Transfer Certificate. For a transfer from a Pension Scheme or Policy to Standard Life EPP/Group Plan PEN Filling in this form

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Albert Horton
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1 Transfer Certificate For a transfer from a Pension Scheme or Policy to Standard Life EPP/Group Plan Filling in this form Standard Life in this form means Standard Life Assurance Limited This application form is for people who wish to transfer the value of rights built up in another pension scheme into a money purchase scheme insured with Standard Life Applicants must be members of the Standard Life scheme into which the transfer payment is being made Please use BLOCK CAPITALS to fill in this form Do not use correction fluid if you make a mistake Please initial any changes you make Part 1 Arrangement for a transfer of Assets Transferring Scheme Reference Number Name of Member Name and address of the administrator of the Transferring Scheme Name Building number Street 0918 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 completion of this form By filling in this form, you are applying to make a transfer payment into a contract with Standard Life This application will be the basis of the transfer if it is accepted Until then, Standard Life s liability is limited to the return of the transfer payment to its source The terms and conditions relating to the contract will be made available on request City/Town County Postcode September 2018 Page 01 of 08

2 Part 1 Arrangement for a transfer of Assets (Continued) Receiving Scheme Reference Number Name and address of the administrator of the Receiving Scheme Name Building number Street City/Town County Postcode Transfer date (or if later, the date on which the Member s consent is received) The Member named above has requested that all or part of the benefits for him/her under the Transferring Scheme named above be transferred to the Receiving Scheme named above Subject to the consent of the Member, the trustees/scheme administrator of the Transferring Scheme and the trustees of the Receiving Scheme hereby agree to the transfer arrangement set out as follows Part 1a Transferring Scheme Provisions 1 The trustees/scheme administrator of the Transferring Scheme hereby agree (a) to transfer to the trustees of the Receiving Scheme on the Transfer Date such assets (the Transfer Value) as represent the interests under the Transferring Scheme of the Member and his/her dependants which are to be transferred; (b) that, if the transfer does not take place on the Transfer Date, or before such later date as the trustees of the Receiving Scheme may agree, this arrangement will be voidable by the trustees of the Receiving Scheme; and (c) to certify to the trustees of the Receiving Scheme on the Transfer Date such information on the Transfer Value as is required by them to satisfy Revenue requirements This amount is not guaranteed Page 02 of 08 September 2018

3 Part 1a Transferring Scheme Provisions (Continued) 2 The trustees/scheme administrator of the Transferring Scheme hereby certify that (a) the Pension Scheme Tax Reference Number for the Transferring Scheme is (b) Transfer Value on is (c) the Transferring Scheme is - an occupational pension scheme a personal pension scheme a stakeholder pension scheme a buy-out policy a retirement annuity contract (d) if the Transferring Scheme is an occupational pension scheme or buy-out policy, the period of service which counts under the Transferring Scheme towards qualifying for preservation of pension rights is from to (e) the Transfer Value includes a Disqualifying Pension Credit Yes No (f) at 5 April 2006 the member had rights under an Occupational Pension Scheme to a lump sum greater that 25% Yes No (g) the Member has been making income withdrawals from his/her fund Yes No Part 1b Receiving Scheme Provisions 1 The trustees of the Receiving Scheme hereby undertake to provide under that Scheme such additional benefits for the Member and his/her dependants as will be secured by applying the Transfer Value when received as if it represented a special contribution 2 The trustees of the Receiving Scheme hereby certify that (a) the Receiving Scheme is a registered pension scheme under Chapter 2 of Part 4 of the Finance Act 2004 (b) the Pension Scheme Tax Reference Number of the Scheme is (c) no greater part of the Transfer Value will be treated as a payment made by the Member than that certified by the trustee of the Transferring Scheme as attributable to payments made by the Member to the Transferring Scheme and no greater part of the Transfer Value will be paid to the Member in his/her lifetime than would have been paid in the same event under the Transferring Scheme If Yes, the fund must be used to buy an annuity since income withdrawal is not available under the Receiving Scheme September 2018 Page 03 of 08

4 Part 2 Data Protection Notice and Communication Preferences - Important, please read Data Protection Notice Using your Personal Information We will collect and use personal information about you and any other named individual on your application such as your name, date of birth and national insurance number in order to provide this product or service and manage our relationship with you It may be necessary as part of this product or service to collect and use personal information which is defined as special category data by data protection law eg Health related Any such special category data will only be collected and used where it s needed to provide the product or service you have requested or to comply with our legal and regulatory obligations and where we have obtained your explicit consent to process such information To provide this product or service and meet our legal and regulatory obligations, we will keep your personal information and copies of records we create (eg calls with us) while you are a customer of ours If this application does not proceed or when you no longer have a relationship with us, we are required to keep information for different legal and regulatory reasons The length of time will vary and we regularly review our retention periods to make sure they comply with all laws and regulations The information collected may be shared with other parts of Standard Life Assurance Limited, Standard Life Aberdeen plc, Phoenix Holding Group (PHG) and other companies we work with to support us in the provision of the product or service you have with us We may also share your information with our regulators, HM Revenue & Customs and your adviser / employer (for applicable products and services) where necessary and lawful to do so Whenever we share your personal information, we will do so in line with our obligations to keep your information safe and secure The majority of your information is processed in the UK and European Economic Area (EEA) However, some of your information may be processed by us or the third parties we work with outside of the EEA, including countries such as the United States and India Where your information is being processed outside of the EEA, we take additional steps to ensure that your information is protected to at least an equivalent level as would be applied by UK / EEA data privacy laws eg we will put in place legal agreements with our third party suppliers and do regular checks to ensure they meet these obligations For more information on how Standard Life processes your personal information and what your rights are, please read our Privacy Policy at wwwstandardlifecom/privacy or write to the Data Protection Officer at Standard Life Assurance Limited, 30 Lothian Road, Edinburgh, EH1 2DH Communication Preferences Your essential updates We ll share important information on your plan and your choices, products and services, plus financial tips from our experts We also want to help you plan for the future by keeping you updated on: Latest news and offers from Standard Life Aberdeen PLC No Yes For information about Standard Life Aberdeen companies visit StandardLifeAberdeencom Offers of interest from our preferred partners No Yes To understand how, where and why we use your information, read our Privacy Policy Part 3 Money Laundering Notice To comply with the Money Laundering Regulations we are required to verify the identity of our customers We do this by carrying out an online identity check with a reference agency This is not a credit check and will not affect your credit rating The agency will verify your identity against public records and confirm whether you have a credit history (but will not disclose any information to us about your actual borrowings) The agency will add a note to your credit file to show that an identity check was requested by Standard Life If successful, a copy of the results will be held by Standard Life to evidence that your identity has been verified We regret that we cannot offer an alternative unless the online check does not confirm your identity, in which case we will carry out a manual check Page 04 of 08 September 2018

5 Part 4 Member s consent To the trustees/scheme administrator of the Transferring Scheme and to the trustees of the Receiving Scheme I have read and understood this document setting out the arrangement to be made between the trustees/scheme administrator of the Transferring Scheme and the trustees of the Receiving Scheme I understand that the amount of the Transfer Value shown in this agreement is not guaranteed and may fluctuate The amount of the Transfer Value at the Transfer Date will represent the value at that date of my interests under the Transferring Scheme which are to be transferred I hereby consent to the transfer to the Receiving Scheme of the Transfer Value In consideration of the arrangement made for the provision of additional benefits for me and my dependants under the Receiving Scheme, I hereby discharge to the trustees/scheme administrator of the Transferring Scheme of all claims which I and my dependants have or may have to the benefits under the Transferring Scheme in respect of the Transfer Value I have read the Data Protection Notice and I agree that my personal information may be used for the purposes described, subject to me exercising my right not to be contacted with details of other products and services This document is signed by the Member and for and on behalf of the trustees/scheme administrator of the Transferring Scheme and the trustees of the Receiving Scheme as follows Signature of Member Date Signature required For and on behalf of the trustees/scheme administrator of the Transferring Scheme Position Signature Date For and on behalf of the trustees of the Receiving Scheme Signature required This must be signed on behalf of the trustees of the Receiving Scheme if it is an Own Trust arrangement Position Signature Date Signature required September 2018 Page 05 of 08

6 Part 5 - Financial adviser s details Please provide an accurate quotation that reflects the terms of business Alternatively, please complete the percentage of entitlement box below Failure to do this may result in processing delays and late payment of commission Financial adviser s details Agency Code Name of contact Location Commission Basis Type of commission % of entitlement Fund Based Commission (FBC) % Level % Nil Commission FCA or Authorisation number From 31 December 2012, the way advisers can be paid for providing personal recommendations has changed Commission can continue to be paid when members change employer if no advice is provided or if the personal recommendation is provided under the terms of the agreement between the new employer and adviser The agreement between the new employer and the adviser for individual advice to be provided to employees must have been in place before 31 December 2012 The new employer must have been a participating employer in the scheme before 31 December 2012 By submitting this application on a commission basis, you confirm that both conditions above apply in this instance 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, reproduced under licence All rights reserved Page 06 of 08 September 2018

7 For a transfer from a Pension Scheme or Policy to Standard Life EPP/Group Plan Name of Member Transferring Scheme Receiving Scheme Transfer Date The trustees/scheme administrator of the Transferring Scheme hereby certify to the trustees of the Receiving Scheme that on the Transfer Date a the Transfer Value is b the part of the Transfer Value attributable to contributions paid by the Member is as follows (i) Compulsory (ii) Voluntary c the part of the Transfer Value that represents a Disqualifying Pension Credit is d if the Transfer Value is part of a block transfer to preserve the member s rights at 5 April 2006 to lump sum greater than 25% from an occupational pension scheme (i) Value of lump sum rights at 5 April 2006 is (ii) Value of fund at 5 April 2006 is (iii) Member has accrued benefits after 5 April 2006 Yes No For and on behalf of the trustees/scheme administrator of the Transferring Scheme Position Signature Date Signature required September 2018 Page 07 of 08

8 Standard Life Assurance Limited is owned by the Phoenix Group and uses the Standard Life brand under licence from the Standard Life Aberdeen Group You can find more information about Standard Life Aberdeen plc s strategic partnership with Phoenix at wwwstandardlifecom/partnership 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, reproduced under licence All rights reserved September 2018 Page 08 of 08

With Profits Bond. Application form WPB Who this form is for. Part 1 Filling in this form. Part 2 Details of your investment

With Profits Bond. Application form WPB Who this form is for. Part 1 Filling in this form. Part 2 Details of your investment Application form Who this form is for This form is for existing customers who want to make an additional payment into Standard Life's With Profits Bond. Part 1 Filling in this form If you are receiving