme has individual trustees, each and every trustee must sign this form. (s) Page 06 of 08 August 2017

7 Checklist Important Please make sure you have enclosed: Completed application form with appropriate signatures and date (see part 10) Copy of authorised signatory list if applicable (see part 3) Copy of establishing Trust Deed and/or latest Deed of Appointment/Removal (this must confirm all current trustees) (see margin note in part 1) Please do not send the initial investment until we have confirmed receipt of the above documentation and provided a plan number. Please return completed application to: Global Servicing Team Tel (call charges may vary) Global Client Operations Fax Standard Life Investments globalclientservicing@standardlife.com 1 George Street Edinburgh EH2 2LL Our bank details for payment by CHAPS and BACS are: Account Standing Order Collections Bank Address HSBC Bank plc Account Number Holborn Circus Branch Sort Code Holborn LONDON EC1N 2HR Standard Life Investments will own and support the administrative functions of the contract from new business to day-to-day servicing. Standard Life Investments will liaise with Standard Life Assurance Limited (SLAL) on all legal matters. Please note cheques are no longer accepted as a method of payment. August 2017 Page 07 of 08

8 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 Standard Life Aberdeen, images reproduced under licence. All rights reserved. Page 08 of 08 August 2017

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