COFUNDS PENSION ACCOUNT TRANSFER REQUEST FORM for existing clients
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1 COFUNDS PENSION ACCOUNT TRANSFER REQUEST FORM for exstng clents Also avalable on the Aegon webste: Cofunds Penson Account Drawdown Transfer Request Form transfer a penson plan from whch full or partal benefts are beng taken nto an exstng Cofunds Penson Account. We recommend that you complete ths form n conjuncton wth your advser/ntermedary. Ths form must be completed f you are transferrng a plan, from whch you are not takng benefts, to your Cofunds Penson Account. A separate copy of ths form must be completed where more than three schemes are beng transferred. Please complete ths form and return t to: Aegon Cofunds Admnstraton, PO Box 1791, Ednburgh, EH12 1PB Secton 1 Clent detals Product number 8 Mr/Mrs/Mss/Ms/Other - please specfy Full forename(s) When completng date felds please use the usual DD/MM/YYYY format. Surname Secton 2 Frst scheme to be transferred 2A. Scheme detals Full name of transferrng scheme Type of scheme beng transferred (e.g. personal penson) Name of scheme admnstrator/ trustee/nsurance company Scheme admnstrator/trustee/ nsurance company address Please check wth the current scheme provder f dscharge forms are requred. If so, please enclose them wth ths form. Not enclosng these may result n a delay to the Polcy/account number (f applcable) Is the transferrng scheme a full or partal transfer? Full Partal Amount transferred: or % Is the transferrng scheme a defned benefts penson scheme, for example, a fnal salary scheme? Yes No does the transferrng scheme nclude: Guaranteed Annuty Rates Yes No check wth your current Any other safeguarded benefts that provde a guarantee or promse such as Guaranteed Mnmum Penson (GMP) or guaranteed growth rates Yes No If yes to any queston, I confrm that a sutably authorsed fnancal advser recommended that I transfer the We wll not accept ths transfer unless you have receved a recommendaton from a sutably authorsed fnancal advser to transfer the If the advser/ntermedary named n Secton 5 gave ths advce they wll be requred to sgn and complete Secton 5. If they ddn t gve ths advce but you would stll lke to transfer the scheme you are requred to seek transfer advce from an authorsed advser who should confrm ther recommendaton to transfer by completng Appendx I. Cofunds Penson Account Transfer Request Form 1
2 Secton 2 Frst scheme to be transferred contnued 2B. Assets to be transferred The transfer payment wll comprse only cash Other assets are to be transferred as nvestments (.e. transferrng nvestments wthout sellng them). Please ensure that the current scheme admnstrator permts ths. Please nclude one of the below : A full fund lst ncludng the number of unts and SEDOL codes s enclosed A completed Investment Transfer Schedule s enclosed avalable n the Cofunds Penson Account must ether be sold before the transfer s made or reman wth the current Secton 3 Second scheme to be transferred 3A. Scheme detals Full name of transferrng scheme Type of scheme beng transferred (e.g. personal penson) Name of scheme admnstrator/ trustee/nsurance company Scheme admnstrator/trustee/ nsurance company address Please check wth the current scheme provder f dscharge forms are requred. If so, please enclose them wth ths form. Not enclosng ths may result n a delay to the Polcy/account number (f applcable) Is the transferrng scheme a full or partal transfer? Full Partal Amount transferred: or % Is the transferrng scheme a defned benefts penson scheme, for example, a fnal salary scheme? Yes No does the transferrng scheme nclude: Guaranteed Annuty Rates Yes No check wth your current Any other safeguarded benefts that provde a guarantee or promse such as Guaranteed Mnmum Penson (GMP) or guaranteed growth rates Yes No If yes to any queston, I confrm that a sutably authorsed fnancal advser recommended that I transfer the scheme We wll not accept ths transfer unless you have receved a recommendaton from a sutably authorsed fnancal advser to transfer the If the advser/ntermedary named n Secton 5 gave ths advce they wll be requred to sgn and complete Secton 5. If they ddn t gve ths advce but you would stll lke to transfer the scheme you are requred to seek transfer advce from an authorsed advser who should confrm ther recommendaton to transfer by completng Appendx I. 3B. Assets to be transferred The transfer payment wll comprse only cash Other assets are to be transferred as nvestments (.e. transferrng nvestments wthout sellng them). Please ensure that the current scheme admnstrator permts ths. Please nclude one of the below : A full fund lst ncludng the number of unts and SEDOL codes s enclosed A completed Investment Transfer Schedule s enclosed avalable n the Cofunds Penson Account must ether be sold before the transfer s made or reman wth the current Cofunds Penson Account Transfer Request Form 2
3 Secton Thrd scheme to be transferred A. Scheme detals Full name of transferrng scheme Type of scheme beng transferred (e.g. personal penson) Name of scheme admnstrator/ trustee/nsurance company Scheme admnstrator/trustee/ nsurance company address Please check wth the current scheme provder f dscharge forms are requred. If so, please enclose them wth ths form. Not enclosng ths may result n a delay to the Polcy/account number (f applcable) Is the transferrng scheme a full or partal transfer? Full Partal Amount transferred: or % Is the transferrng scheme a defned benefts penson scheme, for example, a fnal salary scheme? Yes No does the transferrng scheme nclude: Guaranteed Annuty Rates Yes No check wth your current Any other safeguarded benefts that provde a guarantee or promse such as Guaranteed Mnmum Penson (GMP) or guaranteed growth rates Yes No If yes to any queston, I confrm that a sutably authorsed fnancal advser recommended that I transfer the scheme We wll not accept ths transfer unless you have receved a recommendaton from a sutably authorsed fnancal advser to transfer the If the advser/ntermedary named n Secton 5 gave ths advce they wll be requred to sgn and complete Secton 5. If they ddn t gve ths advce but you would stll lke to transfer the scheme you are requred to seek transfer advce from an authorsed advser who should confrm ther recommendaton to transfer by completng Appendx I. B. Assets to be transferred The transfer payment wll comprse only cash Other assets are to be transferred as nvestments (.e. transferrng nvestments wthout sellng them). Please ensure that the current scheme admnstrator permts ths. Please nclude one of the below : A full fund lst ncludng the number of unts and SEDOL codes s enclosed A completed Investment Transfer Schedule s enclosed avalable n the Cofunds Penson Account must ether be sold before the transfer s made or reman wth the current Cofunds Penson Account Transfer Request Form 3
4 Secton 5 Advser/Intermedary detals (for advser/ntermedary use only) Advser/ntermedary name Frm name 5A. Advce gven Dd you advse your clent on the sutablty of transferrng any employer-sponsored schemes to the Cofunds Penson Account? Yes No Dd you advse your clent to transfer any safeguarded benefts to the Cofunds Penson Account? Yes No 5B. Authorsaton I/We also confrm that: I/we have provded my/our clent wth the detals of the fees approprate to ther nvestment (f applcable). Sgned Date / / Advser/Intermedary name Frm name FCA Reference Number (Frm) Poston Secton 6 Declaraton It s a serous offence to make false statements. The penaltes are severe. False statements could lead to prosecuton. 6A. Please read and sgn the declaraton below to authorse the transfer(s): I declare that to the best of my knowledge and belef the statements made n ths secton (whether n my handwrtng or not) are correct and complete. I hereby consent to Suffolk Lfe obtanng detals from the admnstrator/trustee or nsurance company or other penson provder of any scheme, contract or arrangement of whch I am or have been a member n connecton wth the transfer and authorse the gvng of such detals to Suffolk Lfe. I also consent to my advser/ntermedary obtanng the same detals. Whle Suffolk Lfe wll request transfers n a tmely manner, I understand that Suffolk Lfe s not responsble for the tmely completon of the I understand that Suffolk Lfe wll not request any n spece transfer untl all of the nformaton requested has been provded. I wsh for the penson scheme benefts detaled to be transferred to my Cofunds Penson Account. 6B. Declaraton to the admnstrator of the transferrng scheme(s) I authorse and nstruct you to transfer funds from the plan(s) as lsted above drectly to Suffolk Lfe. Where you have asked me to gve you any orgnal polcy document(s) n return for the transfer of funds and I am unable to do so, I promse to accept responsblty for any clams, losses and expenses of any nature whch you may ncur as a result of havng made the transfer(s) lsted above. I authorse you to release all necessary nformaton to Suffolk Lfe to enable the transfer of funds to Suffolk Lfe. I authorse you to obtan from and release to the advser/ntermedary named opposte any addtonal nformaton that may be requred to enable the transfer of funds. If an employer s payng contrbutons to any of the plans as lsted above, I authorse you release to that employer any relevant nformaton n connecton wth the transfer of funds from the relevant plan(s). Untl ths applcaton s accepted and complete, Suffolk Lfe s responsblty s lmted to the return of the total payment(s) to the admnstrator of the transferrng scheme(s). Where the payment(s) made to Suffolk Lfe represent(s) all of the funds under the plan(s) lsted above, then payment made as requested wll dscharge the admnstrator of the transferrng scheme of all clams and responsbltes n respect of the plan(s) lsted. Where the payment(s) made to Suffolk Lfe represent(s) part of the funds under the plan(s) lsted above, then the admnstrator of the transferrng scheme wll be dscharged of all clams and responsbltes only n respect of the part of the plan(s) represented by the payment(s). 6C. Declaraton to Suffolk Lfe and the admnstrator of the transferrng scheme(s): I promse to accept responsblty n respect of any clams, losses and expenses that Suffolk Lfe and the admnstrator of the transferrng scheme may ncur as a result of any ncorrect nformaton provded by me or of any falure on my part to comply wth any aspect of ths transfer form. Clent sgnature Date / / Clent name Cofunds Penson Account Transfer Request Form
5 Appendx I Advser declaraton Advser detals Name of authorsed ndvdual Full name of regulated organsaton Regulator s reference number for organsaton Regulator s reference number for ndvdual Address Telephone number Fax number Emal address Please complete ths secton, n full, f you are not the clent s current advser as known to Aegon. Ths secton should be completed by a sutably authorsed UK advser f advce has been gven on transfers from schemes contanng safeguarded benefts. If the regulated organsaton s an apponted representatve or part of a network, please gve detals below. Name of prncpal or network Regulator s reference number for prncpal or network Declaraton (to be completed and sgned f the clent has stated they have sought advce n transferrng a scheme contanng safeguarded benefts) Please confrm whether you have provded advce to your clent on transferrng a scheme contanng safeguarded benefts nto the Cofunds Penson Account: I confrm that I have recommended the clent (as named n Secton 1) to transfer hs/her penson scheme(s) contanng safeguarded benefts to the Cofunds Penson Account. Name Poston n organsaton Advser sgnature Date / / The Cofunds Penson Account s provded by Suffolk Lfe Pensons Lmted (Suffolk Lfe) 153 Prnces Street, Ipswch, Suffolk IP1 1QJ. Regstered n England and Wales number Suffolk Lfe s authorsed and regulated by the Fnancal Conduct Authorty (FCA). FCA regstraton number All assets held n the Cofunds Penson Account are legally owned by Suffolk Lfe Trustees Lmted and are held on the Aegon Platform provded by Cofunds Lmted (Cofunds). Regstered address: Level 3, The Leadenhall Buldng, 122 Leadenhall Street, London, EC3V AB. Regstered n England and Wales No Authorsed and regulated by the Fnancal Conduct Authorty (FCA) under FCA Regstraton No PA33GBUB Non Drawdown 05/18 Cofunds Penson Account Transfer Request Form 5
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