ITC ARF APPLICATION FORM.

Transcription

1 ITC ARF APPLICATION FORM

2 ITC ARF Application Checklist Please ensure you have completed the following document before returning the completed application to ITC: Check Completed ARF / AMRF Application Form - signed in all places Eligibility Terms of Engagement Fax/ Indemnity Custody trust subscription Certificate of source of investment for approved retirement fund Certificate of source of investment for approved minimum retirement fund Copy of Annuity Policy, if applicable Copy of pension/property adjustment order, if applicable Please ensure you have included all the following documents before returning the completed application to ITC: Check ID Verification One of the following: a. Current (i.e. in date) and valid passport. Or b. Current, full and valid Driving Licence Must be certified as a true copy of the original and dated by an Accountant, Solicitor, Garda or Regulated entity based in Ireland. Address Verification One of the following & less than 3 months old from the issue date: a. Residential Utility Bill for your home address (electricity, gas, water, home phone or home broadband) Or b. Personal Bank / Building society / financial institution statement (must be a full page statement and show activity on the account) Must be certified as a true copy of the original and dated by an Accountant, Solicitor, Garda or Regulated entity based in Ireland. Proof of PPS Number - a document from the Revenue Commissioners showing your PPS Number (e.g. P60, P45, P21, etc.) ITC will not be able to process your application until we have received all the above documents. page 1 of 11

3 Application Form Investment Type Approved Retirement Fund* Investment Amount Approved Minimum Retirement Fund* Investment Amount *Subject to the calculation of allowable limits Personal Details Title Surname Marital status PPS number First name Date of Birth Gender Spouse s Date of Birth Contact Details Address Address Home Telephone Mobile Work Telephone Fax Where possible your correspondence will be issued to the address provided above. If you would like to receive your correspondence in a format other than , please confirm the method here: Background Details Are you resident in the Republic of Ireland for tax purposes? Yes No Value of Existing Pension Benefits (include all pension types e.g. Personal, Occupational, PRSA, ARF, etc.) Pension Provider Normal Retirement Age Policy Number Value In respect of previous or current employment To be transferred to ITC ARF 1. Y N 2. Y N 3. Y N 4. Y N 5. Y N Do any of the benefits being transferred contain assets transferring in-specie? Yes No If so, please enclose a copy of the latest scheme report. page 2 of 11

4 Are the benefits subject to a pension/property adjustment order? Yes If yes, please attach a copy of the order No Please indicate the gross level of annual income to be drawn from your ARF and how you would like it to be paid: 1. I require the statutory minimum drawdown (currently 4% / 5% / 6%) or 2. I require the following gross income per annum Payable: Half Yearly Payable: Quarterly Payable: Monthly Advisor Details Bank Details Please provide your bank details to allow us to make payment to you should you request a withdrawal of funds from your scheme. Bank Account Name Address of Bank BIC IBAN Advisor Details Advisor Name Intermediary Agency Code Advisor Company Name Advisor Address Advisor Fee Initial Set Up Fee AMC % The advisor fee will be added to ITC s Annual Management Charge. Advisor Minimum Fee Signature of Advisor: Date: page 3 of 11

5 Declaration I hereby declare that, to the best of my knowledge, I am entitled, under the Taxes Consolidation Act 1997 (as amended), to invest in an ARF and/or an AMRF and that the investment made is from an approved source. I authorise any insurance company, QFM, pension scheme trustee or PRSA provider to give Independent Trustee Company Limited details of any pension arrangements, annuities and/ or ARF/AMRF investments applying to me. Signature Name in capitals Date / / Advisor s Signature Name in capitals Date / / Consent to Marketing Communications: From time to time, we may wish to use the information you have provided for the purposes of providing you with additional information relating to the goods and services of ITC, its associated companies and / or carefully selected third parties. If you consent to our use of your data in these ways, please indicate by ticking this box: page 4 of 11

6 Eligibility for ARF/AMRF If you cannot answer Yes to at least one of the following three questions you must invest 63,500 in an Approved Minimum Retirement Fund until age 75 or purchase an annuity with 63, Are you currently receiving a guaranteed pension income for life of at least 12,700 per annum (this may include the single person s State pension entitlement)? Yes No If yes, please provide details: State pension entitlement (single person entitlement only) Other pension entitlements Pension Provider Name Address Policy / Annuity Ref Number 2. Have you used at least 63,500 from any pension fund to buy an annuity? Yes No If yes, please provide details: Purchase Amount Name of Qualifying Fund Manager Pension Provider Annuity Account Number Please enclose a copy of your annuity policy 3. Do you have 63,500 invested in an Approved Minimum Retirement Fund? Yes No If yes, please provide details: Purchase Amount Name of Qualifying Fund Manager Date of Investment (DD/MM/YYYY) AMRF Ref Number Signature Name in capitals Date / / page 5 of 11

7 Terms of Engagement I confirm my instructions to Independent Trustee Company Limited ( ITC ) to act as the Qualifying Fund Manager for my Approved Retirement Fund ( ARF ) and/ or Approved Minimum Retirement Fund (AMRF ). I acknowledge that the services will be provided in accordance with ITC s Terms of Business, a copy of which has been provided to and read by me. I acknowledge in particular the provisions relating to data protection. In accordance with the Data Protection Acts 1998 and 2003, I, as the data subject, consent to the collection, retention and processing by ITC of any personal data about me for the purposes of providing the above and any ancillary services. I acknowledge that all assets of my ITC ARF (AMRF) will be held by a unit trust or such other custodial vehicle as ITC in its absolute discretion may decide. I acknowledge that ITC does not provide investment advice and that I will be required to obtain such advice from my financial advisor. I acknowledge that it may not be possible to transfer in specie any of the investments made through my ARF/ AMRF to another ARF. I acknowledge that it is my responsibility to obtain such professional advice as is appropriate in connection with the quality, suitability and appropriateness of any investment made through my ARF/ AMRF. I confirm that ITC does not have any responsibility for assessing the quality, suitability or appropriateness of any investment made through my ARF/ AMRF. I confirm and acknowledge that any investment made through my ARF/ AMRF will be undertaken at my request and direction and agree to release, indemnify and hold harmless ITC from any and all liability in connection with or arising from any investment. I confirm that I, in conjunction with my financial advisor, will make provision to ensure that at all times the ARF/ AMRF has sufficient liquidity at all times to make payments as they fall due e.g. the compulsory annual draw-down, fees, etc. Where there is insufficient liquidity to meet the liabilities of the fund I agree to indemnify and hold harmless ITC against any claims or liabilities discharged on my behalf. Client Portal - Consent Access to the ITC Client Portal can be gained from the website, or by downloading the app to phone or tablet from the App Store. I confim that I do not wish to receive reports, statements or projections as hard copy (by post) I wish to gain access to the ITC Client Portal and consent to receiving relevant scheme documentation, reports, statements and projections via my ITC Client Portal. Signature Name in capitals Date / / page 6 of 11

8 UNIT TRUST SUBSCRIPTION If you wish to invest in non-exchange traded assets, typically bonds, bank deposits or direct property, or where funds need pre-clearing, we will open a separate bank account under the terms of the Custody Trust dated 25th April 2014, an Exempt Unit Trust, established pursuant to Section 731 (5) TCA97 (the Trust ). The terms of the Trust are available to view on the ITC website at This application form relates to all initial and subsequent subscriptions for Units in the Custody Trust made on behalf of your ITC ARF, as evidenced by the transfer of subscription monies into the appropriate Sub-fund account. To be completed by ITC Trust Reference The Pension Investor Representations and Warranties The capitalised words and expressions used in this application form shall have the meaning ascribed to them in the Trust. 1. I confirm that having considered the Declaration of Trust and a specimen Supplemental Declaration of Trust in relation to the Sub-fund, this application is based solely on the Declaration of Trust and the Supplemental Declaration of Trust and I am not relying on any other information or representation. 2. I agree that all representations, warranties and declarations which I make or give here will apply with respect to future acquisitions of Units in the Trust as if repeated in full at the time of the future acquisition. 3. I hereby acknowledge and agree that the Trustee reserves the right at its sole discretion to accept or reject in whole or in part my application. 4. I acknowledge the right of the Trustee in its capacity as trustee of the Trust to issue such number of Units upon the transfer of initial or subsequent subscription monies into the account of the Sub-fund as the Trustee may in its sole discretion determine in accordance with the provision of the Declaration of Trust. 5. I further acknowledge and agree that the transfer of monies by me into the account of the Sub-fund will be deemed to be an irrevocable subscription for Units in the Trust. 6. I acknowledge the right of the Trustee in its capacity as trustee of the Trust, to redeem the Units in the event that the representations or warranties set out herein above are no longer accurate. 7. I acknowledge the right of the Trustee in its capacity as trustee of the Trust to compulsorily redeem Units in the event that such units are (i) held in breach of any law or requirement of any country or governmental authority; (ii) held in circumstances which in the opinion of the Trustee might result in the Trust incurring any liability for taxation or suffering any legal, pecuniary, regulatory or material administrative disadvantage which the Trust might not otherwise have incurred or suffered; or (iii) are held by a Unit holder who is not or page 7 of 11

9 cease to be a Pension Investor (as defined in the Declaration of Trust); or (iv) held in circumstances in the opinion of the Trustee which might result in the Series Trust or Trust being deemed to be a unit trust scheme as defined in Section 1(1) of the Unit Trusts Act, 1990; (v) held in the circumstances in the opinion of the Trustee might result in the Sub-fund or Trust being deemed to be an Alternative Investment Fund (as defined in the European Union (Alternative Investment Fund Managers) Regulations 2013). 8. I understand that during the Term of the Sub-fund, the redemption of Units shall be subject to restrictions which may adversely affect the ability to redeem Units. 9. I shall provide the Trustee with any additional information which it may require in connection with my tax status and authorise them to disclose such information relating to this application to such persons as it may be required for taxation, legal or regulatory purposes. 10. I acknowledge that it is envisaged that additional subscriptions for Units in the Trust shall be made in such an amount as shall be determined by me. Where additional subscriptions are not made and where, as a result, there may not be sufficient assets within the Series Trust to discharge its liabilities from time to time I acknowledge that this may result in the Trustee being obliged to sell or otherwise dispose of some or all of the assets of the relevant Series Trust. Acknowledged and agreed by Investor Signature Print Name Date page 8 of 11

10 Certificate of source of investment for Approved Retirement Fund Note: Before ITC can accept monies into an Approved Retirement Fund (ARF), we must receive this Certificate completed by the existing Qualifying Fund Manager, Pension Scheme Trustee or Life Assurance Company and signed by the appropriate person. Applicant s Name PPS Number Transfer Amount Origin of Funds A Existing ARF: If yes please complete section A Yes No From a Pension Fund: If yes please complete section B Yes No Was this ARF set up prior to 06 April 2000? Yes No Were drawdowns (including the imputed distribution) being taken from this ARF for the current year? If yes, please attach a schedule of drawdowns. Yes No Are assets to be transferred in specie to the ARF? Yes No If yes, please provide most recent valuation. B Name of Scheme/ Life Office C Revenue Approval/ Policy Number Is this ARF subject to a Pension / Property Adjustment Order? Copy Pension / Property Adjustment Order attached? Yes Yes No Certification (to be completed by current pension provider) We certify the following: i. The funds to which this certification relates comprise of assets to which the individual named in this application is beneficially entitled; and ii. The assets to which this certificate relates derive from an approved source within the meaning of section 784B Taxes Consolidation Act 1997 (as amended). / / page 9 of 11

11 Certificate of source of investment for Approved Minimum Retirement Fund Note: Before ITC can accept monies into an Approved Minimum Retirement Fund (AMRF), we must receive this Certificate completed by the existing Qualifying Fund Manager, Pension Scheme Trustee or Life Assurance Company and signed by the appropriate person. Applicant s Name PPS Number Transfer Amount Origin of Funds Existing AMRF: If yes please complete section A Yes No From a Pension Fund: If yes please complete section B Yes No A Was this AMRF set up prior to 06 April 2000? Yes No Were drawdowns (including the imputed distribution) being taken from this AMRF for the current year? If yes, please attach a schedule of drawdowns. Yes No Are assets to be transferred in specie to the AMRF? Yes No If yes, please provide most recent valuation. B Name of Scheme / Life Office Revenue Approval / Policy Number Certification (to be completed by current pension provider) We certify the following: i. The funds to which this certification relates comprise of assets to which the individual named in this application is beneficially entitled; and ii. The assets to which this certificate relates derive from an approved source within the meaning of section 784C Taxes Consolidation Act 1997 (as amended). / / page 10 of 11

12 Independent Trustee Company Limited Harmony Court Harmony Row Dublin 2 Tel: (01) Fax: (01) info@independent-trustee.com AR Effective from November Independent Trustee Company Limited, part of the ITC Group, is regulated by the Central Bank of Ireland. Please note that the provision of this product or service does not require licensing, authorisation, or registration with the Central Bank of Ireland and, as a result, it is not covered by the Central Bank s requirements designed to protect consumers or by a statutory compensation scheme.