INSTRUCTION TO TAKE. Options* *APTFC0100F* From the Collective Retirement Account (CRA) For use by financial advisers only

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1 Application reference number For office use only INSTRUCTION TO TAKE Tax-Efficient Regular Income Options* From the Collective Retirement Account (CRA) For use by financial advisers only *APTFC0100F* *The tax treatment and efficiency of these options will depend on the individual circumstances of each customer. Tax rules and their application may change in the future. THESE OPTIONS ARE not available in the following circumstances : If you are aged 75 or over. If you are applying for ill-health income payments. If you have registered your total pension savings for any form of Lifetime Allowance protection. If you have insufficient remaining Lifetime Allowance to allow the proposed payments to be made without an additional tax charge. If you have a protected early retirement age or protected tax-free cash entitlement that applies to your Accounts. If your CRA investment is from a disqualifying pension credit. This is a payment received, following divorce, from a pension-sharing order which has no tax-free cash entitlement. Guidance notes It is important that you read the guidance notes at the back of this form. They explain how to complete each section and contain details of any additional documents we need. l Tax-efficient regular income options are only available from accounts that are are in flexi-access drawdown. If your account is in capped drawdown it will be converted to flexi-access. Once you have taken a taxable income payment, the maximum you can pay into money purchase (also known as defined contribution ) schemes in any tax year without being liable to a tax charge is subject to the Money Purchase Annual Allowance (MPAA). This is currently 4,000. l Tax-free cash payments will normally be paid 5 working days prior to the 25th of the month*. Taxable income payments will normally be paid on the 25th of the month. Provided we have received all of our requirements by the cut-off dates below, payments will start in the month we receive your request (or the month you have specified, if different). Where the request is received after the specified cut-off date, payment will be made in the following month. l You will have to pay tax on the income you receive in the same way as you would on a salary. How much you pay depends on your total income. Generally Old Mutual Wealth will not know your overall income and will use an emergency tax code to start with. This means you may pay too much tax initially and have to claim the money back. Alternatively you may owe more tax if you have other sources of income. l Cut-off dates: 7th of the month. Where these dates fall on a non-working day, the cut-off date will be the previous working day. non UK Tax -If you are subject to tax in any country outside the UK, please contact your tax specialist, to understand whether you will be liable for tax in that country * Each month we sell units from your client s account to meet their Income payments. We pay the tax-free cash element of the payment as soon as the proceeds of the sale are available. Typically this will be five working days before the taxable income payment, but this may vary depending on whether any other investment transactions are awaiting completion on the account. Send the completed form to: Old Mutual Wealth Old Mutual House Portland Terrace Southampton SO14 7AY 1 of 6

2 Please complete this form using BLOCK CAPITALS only using blue or black ink. 1 personal details Please state your client reference number u if known Title Mr Mrs Miss Other Surname Full forename(s) Date of birth National Insurance Number D D M M Y Y Y Y Address u We will require proof of your residential address if it is different from the one we have on our records or has changed in the last 12 months, for example an original household bill dated within the last 6 months (mobile phone bills are not acceptable). Postcode Telephone number address Collective Retirement Account number Evidence of Age : If this is the first time you have made a withdrawal from this or any other Collective Retirement Account, we must have evidence of your age. You are not able to use this option before you reach the age of 55. Please refer to the accompanying guidance notes at the back of this form for more information. 2 FINANCIAL ADVISER STATEMENT this statement must be completed in order for Old Mutual Wealth to carry out the instruction for the client This is to confirm that I have provided my client with advice and discussed the appropriate risks in relation to this transaction. Financial adviser name u please print Signature Date D D M M 2 0 Y Y 3 Setting up tax-efficient regular income options In this section, and in other parts of this form, we refer to crystallised and uncrystallised parts of your account. When some or all of your Collective Retirement Account is set aside for the purpose of providing tax-free cash and taxable income withdrawals, it is known in pension regulations as crystallising the amount involved. WITHDRAWAL instruction I wish to crystallise an amount of. each month (Minimum amount 125 per month). I understand that 25% of this figure will be paid to me as a tax-free cash lump sum and that the remaining 75% is available for taxable income withdrawals. From this remaining 75% I wish to take the following level of taxable income each month. (tick) All of it None A gross amount of. each month l Money that has been made available for taxable income withdrawals but not yet taken can be taken at a later date. l The payment of tax-free cash will normally be made 5 working days before the 25th of the each month. l If you are already receiving taxable income from your Collective Retirement Account, these payments will continue to be made but please contact us if you wish to change them. l Payments under these options will stop at age 75. We will write to you as you approach age 75 with alternative withdrawal options. 2 of 6

3 4 Bank details Please state the bank account where you want your tax-free cash and income withdrawals paid. We cannot make payments to third parties. We will need to see proof of the bank account ownership. Details of acceptable proof are in the guidance notes at the end of this form. Name of bank/building society account holder Bank/building society name Branch address of bank/building society u this must be in the UK. Postcode Bank/Building society account number Sort code Building society roll number u if applicable. 5 LIFETIME ALLOWANCE When you crystallise all or part of your savings in any pension scheme, the provider will tell you what percentage of your Lifetime Allowance has been used up. We need the following to ensure you do not exceed the Lifetime Allowance. We cannot process this form if this section is not completed the guidance notes at the end will help you. Please tick/complete any/all of the following that apply to you. You must complete at least one A I have never taken any benefits from a UK registered pension scheme B I have only taken benefits from my Collective Retirement Account(s) Before and after 6 April 2006; you must complete both section C and D if you have previously taken benefits from one or more pension schemes before and after 6 April C I have taken benefits from one or more UK registered pension schemes on or after 6 April The total percentage of the standard Lifetime Allowance I have used is: The first time I took pension benefits after 5 April 2006 was: % D D M M Y Y Y Y (Only required if both C and D are being completed) D I have taken benefits from one or more UK registered pension schemes before 6 April 2006, these are not included in any lifetime allowance figure completed above in option C. (Please complete all that apply) I m in capped drawdown and my gross maximum annual income limit is: AND/OR I m in flexi-access drawdown and my previous gross maximum annual income was: AND/OR I m paid a lifetime annuity/scheme pension and the gross amount I receive each year is: 3 of 6

4 6 CLIENT declaration I instruct you to make payments from my Collective Retirement Account and declare: 1. I have read the attached guidance notes. 2. The information supplied by me is true and complete to the best of my knowledge as at the date of this Declaration. 3. I will inform Old Mutual Wealth Life & Pensions Limited of any change to the information provided occurring after the date of this Declaration and before you process this instruction. 4. I understand that any false statement may result in HM Revenue & Customs imposing penalties on me. 5. I understand that income paid from my CRA will be subject to income tax deducted by Old Mutual Wealth and paid to HM Revenue & Customs. Old Mutual Wealth will submit my personal and income details to HM Revenue & Customs. 6. I have sufficient unused Lifetime Allowance to allow payments under this option and I will inform Old Mutual Wealth Life & Pensions Limited when I take benefits from any other registered pension scheme. 7. I agree that I will indemnify Old Mutual Wealth Life & Pensions Limited against any liability to pay any tax or other charges which arise out of the provision of false or misleading information. 8. I declare that any payment by Old Mutual Wealth Life & Pensions Limited of the benefits under this CRA shall constitute a full discharge from all liabilities and claims arising from this transaction. 9. Any tax-free cash will not be used to fund further contributions to any registered pension scheme to the extent that either Old Mutual Wealth Life & Pensions Limited or I will suffer a tax liability. 10. I understand that if this is the first time I have taken a payment from this Account, I have 30 days from the date payment is made by Old Mutual Wealth in which to cancel this transaction by writing to Old Mutual Wealth at the address shown on page 1 of this form. If I do so I will return all money received in respect of this Account to Old Mutual Wealth. 11. I understand that in implementing this instruction my Account will be converted to flexi-access drawdown and where I take taxable income, it will subject me to the Money Purchase Annual Allowance. 12. If section 2 has been completed, I have read and understood the contents of Old Mutual Wealth s leaflet: Taking Tax into Account, and the accompanying document entitled Tax-efficient Regular Income Options. Name u please print Signature Date D D M M 2 0 Y Y *APTFC0500X* 4 of 6

5 GUIDANCE S You should obtain a current valuation statement showing the value of the savings held within your CRA. (Please note the value on this statement is not guaranteed and is subject to change.) You can only make this withdrawal after reaching your minimum pension age, which is typically 55. Please note your plan will be converted to flexi-access drawdown and following the first taxable income payment, the maximum you will be able to contribute to money purchase pension schemes will be 4,000 a year. Section 1 Personal details Enter your details in this section. We will require proof of your residential address if it is different from the one we have on our records or has changed in the last 12 months, for example an original household bill dated within the last 6 months (mobile phone bills are not acceptable). Evidence of Age If this is the first time you have taken tax-free cash from the Collective Retirement Account, we must have evidence of your date of birth. We will require one of the following: your photocard driving licence your passport (Your driving licence or passport must be valid and must not have expired.) your birth certificate (If your name is currently different from your birth certificate, we will require evidence of the change of name for example your marriage certificate or change of name deed) a Confirmation of Verification of Identity (CoVI) from your financial adviser. Section 2 Financial adviser statement The Financial Conduct Authority (FCA) has stated that all providers must inform clients of the risks associated with taking money from their pension. We are required to record when advice has been given. Section 3 Payment instructions To enable a withdrawal of benefits from your CRA you must crystallise part of your CRA. On a fully uncrystallised account, the amount of money you must retain in your account following any withdrawal is now the greater of 10% of the entire fund value or x any outstanding Phased Initial Charge. On a partially crystallised plan, the amount of money you must retain following any withdrawal is now the greater of 10% of the uncrystallised fund value or x any outstanding Phased Initial Charge. Tax-free cash You will be be entitled to take part of your CRA as taxfree cash, this will be 25% of the amount being crystallised. Tax-free cash will normally be paid 5 working days prior to the 25th of the month. Please note, you could suffer a tax liability if pension contributions are funded from a tax-free cash sum received from a registered pension scheme. Income payable from your CRA is subject to income tax. Income payments will normally be paid on the 25th of the month provided we have received all of our requirements by the 7th of the month We will deduct tax from your income payments using an emergency tax code until we are notified by HMRC of your correct tax code. Please refer to the enclosed Income Tax leaflet for further information. Section 4 Bank details This is for details of the bank account where you would like your tax-free cash or income withdrawals paid. We will need to see proof of the bank account ownership. The proof can be a voided cheque a copy of your bank account statement dated within the last six months (certified as a true copy by your financial adviser). Or, if you have online bank account statements, a printed copy certified by your adviser will suffice. Section 5 Lifetime Allowance Complete this section to tell us whether you have previously taken benefits from any UK registered pensions scheme(s). You can only select one of the five options. Please ignore State Pensions you are receiving. Option A Select this option if you have never taken tax-free cash and/or income from any UK registered pension scheme. Option B Select this option if you have only taken tax-free cash and/ or income from your Collective Retirement Account(s). Option C Select this option if you have taken tax-free cash and/or income from a pension scheme, on or after 6 April The provider(s) who paid your benefits will be able to tell you how much Lifetime Allowance you have used. The percentage figure needs to be the total percentage of the Standard Lifetime Allowance you have used with all your pension providers. If you have also taken tax-free cash and/or income before 6 April 2006 you will also need to complete Option D. Option D Select this option if you have taken tax-free cash and/or income from a pension scheme and the first payment was before 6 April If you are in capped drawdown, enter the maximum gross annual income limit. If you entered flexible drawdown before 6 April 2015, enter the maximum gross annual income limit immediately before the plan was converted to flexible drawdown. If you are in flexi-access drawdown and you did not enter flexible drawdown before 6 April 2015, enter the maximum gross annual income limit immediately before the plan was converted to flexi-access drawdown. If you are being paid a scheme pension or a lifetime annuity from a pension scheme, enter the gross annual amount you received. Section 6 Client Declaration This section is for you to sign, declaring that you understand and agree various points. The information given on this form is based on our understanding of pension and taxation legislation. Old Mutual Wealth Life & Pensions Limited does not accept any liability for any loss arising from the misunderstanding of the information provided or omissions therein. All benefits are payable in accordance with the Terms and Conditions of the Collective Retirement Account available from To make a false statement knowingly may be considered tax evasion by HMRC and could result in legal action against you. We strongly recommend that you seek financial advice before instructing us to crystallise all or part of your pension savings. 5 of 6

6 Calls may be monitored and recorded for training purposes and to avoid misunderstandings. Old Mutual Wealth is the trading name of Old Mutual Wealth Limited which provides an Individual Savings Account (ISA) and Collective Investment Account (CIA) and Old Mutual Wealth Life & Pensions Limited which provides a Collective Retirement Account (CRA) and Collective Investment Bond (CIB). Old Mutual Wealth Limited and Old Mutual Wealth Life & Pensions Limited are registered in England and Wales under numbers and respectively. Registered Office at Old Mutual House, Portland Terrace, Southampton SO14 7EJ, United Kingdom. Old Mutual Wealth Limited is authorised and regulated by the Financial Conduct Authority. Old Mutual Wealth Life & Pensions Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Their Financial Services register numbers are and respectively. VAT number When printed by Old Mutual this item is produced on a mixed grade material, which uses a combination of recycled wood or paper fibre from controlled sources and virgin fibre sourced from well managed, sustainable forests. PDF12134/ /November of 6

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