GROUP STAKEHOLDER PENSION PLAN TRANSFER APPLICATION FORM. For Individual Transfers to existing Scottish Widows Schemes Only
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1 GROUP STAKEHOLDER PENSION PLAN TRANSFER APPLICATION FORM For Individual Transfers to existing Scottish Widows Schemes Only
2 FINANCIAL ADVISER DETAILS (TO BE COMPLETED BY YOUR FINANCIAL ADVISER IF APPROPRIATE) Your Scottish Widows agency number A Name Address Postcode Telephone number (incl. code) (useful if there is a query) Mobile number If you have previously obtained a quote and would like to follow the same details please include the Quote Number: (Please note section A will still need to be completed). GROUP STAKEHOLDER PENSION PLAN TRANSFER APPLICATION FORM NOTE: FAILURE TO COMPLETE ALL PARTS OF THIS APPLICATION FORM WILL DELAY PROCESSING. Warning: You must not make false statements when filling in this application; it is a serious offence. The penalties are severe and you could be prosecuted. If you have applied to HM Revenue & Customs for Enhanced or Fixed Protection from any potential lifetime allowance tax charge, such protection could be lost on transfer. For further information, please seek financial advice. Please read the Group Stakeholder Pension Plan literature including the Key Features before completing this application. Please use BLOCK CAPITALS or tick relevant boxes. Note, a separate plan will automatically be set up by us in the following circumstances (please see Section D for more details): If the transfer results from a pension sharing order and your ex-spouse s / ex-civil partner s pension was already in payment at the time of divorce / dissolution of the civil partnership. If you are a continued rights member of an occupational scheme and you are transferring deferred pension benefits from that scheme, having already taken tax-free cash on or after 27th July In the above circumstances, HM Revenue & Customs legislation currently requires that no tax-free cash will be payable under the separate plan. Please note that Scottish Widows can only accept applications from individuals who are habitually resident in the United Kingdom, or in a limited number of overseas territories. Unless you are habitually resident in the United Kingdom, or in one of the other territories referred to, we will be unable to accept your application. Please make cheques payable to Scottish Widows and quote our reference number on all correspondence. Please return correspondence to: Scottish Widows, New Business Transfer Unit, P.O. Box 13955, 15 Dalkeith Road, Edinburgh EH16 5AD. Contact details for Scottish Widows
3 NOTES TO SECTIONS A & B (1) This should be your permanent residential address. We will send all correspondence to this address. Please ensure the postcode is provided. (2) Habitual residence means your permanent residential address. We can only accept applications from a limited number of overseas countries. If you are not resident in the United Kingdom, please speak to your financial adviser or contact us to confirm your eligibility. (3) To be eligible to make personal contributions you must be resident in the United Kingdom or otherwise entitled to tax relief on your payments. (4) WARNING: Sending personal information by is not secure. Only include your address if you agree to Scottish Widows sending you s. (5) Your National Insurance Number can be found on a payslip or P60, or on a tax return. It is essential that you provide it, otherwise we are unable to accept contributions and cannot process your application. If you cannot find your National Insurance Number please phone the HM Revenue & Customs Enquiry helpline (6) Each of our Pension Investment Approaches invests using one or more of our Pension Portfolio funds. These Pension Portfolio funds use a varying mix of higher and lower risk investment assets. The Pension Portfolio fund you will initially be invested in will depend on your chosen Pension Investment Approach and the time until your selected pension age. For more details, please see our Pension Investment Approach Guide. (7) Please note that if you invest the transfer payment in one of our Pension Investment Approaches or invest it in a different way from the current investment choice/ option(s) applicable to your Scottish Widows Group Stakeholder Pension plan this could override the investment choice/option(s) already set up under your plan. Please contact us if you want any further information on this matter. A. CLIENT DETAILS 1. Title Mr Mrs Miss Ms Other (please specify) 2. Surname 3. First name(s) 4. Address (see note 1) Postcode 5. Country 6. Eligibility In order to determine whether you are eligible to take out a Stakeholder Pension Plan, please provide the following information: Country of habitual residence (see note 2) Nationality And, if you are not resident in the United Kingdom: (see note 3) I am a Crown employee, or the husband, wife or registered civil partner of a Crown employee, who has general earnings from overseas Crown employment. or I have earnings which are chargeable to United Kingdom Income tax. 7. Phone number (useful if there is a query) 8. address (see note 4) 9. Date of birth (DD MM YYYY) 10. Are you Male Female 11. Employment status Employed Self-employed A pensioner Other If Other please indicate which of the following applies to you: Caring for one or more children under 16 In full-time education Unemployed Other 12. Your National Insurance Number (see note 5) 13. Existing Scottish Widows Group Stakeholder Pension Plan Number B. YOUR INVESTMENT Caring for a person aged 16 or over I understand that my transfer payment will be invested in the same way as the current investment option(s) applicable to my Scottish Widows Group Stakeholder Pension plan. Please contact us if you would prefer your transfer payment to be invested in a different way, for example, using our Pension Investment Approaches or making your own fund selection(s). (see notes 6 & 7) Your investment options should be reviewed regularly and you can change you investment selection at any time. Simply log in at or call
4 DATA PROTECTION (Please read this important note before making your decision. Scottish Widows will rely on these notes when administering your investment. If you do not understand any of these notes, please let us know). Data Protection Act Your information will be held by Scottish Widows which is part of the Lloyds Banking Group. More information on the Lloyds Banking Group can be found at We may ask you to provide physical forms of identity verification when you open your investment or plan. Alternatively, we may search credit reference agency files in assessing your application. The agency also gives us other details and information from the Electoral Register to verify your identity. The agency keeps a record of our search, whether or not your application proceeds. Our search is not seen or used by lenders to assess your ability to obtain credit. We will share your personal information from your application with fraud prevention agencies. If necessary a copy of the application form and any other supporting information may be given to a reassurance company who will share the risk with us. If false or inaccurate information is provided and fraud is identified, details of this fraud will be passed to these agencies to prevent fraud and money laundering. Further details explaining how information held by the fraud prevention agencies may be used can be obtained by reading the privacy notice at If you make a claim, any information you give to us, may be put onto a register of claims and shared with other insurers to prevent fraudulent claims. Your personal information will be shared within the Lloyds Banking Group so that we and any other companies in our Group can look after your relationship with us. By sharing this information it enables us to better understand your needs and provide products in the efficient way that you expect. If you apply to us for insurance, a pension or life insurance, we may ask you for some sensitive details, for example your medical history. We will only use this information to provide the service you require and we will ask for your explicit consent. It is important that you understand how the personal information you give us will be used. Therefore, we strongly advise that you read our Privacy Statement, which you can find at or you can ask us for a copy. By signing this application/declaration you agree to your personal information being used in the ways we describe in our Privacy Statement. Please let us know if you have any questions about the use of your personal information. C. DECLARATIONS THE DECLARATION SHOULD BE COMPLETED BY THE APPLICANT. SCOTTISH WIDOWS STAKEHOLDER PENSION SCHEME (the Scheme) Declaration to Scottish Widows Scottish Widows has set up the above Scheme by Deed Poll. To enable your transfer value to be paid to Scottish Widows, you must be a Member of the Scheme. Scottish Widows is the Administrator of the Scheme and is responsible for running it according to the Scheme Rules. I am a member of the Scheme and: a) I understand that this application forms part of my contract with Scottish Widows, along with the Rules of the Scheme, the policy provisions, the policy schedule and amendments to the policy schedule or policy provisions. Copies of these are available from Scottish Widows. b) I agree that payments received will be invested in one Arrangement. c) If I am transferring benefits currently held as GMP or section 9(2B) rights in the transferring scheme, I confirm that I have acknowledged in writing to the transferring scheme that: I have received a statement from Scottish Widows showing the benefits to be awarded in respect of the transfer payment I accept that the benefits to be provided by Scottish Widows may be in a different form and of a different amount to those which would have been payable by transferring scheme and I accept that there is no statutory requirement on Scottish Widows to provider for survivor s benefits out of the transfer payment. d) I also acknowledge that Scottish Widows is not accepting liability to provide benefits in the form of GMP or section 9(2B) rights. 3
5 C. DECLARATIONS (CONT D) e) I consent to Scottish Widows seeking further information from other pension providers, trustees, or scheme administrators, for any other pension arrangements under which I have benefits. I authorise the provision of any information requested. f) To the best of my knowledge and belief, all the statements I have made, whether in my own handwriting or not, are true and complete. g) I have received the Important Notes for Applications document and the Key Features Document. For your own benefit and protection, please read these documents before you sign this application. Scottish Widows will rely on them when administering your contract. If you do not understand any point, please let us know. Declaration to the provider/administrator of the transferring scheme named by my employer on the transfer spreadsheet a) I authorise and instruct you to transfer sums and assets from the plan(s) as listed in Section D directly to Scottish Widows and to provide any instructions and/or discharge required by any relevant third party to do so. b) I authorise Scottish Widows, the current provider and any financial adviser named in this application to obtain from each other, and release to each other, any information that may be required to enable the transfer of sums and assets to Scottish Widows. c) I authorise Scottish Widows, the current provider and any employer paying contributions to any of the plans listed in Section D to obtain from each other, and release to each other, any information that may be required to enable the transfer of sums and assets to Scottish Widows. d) Until this application is accepted and complete, Scottish Widow s responsibility is limited to the return of the total payment(s) to the current provider(s). e) When payment is made to Scottish Widows as instructed, this means that I shall no longer be entitled to receive pension benefits from the whole of the plan(s) listed in Section D where the whole of the plan(s) is transferring, or that part of the plan(s) represented by the payment(s) if only part of the plan(s) is transferring. Lloyds Banking Group companies may use your information to contact you by mail, telephone, or text message about products and services that may be of interest to you. If you do not wish to receive this information please tick this box. Declaration to Scottish Widows and the provider/administrator of the transferring scheme named by my employer on the transfer spreadsheet I accept responsibility in respect of any claims, losses, expenses, additional tax charges or any penalties that Scottish Widows and the current provider may incur as a result of any incorrect, untrue, or misleading information in this application or given by me, or on my behalf, or any failure on my part to comply with any aspect of this application. This includes where I have been asked to provide any original policy document(s) in return for the transfer of funds and I am unable to do so. Your signature Date (DD MM YYYY) A copy of the completed transfer application, Scheme Rules and Policy Provisions are available from Scottish Widows. Warning: Deciding whether or not to transfer can be complicated. Therefore before you sign your application you should satisfy yourself that transferring your pension fund is right for you. It is important that you are sure about the suitability of transferring and that you understand the risks. If you have received financial advice your adviser will have discussed the relevant issues with you for your circumstances. If you have chosen not to obtain financial advice you should take the opportunity to read the Key Features document and our product literature. Further information on pension transfers can be viewed on the following website: 4
6 NOTES TO SECTION D (1) If you ticked yes we will automatically set up a separate plan for the amount of the transfer value relating to the pension in payment. No tax-free cash will be payable under the separate plan. (2) If you ticked yes we will automatically set up a separate plan. No tax-free cash will be payable under the separate plan. (3) Government rules allow certain individuals to protect entitlements to tax-free cash which exceeded 25% of the value of that individual s pension fund, as at 5th April This protection is normally lost on transfer, unless the transfer is part of a block transfer. A block transfer is defined in section 22(6) of schedule 36 of the Finance Act 2004, and refers to transfers which involve two or more members of a transferring scheme, transferring all sums and assets held in respect of them by that scheme, to a single receiving scheme. Block transfer rules also stipulate that any transferring member who has been a member of the receiving scheme for longer than 12 months before the date of transfer will lose protection on transfer. Note, if no protected tax-free cash amount is confirmed, then the maximum tax-free cash available from the transfer payment will normally be limited to 25% of the value of the transfer payment at the date(s) benefits are taken. D. TRANSFERRING SCHEME S DETAILS Please tick one box. 1. Is the transfer coming from a: a) Registered Pension Scheme (As defined in part 4 of the Finance Act 2004) b) Recognised Overseas Pension Scheme (As defined in part 4 of the Finance Act 2004) c) Overseas Pension Scheme (As defined in part 4 of the Finance Act 2004) d) Employer Financed Retirement Benefits Scheme (As defined in Income Tax (Earnings and Pensions) Act 2003) 2. Details of the transferring scheme Full name of the scheme or provider/administrator Address Postcode HM Revenue & Customs pension scheme tax reference number Policy number (transferring plan) For transfers from an occupational pension scheme, please indicate if the transferring scheme is: A money purchase scheme If so, please confirm if the scheme is: an Executive Pension Plan or a Small Self-Administered Scheme A defined benefits scheme For further information please speak to your financial adviser. 3. If the transfer results from a pension sharing order, was any part of the Yes No ex-spouse s / ex-civil partner s pension already in payment at the time of the divorce / dissolution of the civil partnership? (see note 1) If yes, how much of the transfer value relates to the pension in payment 4. Does the transfer value relate to pension benefits for a continued Yes No rights member of an occupational scheme who has taken their tax-free cash on or after 27th July 2004 whilst deferring their pension? (see note 2) 5. Is this transfer being made as part of a block transfer? Yes No If yes, please complete the following: Protected Tax-Free Cash: (see note 3) If the transfer payment includes a Protected Tax-Free Cash amount, please confirm: The Protected Tax-Free Cash amount. The value of the pension benefits to which the amount relates, as at 5th April Has a partial transfer been taken by the individual on or Yes No after 6th April 2006? If Yes, please provide the partial transfer value taken. 5
7 D. TRANSFERRING SCHEME S DETAILS (CONT D) (4) The normal minimum pension age is 55. Government rules may allow individuals to retain a lower or earlier pension age, where a right to take pension benefits at that age existed prior to 6th April This right is normally lost on transfer, unless the transfer is part of a block transfer. Please see note 3 for an explanation of the term block transfer. Note, unless this question is appropriately answered, we cannot normally accept a selected retirement age below the normal minimum retirement age. (5) For earmarking orders the Scheme Administrator or Trustee of the transferring scheme should advise the exspouse of the transfer within 14 days. (6) The Financial Conduct Authority (FCA) requires that certain transactions are reported by authorised persons. These include certain pension transfers, specifically those from: - A relevant statutory scheme; - An occupational sponsored pension scheme; or - An individual pension contract or buy out plan. (e.g. Section 32 plan) which provides guaranteed or fixed benefits. If the proposed transfer payment arises from a scheme or arrangement falling within one of the above descriptions, please tick the box shown. If the proposed transfer payment arises from any other scheme or arrangement, please do not complete this section. Note, if the transfer payment is a pension credit resulting from a pension sharing order and the applicant has not been offered membership of the transferring scheme in their own right, please do not complete this section. (7) When writing a cheque, it will help to prevent fraud if you include additional information on the Payee Line. For example, Scottish Widows re: your name, your reference policy number xxxyyz. Remember to draw a line through unused space on the cheque so extra numbers or names cannot be added. Protected Pension Age: (see note 4) If the selected pension age detailed in section A is below the normal minimum pension age (as defined in Part 4 of the Finance Act 2004), please tick the box, opposite, to confirm that the pension age is a protected pension age. 6. Is the current plan subject to any existing or proposed trustee in bankruptcy orders, Yes No or earmarking or pension sharing orders, or other receiving orders? (see note 5) If Yes, please attach details. 7. Please tick the box opposite if the proposed transfer must be reported to the Financial Conduct Authority (FCA). (see note 6 for further details of reportable pension transfers) E. TRANSFERRING SCHEME/ARRANGEMENT DECLARATION (TO BE COMPLETED BY YOUR FINANCIAL ADVISER) We declare that the particulars of the application and declaration, together with any other declaration or statement made by us in connection with this application, whether in our handwriting or not, are true. We agree to pay the transfer payment to Scottish Widows as Administrator of the Scottish Widows Stakeholder Pension Scheme. We will forward a cheque for the transfer payment crossed A/C Payee only and made payable to Scottish Widows. I certify that I am authorised to sign this application on behalf of the transferring scheme or arrangement. Signature Date (DD MM YYYY) Name (print) Position Insurer/Provider (where applicable) A copy of the completed transfer application, Scheme Rules and Policy Provisions are available from Scottish Widows. PENSION PROVIDERS WARRANTY Scottish Widows warrants and undertakes that all relevant requirements of section 95(6) of the Pension Schemes Act 1993 have been satisfied and in particular: a) Scottish Widows is such a person or body as is listed in section 154 of the Finance Act b) The Scottish Widows Stakeholder Pension Scheme is a Registered Pension Scheme, as defined under Part 4 of the Finance Act 2004 (HM Revenue & Customs PSTR number RH). c) The applicant is a member of the Scottish Widows Stakeholder Pension Scheme. d) If any part of the Member s cash equivalent transfer value is accepted by us, it will be applied by us to provide money purchase benefits for and in respect of the member. e) The Scottish Widows Stakeholder Pension Scheme is an appropriate scheme and is the subject of a current appropriate scheme certificate from HM Revenue & Customs (ASCN Reference No R). We note that in consideration of the above the transferring scheme or arrangement will forward the transfer payment by either direct transfer (BACS or CHAPS) or by cheque made payable to Scottish Widows and crossed A/C Payee Only. (see note 7) REVIEW REGULARLY You should review your retirement goals regularly. Some of the retirement options you may want to consider are: 1) Your investment selection 2) Your contribution levels 3) Nomination of death benefits Your options can be changed at any time, simply log in at or call
8 Scottish Widows Limited. Registered in England and Wales No Registered office in the United Kingdom at 25 Gresham Street, London EC2V 7HN. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Financial Services Register number /17
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