INHERITABLE ISA ALLOWANCE TRANSFER OF UNITS FORM

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1 INVESTOR PORTFOLIO SERVICE INHERITABLE ISA ALLOWANCE TRANSFER OF UNITS FORM Use this form to transfer funds from your deceased spouse/civil partner s holding, to a stocks and shares ISA with IPS. FOR ADVISER USE ONLY Agent number Introducing branch reference Adviser name IOB Ref Basis of advice declaration. To meet Financial Conduct Authority Regulatory Reporting Requirements, Cofunds must record whether advice was given to your client regarding the sale of this product. Please tick the relevant box below: Was advice given? Please complete in BLOCK CAPITALS using black ink and return to: Investor Portfolio Service, PO Box 1112, Chelmsford CM99 2UX. Please ensure you ve read the current version of the following Product Documents before you make any investment decisions: Key Investor Information Document (KIID) you can find these at nationwide.onlineips.co.uk/content/investments.aspx Investing with IPS IPS Terms and Conditions Important Fund Information. If you don t understand any point in these documents, please ask your financial adviser for further information. Alternatively you can contact us on and we ll be happy to help. Call charges will vary. We may record or monitor calls. We ll use your address, address and phone number collected in Section 1 of this form to contact you about your investments. We will not use them to send you information on Aegon products or services. WHAT YOU NEED TO KNOW Please complete this form if you wish to transfer an inherited ISA into a stocks and shares ISA in your name, utilising your inheritable ISA allowance. We can only transfer funds if your deceased spouse/civil partner held their ISA with Cofunds. You will not be able to select different funds to invest for this transfer. You will be invested in the commission-free share class. If a commission-free share class is not available we will let you know. Where the value of the funds you ve asked to transfer is more than your inheritable ISA allowance, we will transfer proportionately across all the funds and the excess will be placed in a unit trust/oeic outside of an ISA. If you want to make an additional permitted subscription by cheque or switch funds from your own unit trust/oeic please use the Inheritable ISA allowance application form.

2 SECTION 1. Personal details complete this section in full Part 1.1 Applicant IPS customer reference Mr/Mrs/Ms/Miss/Other Surname Forename(s) in full Address We need your permanent residential address including the postcode, we can t accept a c/o address. If you ve lived at this address for less than three months, please provide your previous house number/name and postcode. Contact telephone number Date of birth Please tick Do you have a National Insurance number? Male Female If, please provide National Insurance number Tax residency Please read the following sentence and confirm by ticking the box if applicable. I confirm that I am solely UK resident for tax purposes and not a US citizen. If you can t confirm and tick the box, please complete the Individual Self-Certification form available from Customer Services. Please note, there may be times when we need further identification from you. We ll contact you if this is the case. Please see the Using IPS document for more information on our identification process and why we may need additional information. You can find this document online at Part 1.2 Details of deceased IPS customer reference Mr/Mrs/Ms/Miss/Other Surname Forename(s) in full Address We need the permanent residential address as at date of death. Date of birth Date of death National Insurance number? If, please provide National Insurance number Relationship to applicant Spouse Civil Partner Date of marriage/civil partnership Page 2/5

3 SECTION 2. Transfer details We will transfer all funds as held in the deceased s holding into your ISA. You will not be able to select different funds to invest in. Please enter your inheritable ISA allowance here Once you ve made a subscription to an inheritable ISA allowance, any future subscriptions under that allowance MUST be made to Cofunds and be accompanied by the signed Declaration. SECTION 3. minated bank account You need to provide the details of your bank/building society account so we can make any payments by BACS. This is a quick and secure method of transferring money. We may use these details to pay you the proceeds of any future withdrawals. If you ve selected income units/shares please complete the Income options section below. Name and full postal address of your bank/building society Name(s) of account holder(s) Bank/building society account number Branch sort code Roll number (if applicable) This account must be held, or jointly held, by the named applicant(s). We can t make payments to a third party. If any of these details change in the future, please contact us. SECTION 4. Income options If you re transferring any INC units/shares Complete this section if you ve chosen income units/shares (INC). Tick one: Receive the income. Any income will be paid to you. Income received from your investments in INC units/shares will be paid into your IPS cash account and then paid to your nominated bank account on the next monthly payment date. Reinvest into the fund. Income received from your investments in INC units/shares will be used to buy more units/shares in the fund. Hold in my IPS Cash Account. Income received from your investments in INC units/shares will be paid into your IPS Cash Account for you to withdraw, invest in future or maybe use to pay for any adviser charges and/or platform fees. If you have selected to Reinvest into the fund this will be applied to all commission-free share classes you hold in your account. Commission-included share classes you hold will continue to pay income in accordance with your previous instruction. If you don t already hold income units/shares in this product and you don t tick one of these boxes we will select the Reinvest into the fund option by default. If you already hold income units/shares within this product and you don t tick one of these boxes we will apply your existing income options to all funds within this product. Page 3/5

4 SECTION 5. Adviser Charges (For adviser use only) This section confirms any Adviser Charges that you ask us to pay from the amount you are transferring. 5.1 Initial Adviser Charge I would like you to pay the following initial Adviser Charge(s) to the organisation shown below: Total initial Adviser Charge on transfer: Name of organisation to be paid: 5.2 Ongoing Adviser Charge Use this section to add or amend an ongoing Adviser Charge. If left blank any existing ongoing Adviser Charge will continue. I am aware I need to pay my adviser for any ongoing service they are providing and that this will be paid for from the money I hold in my IPS Cash Account. I am aware that I can ask you to cancel or alter my ongoing Adviser Charge at any time subject to the notice period described in the Terms and Conditions. For the investments held in this IPS account: I agree to pay an ongoing Adviser Charge of % each year of my investment s value to the organisation shown below. Please calculate and pay this on a monthly basis. Name of organisation to be paid: I will ensure that my IPS Cash Account has enough money in it to pay my ongoing Adviser Charge, and any other charges, through one of the following methods: by sending you a cheque; by bank transfer from my minated Bank Account; by using part of the income received from my investments held on IPS. Sale for Regular Payment mandate: By signing this application form, when there are insufficient funds in my IPS Cash Account, I authorise you to sell units/shares from my IPS investments in line with the Terms and Conditions each month to provide the funds required to pay my Adviser Charges. For jointly held unit trusts/oeics Units/shares will be sold from the largest holding in my joint unit trusts/oeics to pay for the charges and fees relating only to that investment. For solely held unit trusts/oeics and ISAs Units/shares will be sold from the largest holding in my unit trust/oeic or, if I don t have a unit trust/oeic, from the largest holding in my ISA. If there is insufficient money left in my unit trust/oeic, units/shares will automatically be sold from the largest holding in my ISA if I have one. I am aware that: There are other ways of paying for my Adviser Charges that do not involve selling units/shares from my IPS holding. This will result in the reduction of my capital. I will permanently lose the ISA tax benefits on any ISA units/shares sold. This may give rise to a capital gains tax liability on my unit trust/oeic. Units/shares will be sold in the same way to pay for my Platform Fee when there are insufficient funds in my IPS Cash Account to pay it. Page 4/5

5 SECTION 6. Declaration and authority I declare that: I declare I was married to or in a civil partnership with the deceased at their date of death and have evidence to support this declaration that can be produced on request. I am the surviving spouse/civil partner of the deceased. I was living with the deceased within the meaning of Section 1011 of the Income Tax Act 2007 at the date of the deceased s death (we were not separated under a court order, under a deed of separation, or in circumstances where the marriage or civil partnership had broken down). The subscription is made under the provisions of regulation 5DDA of the ISA regulations (additional permitted subscription) the subscription is being made within 180 days of beneficial ownership passing to me (where the deceased died in the period beginning with 3 December 2014 and ending on 5 April 2015, this is treated as occurring on either 6 April 2015, or, the actual date of distribution, which ever is the later). I am aged 18 years of age or over. All subscriptions made, and to be made, belong to me. I am resident in the United Kingdom for tax purposes or, if not so resident, either perform duties which, by virtue of Section 28 of the Income Tax (Earnings & Pensions) Act 2003 (Crown employees serving overseas), are treated as being performed in the United Kingdom, or I am married to, or in a registered civil partnership with a person who performs such duties. I will inform Cofunds if I cease to be so resident or to perform such duties or to be married to, or in a registered civil partnership with a person who performs such duties. The information given in this application is full and accurate to the best of my knowledge and belief and I will inform Cofunds Limited without delay of any change in my circumstances affecting any of the information in this form. Please note: Details about residence are available from your tax office or on HM Revenue & Customs website. I authorise Cofunds: to hold my cash subscription, ISA investments, interest, dividends and any other rights or proceeds in respect of those investments and any other cash; and to make on my behalf any claims for tax relief in respect of ISA investments. We work with carefully selected suppliers that carry out certain functions on our behalf. We only share the appropriate level of personal information necessary to enable our suppliers to carry out their services and they need to keep the information safe and protected at all times. Our suppliers must only act on our instructions and can t use your personal information for their own purposes. The personal information we collect may be transferred to, and stored at a destination outside the European Economic Area (EEA). This could be to other companies within the Aegon Group or to our service providers. Where any such processing takes place, appropriate controls are in place to make sure your information is protected. We may disclose your information to credit, fraud and financial crime agencies to enable us to verify your identity and help make decisions regarding the ongoing administration of your investments. This will be undertaken during the application process and on an ongoing basis, for you and anyone you re linked with financially or other members of your household. Our enquiries or searches may be recorded. You can find more information on how we use and share your personal information, including how long we keep it and details of your rights at or by contacting us. PLEASE READ AND SIGN BELOW: I understand that a copy of the completed application form and/or Terms and Conditions is available on request. I have been provided with the Terms and Conditions of the IPS Platform and by signing this application form I agree to be bound by them. I confirm that I have received the Product Documents and Key Investor Information Documents (KIID) relating to my investment. I understand that I will pay the IPS Platform Fee for use of the IPS service and I authorise Cofunds to collect this fee from my IPS Cash Account. If there is insufficient money in my IPS Cash Account, I authorise Cofunds to sell enough of my assets to pay the fee in accordance with the Terms and Conditions. I understand that my signed application form and the Terms and Conditions form the basis of my agreement with Cofunds. IMPORTANT PLEASE READ: DATA PROTECTION How we treat your personal information: At Aegon, we re committed to protecting and respecting your privacy. We collect your personal information so that we can verify your identity, set up your account and provide ongoing administration. We need this information to carry out our obligations and to provide you with the products and services under the terms of your contract with us. ISA APPLICANT AUTHORISATION ISA applicant Date Please send your completed application to: Investor Portfolio Service, PO Box 1112, Chelmsford CM99 2UX Cofunds Limited Registered in England and Wales Registered office: Level 43, The Leadenhall Building, 122 Leadenhall Street, London, EC3V 4AB We are authorised and regulated by the Financial Conduct Authority. Q51818 P /18 NON ASD

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