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

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1 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 advice from a financial adviser, remember that the adviser is acting on your behalf, not only by giving you advice, but also regarding how this form is filled in. Before completing this form, please read the With Profits Bond Key Features Document (WPB17). A copy of your completed application form will be sent to you on request. Please use BLOCK CAPITALS to fill in this form. Do not use correction fluid if you make a mistake. If you need to correct a mistake, please initial any changes you make to show your agreement to them. Part 2 Details of your investment Please give the number of your existing bond When we refer to Standard Life we mean Standard Life Assurance Limited. This application is for a UK bond and is only for use by applicants who are habitually resident in the UK. Please ask your financial adviser if you require any guidance. Please make sure you complete all parts of this form. For further information on filling out this form or for information on the contract or product, please contact your financial adviser. Bond number X First bond holder name How much do you want to invest in your bond?. If you are making an additional investment to a bond which was taken out before 13/09/04 then the terms and conditions of your policy for this additional investment have changed. The policy provisions of your existing bond allow us to do this. Please see the Key Features Document (WPB17) for details of the changes and tick this box to confirm that you are aware of these changes. The minimum additional investment you can make is 1,000. Please note that the cheque should be made payable to Standard Life Assurance Limited. If you are making an additional investment to an existing bond where units were allocated before 13 September 2004, the Level Option will be applied to your investment. You cannot switch options once you have taken out your bond. September 2018 Page 01 of 08

2 Part 3 Money laundering regulations individuals Due to Financial Conduct Authority (FCA) requirements, we are required to obtain information about the applicants or settlor s employment and income before we can accept the application. If the applicant(s) does not work, please state position, e.g. retired, student. Person 1 Occupation Person 2 Occupation Person 3 Occupation Annual income before taxation Please indicate which income band applies to you. (If this is a joint application, please state the combined income of the bond owners). In some cases, we may require documentary evidence to verify the information supplied in this section. For Standard Life trust cases we require this information for the settlor(s). If there are more than three individuals please photocopy this page. Under 10,000 10,000 to 14,999 15,000 to 19,999 20,000 to 24,999 25,000 to 29,999 30,000 to 39,999 40,000 to 49,999 50,000 or more Source of wealth We are also required to obtain information about the source of your investment before we can accept your application. Please tell us how you acquired the money you are investing. (Please cross all that apply). Compensation payment Money from existing trust Savings Inheritance Divorce settlement Gift Salary/bonus Lottery/betting win Policy claim/maturity Sale of company Sale of investments Sale of property If Other, please provide details: Other Please continue on a separate piece of paper if necessary. 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 02 of 08 September 2018

3 Part 4 Regular withdrawals If you want to change the regular withdrawals from your bond, show the percentage of the total amount invested, or the total amount you want to withdraw each year, or tick the Bonus Withdrawal Amount in the appropriate box below. If you tick Bonus Withdrawal Amount, withdrawals will be based on the bonus growth rate. Stepped option only complete if you took out this bond with the stepped charging option a.. % each year (maximum allowed is 7.5%) b.. each year ( maximum allowed is the monetary value of 7.5%) c. Bonus Withdrawal Amount (please tick the box if required) Level option only complete if you took out this bond with the level charging option a.. % each year (maximum allowed is 10.0%) b.. each year ( maximum allowed is the monetary value of 10.0%) Existing arrangements for regular withdrawals will apply to your additional investment (i.e., same type, frequency and payment date). If you wish to change this, all future regular withdrawals will be paid according to what you complete here. You cannot take regular withdrawals of more than 7.5% a year of the total amount invested if you have chosen the Stepped option, or 10.0% if you have chosen the Level option, less any one off withdrawals. The minimum regular withdrawal is 50. For an explanation of 'Bonus Withdrawal Amount', please see the With Profits Bond Key Features Document (WPB17). c. Bonus Withdrawal Amount (please tick the box if required) 1. Tick the appropriate box to show how often during the year you want to make withdrawals. Once a year Every 6 months Every 4 months Every 3 months Every Month 2. On what date do you want your first regular withdrawal to be paid? Payments can be made from 1-28 of the month. September 2018 Page 03 of 08

4 Part 5 Authority for payment Withdrawal payments are paid to your Bank or Building Society account. Please fill in your Bank or Building Society details. Name of Bank/ Building Society Name Address Building number Street City/Town County Postcode Name(s) of Account holder(s) Bank account number Building Society roll number Branch sort code Page 04 of 08 September 2018

5 Part 6 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 e.g. 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 (e.g. 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 e.g. 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 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 StandardLifeAberdeen.com. Offers of interest from our preferred partners No Yes To understand how, where and why we use your information, read our Privacy Policy September 2018 Page 05 of 08

6 Part 7 Declarations Important, please read carefully To be completed by all the bond owners. I/we, the bond owners invested in the bond in which I/we have an insurable interest, agree that the answers given in this form are true and complete to the best of my/our knowledge and belief. In particular, I/we understand that, if I/we withdraw money from the With Profits Bond, the price of the units may be reduced. In some circumstances this may result in the value available on surrender being substantially below the amount invested. For your own benefit and protection, you should read the following: the Data Protection Notice the section headed Filling in this form the Key Features Document I/We agree that my/our personal information (including special category data) may be used for the purposes described (subject to me/us exercising my/our right not to be contacted with details of other products and services). I/We confirm that I/we are habitually resident in the UK. Signature(s) Signature(s) required Page 06 of 08 September 2018

7 IMPORTANT This section must be completed by your financial adviser Financial adviser s details Intermediary Reference No. Name of contact Location Basis of Sale Whole of Market Other If other please specify: Was advice given? Advice No advice (e.g. Execution only) Adviser charges We do not facilitate adviser charges for investment bonds. 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 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, reproduced under licence. All rights reserved. September 2018 Page 08 of 08

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

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