COMPANY PENSION/AVC RETIREMENT OPTIONS REQUEST AND CLAIMS FORM

Transcription

1 PENSIONS INVESTMENTS LIFE INSURANCE COMPANY PENSION/AVC RETIREMENT OPTIONS REQUEST AND CLAIMS FORM PLEASE READ THE QUESTIONS CAREFULLY BEFORE ANSWERING THEM AND USE BLOCK CAPITALS. If any item is blank or illegible, this will cause a delay in processing your application. 1. Financial Adviser Details - only if you have a Financial Adviser Financial Adviser Name Financial Adviser Code 2. Member and Employer Details We will automatically make the retirement lump sum payable to the member and issue the cheque to this address unless we are told otherwise Plans Being Claimed Members Name Members Address PPS Number should contain 7 digits and 1 or 2 letters Country of member residence PPS Number - Date of Birth Members contact phone numbers Home Mobile Employers Name We require evidence of age Your fund value can rise or fall on a daily basis and is not guaranteed to hold. The value which will be paid from your plan will be based on unit prices on the date that final requirements are received. Should you wish to protect the value of your fund while your claim is being processed you should contact Irish Life or your Financial Adviser regarding the possibility of switching your current fund(s) to a low risk Cash Fund which is currently available on your plan. 3. Service and Salary Details for employment as noted above (must be provided for all options) 1. Date of joining employment 2. Date of leaving this employment 3. Within the last three years of service in this employment did the member alone, or together with his or her spouse/registered civil partner and/or minor children, own or control more than 20% Yes No of the voting rights of the company? If No - Please confirm the member s highest salary in the last 5 years prior to retirement Year y y y y OR or if you are taking your benefits at your normal retirement age while continuing to work in this employment, please tick here Salary If YES - Please confirm the member s 3 highest consecutive salaries ending in the last 10 years prior to retirement to be verified with a copy of P60s for each year Year y y y y y y y y y y y y Salary Only required for early retirement claims ILA 8478 (REV 04-17) If you are a 20% director have you disposed of your shareholding in the company? Yes No If yes, please provide confirmation of this by way of a letter from the company accountant. 1

2 ALL QUESTIONS MUST BE ANSWERED. IF THIS SECTION IS INCOMPLETE IT WILL DELAY YOUR RETIREMENT CLAIM IF YOU HAVE MORE THAN ONE PENSION SCHEME PLEASE ATTACH DETAILS ON A SEPARATE SHEET. IF YOUR PLAN IS AN AVC, BENEFITS CAN ONLY BE DRAWN AT THE SAME TIME AND IN THE SAME MANNER AS YOUR MAIN PENSION SCHEME. PLEASE INCLUDE ALL DETAILS OF THE BENEFITS PAYABLE/ PAID UNDER THE MAIN PENSION SCHEME BELOW. 4. Other Pension Benefits - Information required in accordance with Section 787R(4) Taxes Consolidation Act Have you received retirement benefits from any other pension arrangement(s)? Yes No If yes, please complete the following: Name of scheme (if applicable) Employer name (if applicable) Pension type Contact details Policy number Start date of policy Date benefits were paid Retirement benefits you received: Retirement lump sum (before any tax paid) Final value of the pension fund at the time of taking benefits (For Defined Contribution Schemes, PRSAs or Personal Pensions) Annual pension income you are receiving if you were in a defined benefit scheme a year Final value of AVCs (if not included in the above amounts) 2. Have you any other pension arrangements where retirement benefits have not yet been taken or are about to be taken? Yes No If yes, please complete the following: Name of scheme (if applicable) Employer name (if applicable) Pension type Contact details Start date of policy Policy number Date benefits were paid Current value of the pension plan (For Defined Contribution Schemes, PRSAs or Personal Pensions) Expected annual pension income you will receive a year (For Defined Benefit Schemes) Expected retirement lump sum Current value of any AVCs not included in the above amounts 3. Since 7 December 2005 have you, or do you intend to transfer any other pension benefits to an overseas pension arrangement? Yes No If yes, please complete the following: Date or expected date of transfer Contact details for receiving scheme Amount of transfer value 4. Do you have a Personal Fund Threshold Certificate issued by the Revenue Commissioners? Yes No If yes, please provide a copy of your Personal Fund Threshold Certificate with this retirement claim form. 2

3 5. Retirement Options (All benefits are subject to Revenue maximum limits) If you would like us to give you details of the options available to you before making your decision please tick here We will automatically pay a maximum retirement lump, (to a total maximum of 500,000) unless otherwise specified in the following box: Note: The total maximum retirement lump sums allowable from all sources is currently 500,000 and the maximum taxfree lump sum is 200,000. Both of these limits include all retirement lump sums from all sources taken since 7 December Retirement lump sums between 200,000 and 500,000 will be taxed at a standard rate currently 20%. Indicate what you want to do with the remaining fund (after the payment of the retirement lump sum) by ticking the required option: OPTION ADDITIONAL REQUIREMENTS a) Buy a guaranteed pension income for life (Annuity) with Irish Life Annuity Proposal Form b) Invest in an ARF/AMRF with Irish Life ARF/AMRF Application Form (if you have a PRSA AVC you also have the option to leave the balance invested as a Vested PRSA) c) Taxable Cash: pay the balance subject to income tax (restrictions apply) Evidence of 63,500 AMRF investment OR evidence of guaranteed pension income for life of 12,700 a year d) Pay the balance as a trivial payment subject to tax See taxation note below (The balance of your pension funds from all sources after payment of retirement lump sum must be less than 20,000.00) 6) Purchase an Annuity or ARF/AMRF with another provider (if more than one provider, please provide details on a separate sheet). Cheque destination unless otherwise stated Please send my remaining fund after payment of the retirement lump sum to: Insurance Company or QFM Name (cheque payee) Address Contact Name Policy or Reference Number (if available) TAXATION NOTE: Income tax, PRSI and the Universal Social Charge are due on any income withdrawals or pension payments. Retirement Options C & D above will incur an immediate tax liability. Irish Life will deduct tax at the higher rate unless tax credits are allocated to Irish Life under tax registered number C. You should contact your Local Inspector of Taxes in relation to this. If tax credits are not allocated at the time of receiving this form, Irish Life will not be in a position to pay a refund of any over deducted tax. You may apply to Revenue for any over deducted tax at the end of the tax year. 6. Pension Adjustment Order 1) Has a Notice to Trustees been received in connection with a judicial seperation of this member? 2) Has a Pension Adjustment Order been issued or is in the process of being issued in respect of pension benefits held on behalf of the above member? Yes Yes No No If yes - please provide a copy of the Notice to Trustees or the Pension Adjustment Order. If this section is not completed, we will assume that a Notice to Trustees or a Pension Adjustment Order has not been issued on the pension plan. 3

4 7. Company Pension/AVC Trustee Authorisation COMPLETE IN ALL COMPANY PENSION AND AVC CASES, UNLESS YOU HAVE APPOINTED AN INDEPENDENT COMPANY TO ACT AS TRUSTEE. THIS IS NOT REQUIRED FOR PRSA AVC ONLY CASES I confirm that where the scheme rules do not already include an appropriate rule, the scheme rules are hereby endorsed to allow the member to opt for the ARF/AMRF option in accordance with section 772 of the Taxes Consolidation Act 1997, as amended. - Please sign and date I hereby declare that I, being the TRUSTEE of the scheme as named on this form, am legally entitled to claim the amount payable as indicated in this form and authorise that the payment of the tax free lump sum should also be paid as indicated. Signature of Trustee 7 Name in BLOCK CAPITALS Position in company Date If you have appointed an independent company to act as trustee then they must give their agreement before we can pay retirement benefits. Irish Life will arrange this by contacting the trustee on your behalf to let them know of your request. 8. Member/Contributor Declaration (to be completed in all cases) I hereby instruct the Trustees that benefits should be paid in the way selected on my ceasing to be a member of this company pension and / or AVC scheme. I understand that by completing this declaration I release both the trustees of this scheme and Irish Life Assurance plc (Irish Life) from all liability of benefits under this plan with effect from the date retirement benefits are paid. I confirm that I wish to take retirement benefits under my PRSA AVC(s), if any, as outlined in this form. I understand that, where the annuity option is chosen, the declared annuity rate could change if all required claim documentation is not received within 14 days of the annuity quotation date. I consent to Irish Life Assurance plc (Irish Life) obtaining information from or sharing information with any Insurance Company or Qualifying Fund Manager shown above for the purpose of completing my claim. I authorise Irish Life to access and receive this information. I consent to Irish Life disclosing this data to regulatory authorities, or, as required by law to any persons with whom the company has a contract as a service provider, to other insurance companies or to other companies in the Company s group. I understand Irish Life is required to deduct tax from any payments to me (other than any tax-free lump sum) and this tax will be deducted at the higher rate unless Irish Life receives a Certificate of Tax Credits. I also understand that the maximum tax free lump sum I can take is 200,000 from all pensions since 7th December Where my pension lump sum exceeds this limit I understand Irish Life is required to deduct standard rate income tax on the excess between 200,000 and 500, Please sign and date I declare to the best of my knowledge and belief that the information provided in section 4 of this application form in accordance with Section 787R(4) of the Taxes Consolidation Act 1997 is correct. Signed 7 (signature of member) Date All figures and options are correct as of October 2016 and may change. 4

5 Company Retirement Claims Checklist Have all of the relevant sections of the claim form been fully completed? Have you ticked what option you are selecting on Section 5 of the form? Have the Trustees signed Section 7 of the form or if a Liquidator has been appointed have they signed the form on behalf of the Trustees? We will accept a clear certified copy of Birth Certificate, Passport or Driving License Have you submitted evidence of Age? If the Company/Employer that this plan relates to is dissolved, have you signed the Indemnity form provided by Irish Life? Have you requested a Willing and Able Letter from the Life office where you will be investing the balance of your fund if you are investing in an AMRF or ARF that s not with Irish Life? Have you confirmed all details in relation to any other Pensions plans you have on Section 4 of the claim form? If you are a 20% Director, have you submitted P60s or an Accountants letter as verification of your 3 highest consecutive salaries in the last 10 years of your employment with the company that this plan relates to? If you are a 20% director and retiring early (i.e. from age 50) have you provided confirmation from the Company Accountant that you have severed all connections with the Company and sold all of your shareholding? If you are a 20% Director and retiring early (i.e. from age 60 but before Normal Retirement Age (NRA)), have you provided a letter from the Trustees to reduce the NRA to now? Have you completed additional forms such as an Annuity Application form or an AMRF/ARF? (If applicable and purchasing an Irish Life product) If you have tax credits that you wish to allocate to Irish Life to use for your taxable payment (if this option is available to you), have you contacted your Local Inspector of Taxes to obtain one and allocated them to Irish Life under employer registered number C? If your pension funds from all sources are in excess of 2,000,000, have you submitted a copy of your Personal Fund Threshold? If your tax-free lump sum payment is > 50,000 have you submitted a copy of your bank statement showing your Name, Address, BIC and IBAN? (There is no requirement to show any transactions on your account) 5

6 6 Irish Life Assurance plc is regulated by the Central Bank of Ireland. Irish Life Assurance plc, Irish Life Centre, Lower Abbey Street, Dublin 1. T: F: