Personal Pension Plan

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1 Application to increase payments Who this form is for When we refer to Standard Life we mean Standard Life Assurance Limited This form can be used for Personal Pension Plan and Personal Pension One contracts This form is for people who want to: Increase regular payments Make single payments Make regular payments If you have not increased your payments or made a single or regular payment for the first time since 27 November 1995 you MUST complete this form For all other planholders you can either complete this form, write us a letter or call us on Filling in this form Before completing this form, please read the appropriate Key Features Document (PPO17) Important: the information in this application is required for Income Tax purposes It is a serious offence to give false statements The penalties are severe and could lead to prosecution You must also disclose all material facts A material fact is a fact that a reasonable customer would consider to be material in such a contract You must give honest and accurate answers to all of our questions If you do not do this then the terms of your contract may be affected, or your Personal Pension may be declared void If you are receiving advice from a financial adviser you should remember that the financial adviser is acting on your behalf not only by giving you advice, but also regarding completing this form 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 0518 If you have registered for enhanced or any type of fixed protection, you should not complete this form until you speak to your financial adviser By filling in this form, you are applying to enter into a contract with Standard Life If your application is accepted the terms and conditions relating to the contract (and a copy of your completed Application form) will be made available on request Did you know you can increase your regular payments or make single payments online? You can log in or register for our online servicing at wwwstandardlifecouk If this is your first payment increase since 27th November 1995, you will still need to fill out this form, but after that you can do it online May 2018 Page 01 of 16

2 Part 1 Your personal details Title (Mr/Mrs/Miss/Ms/ Other eg Dr/Rev) Date of birth (DD/MM/YYYY) Male Female Surname First and middle names National Insurance Number Marital status Single Married/civil partnership Separated Address Divorced/dissolved civil partnership Widowed/surviving civil partner Notes can be found on pages 10 and 11 House number Street City/Town County Postcode If you have moved address within the last 2 years, please provide details of your previous address: House number Street City/Town County Postcode Telephone (include area dialling code) Work Home Mobile Occupation Page 02 of 16 May 2018

3 Part 1 Your personal details (Continued) Employment Employed Self-employed Pensioner Caring for a child under 16 Caring for an adult In full time education If Other, please specify Your Standard Life Personal Pension number K Unemployed Other If you fall into more than one employment category please tick the most appropriate box If Other please specify You will find this number on the Policy Schedule you received when you first made payments or your yearly statement Part 2a Eligibility To be eligible to make payments to this plan, you must answer Yes to one of the following questions: 1 Are you resident in the UK for tax purposes? (see Note One, Parts B & D) Yes No 2 Are you a Crown Servant performing duties abroad, or the husband, wife or civil partner of such a Crown Servant? (see Note One, Part C) Yes No Part 2b Employees only 1 All employees must complete this part Please provide details of your employer Employer s name Employer s address Building number Street City/Town County Postcode 2 Are you a member of your employer s occupational pension scheme? (see Note One, Part E) 3 Have you opted out of an occupational pension scheme or are you planning to opt out of an occupational pension scheme in favour of making payments to this Plan? 4 Have you chosen not to join an occupational pension scheme which you are currently eligible to join, or which you will be able to join at the end of a specified waiting period, in favour of making payments to this Plan? Yes Yes Yes No No No May 2018 Page 03 of 16

4 Part 3 Increasing existing regular payments read Note Two If you recycle a tax free lump sum you may face a tax charge Our Recycling of Lump Sums leaflet (GEN449) explains what recycling means and what the tax consequences are Payments made by a third party can count as recycling Complete this part to increase existing regular payments You must make this increase using the existing method of payment Please give the gross amount of the increase only Monthly by Direct Debit (min 10), or Yearly by Direct Debit (min 100), or Yearly by cheque (min 100)* You Employer If you are already paying by Direct Debit, the amount debited from your account will increase automatically If you already pay by cheque, write a cheque for the full amount less basic rate tax Date of increase (MM/YYYY) Give the month and year that you want the increase in your payment to start If you are increasing a regular yearly payment, give the year only Automatic yearly increases Do you want your payments to increase automatically every year? Yes No If Yes, fill in one of the boxes below Increase in line with national average earnings, or Increase by between 1% and 10% of your previous year s payments % The gross amount is the total amount of money including basic-rate tax relief * This option is not available if you have a Personal Pension One If the existing payments to your plan already increase automatically each year you can choose for ALL payments (both existing and new) to either maintain the existing level of automatic increase, OR you can choose to change the level of automatic increase (fill in the Automatic yearly increases section in Part 3), OR you can choose to stop the automatic increases each year (tick the No box in this section) NB You must have the same level of increase for ALL regular payments to your Plan Page 04 of 16 May 2018

5 Part 4a Single or new regular payments read Note Two If you recycle a tax free lump sum you may face a tax charge Our Recycling of Lump Sums leaflet (GEN449) explains what recycling means and what the tax consequences are Payments made by a third party can count as recycling Complete this part to start making regular payments for the first time, or if you want to make a single payment Please give the gross amount Monthly by Direct Debit (min 40), or Yearly by Direct Debit (min 400), or Yearly by cheque (min 400)* You Employer To pay by Direct Debit, please complete the Direct Debit Instruction at the end of this form The gross amount is the total amount of money including basic-rate tax relief * This option is not available if you have a Personal Pension One To pay by cheque, write a cheque for the full amount less basic rate tax Date of first regular payment (DD/MM/YYYY) Choose a date between 1 st and 28 th of the month Automatic yearly increases Do you want your payments to increase automatically every year? Yes No If Yes, fill in one of the boxes below Increase in line with national average earnings, or Increase by between 1% and 10% of your previous year s payments % Single Payments You Employer Amount of single payment (min 500) Part 4b How your payments are deducted by your employer Single payments can be made online or by cheque Write the cheque for the full amount less basic rate tax, made payable to Standard Life Assurance Limited Will your employer deduct payments from your salary? Yes No If Yes, are these payments taken via Salary deduction or Salary sacrifice? If Yes, on which date will your employer start deducting payments from your salary? Salary deduction Date (DD/MM/YYYY) Salary sacrifice If Yes, will your payments be deducted Weekly Monthly Other If Weekly, which day of the week will they be deducted on? (Day of week) If Monthly, which date in the month will they be deducted on? (Date of month) If Other, please give details Salary deduction is where your net payments are deducted from your salary and passed to Standard Life by your employer Salary sacrifice (sometimes called Salary exchange) is where you give up part of your normal salary in return for an employer payment to your pension plan We need to be able to tell when each increase in payment is deducted from your salary For example, for a regular payment due to be paid to Standard Life in January, please advise the pay date(s) the payment will be deducted from your salary (DD/MM/YYYY) May 2018 Page 05 of 16

6 Part 4c Money Laundering Regulations 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 Part 5 Your investment choice read Note Three Please choose your fund(s) from the booklet How to choose the right options for your pension and complete the details in the boxes below You can choose to invest in more than 1 fund, but you must ensure that the total percentage adds up to 100% Please note that if you choose a Lifestyle profile and wish to combine this with another investment fund, you can only combine this with the with profits fund available to you Please refer to the booklet How to choose the right investment options for your pension (GPEN4R) for details on the with profits fund applicable to your plan It is not possible to select more than one Lifestyle profile at a time Fund code Fund name (in full) % FA Standard Life PENSION MANAGED ONE FUND EXAMPLE 100 Important Please note that the fund code(s) and the FULL fund name(s) must be included on this form, as shown in the example opposite, in order for us to process your application If we do not have this information we may have to return your application Please refer to the booklet How to choose the right investment options for your pension (GPEN4R) for details of the funds available to you You can switch your payments in and out of various funds to change the mix of investments We may delay switching in some circumstances You can only invest in 12 funds at any one time The maximum number of different funds you can invest in during the term of your plan is 20 Please ensure the total percentage adds up to 100% 100% Page 06 of 16 May 2018

7 Part 6 Payment protection and life cover read Note Four You should complete this part and fill in a supplementary health questionnaire (PEN30) if you: have payment protection for your existing pension payments Do you have payment protection for your existing regular payments? Yes No If Yes, it will now apply to your additional regular payments with the following exception Payment protection cannot be provided for policies started after April 2001 Life Cover If you already have life cover, you might be able to increase the type of cover which you already have: Additional Life Cover or Minimum Death Benefit (see note below) The increased cover will be paid for on the same basis as the existing life cover Additional Life Cover (You should give just the amount of the increase NOT the total amount of life cover you now wish to have) Additional Life Cover provides a specified lump sum in addition to the value of your pension fund Who will pay for the additional life cover? You Employer OR (This option is not available unless you already have this Minimum Death type of life Benefit cover If you are increasing your life cover, you should just give the amount of the increase NOT the total amount of the life cover you now wish to have) Minimum Death Benefit provides a specified lump sum or the value of your pension fund, whichever is greater For this purpose your pension fund means the fund which is held under the 1,000 policies which receive your regular and single payments Note: You will not be able to increase your life cover if: it is paid for by cancelling units under your pension policies, and your Plan started before 27 November 1995 and, prior to 6 April 2001, you had not made a single payment or an additional regular payment since 27 November 1995 May 2018 Page 07 of 16

8 Part 7 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 eg 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 (eg 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 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, the Philippines 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 eg 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 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 StandardLifeAberdeencom Offers of interest from our preferred partners No Yes To understand how, where and why we use your information, read our Privacy Policy Part 8 Putting the additional payments under trust Do you want your additional payments to your Plan to be written under trust? Yes If you have answered Yes : you will need to complete an assignment if your Plan is already written under trust, or you will need to complete a trust deed if your Plan is not already written under trust No If you already have 1000 policies to receive your regular and/or single payments and those policies are under trust, your additional payments are automatically covered by that trust We will send you a draft trust deed or deed of assignment when we issue your Policy Schedule or Acceptance Page 08 of 16 May 2018

9 Part 9 Declaration Declaration by Standard Life If Standard Life Assurance Limited accepts this Application, it hereby agrees as administrator and provider in terms of the rules of the Scheme to administer the Scheme as required by the rules Your declaration 1 I, the person named in Part 1 of this Application, request that the benefits described in or arising from this Application be provided for me under the Standard Life Appropriate Personal Pension Scheme or the Standard Life Appropriate Personal Pension Scheme No 2 as determined by the Personal Pension number given in Part 1 If my Application is accepted, I undertake to be bound in all respects by the rules of the Scheme in force from time to time 2 I declare that to the best of my knowledge and belief, the statements made in this Application, whether in my handwriting or not, are correct and complete 3 I request the administrator of the Scheme to treat this form as an application for 1,000 arrangements for the regular and single payments specified in this form (and any future payments selected by the administrator) unless I already have a series of 1,000 arrangements into which these payments will be made (If your Plan started before 27 November 1995 and this is the first time you have paid a single payment or an additional regular payment since that date, we ll create a new series of policies under your Plan to receive the additional payments and any subsequent payments you may make) 4 I declare that the total payments to any registered pension scheme, in respect of which I am entitled to relief under section 188 of the Finance Act 2004, will not exceed the higher of the basic amount or my relevant UK earnings, within the meaning of section 189 of that Act, for that tax year (The basic amount for the current tax year is 3,600 gross This may change in future tax years) 5 I declare that I will tell Standard Life if an event occurs (such as those listed in my Key Features Document) as a result of which I will no longer be entitled to relief for my payments under section 188 of the Finance Act 2004 I will do so before the end of the tax year in which the event occurs, or within 30 days of the event if this is later 6 I understand that, where I am receiving advice from a financial adviser, the adviser is acting on my behalf 7 I have read the notes on pages 10 and 11 of this form and the Direct Debit Instruction on pages 11 and 12 8 I have read and understood the Data Protection Notice I agree that my personal data (including special category data) may be used for the purposes described (subject to me exercising my right not to be contacted with details of other products and services) Signature Date (DD/MM/YYYY) Signature required Please ensure you send either your cheque or Direct Debit Instruction (on page 12) together with this Application form May 2018 Page 09 of 16

10 Notes Note One This will help you complete Parts 1-2b The descriptions and definitions given in these Notes are to help you complete this form and are not binding in law The descriptions which apply are those set out in the legislation If you are in any doubt you should contact a pensions practitioner, the Scheme Administrator, your accountant or, where appropriate, your Inspector of Taxes a) Civil partnership is a legal contract between two partners of the same sex b) If you are in any doubt as to whether or not you are resident in the UK, (this can also apply to a period of residency within the current tax year), you should check with your UK tax inspector If you cease to be resident in the UK, you can still make payments in a year of assessment as long as you were so resident at any time in the previous 5 tax years c) If you are in any doubt as to whether or not you or your husband/wife/civil partner are a Crown Servant performing duties abroad, you should check with your payroll department d) If you are not resident in the UK for tax purposes, you must provide evidence of your earnings before you can make payments to this scheme This evidence must be either: 1 a copy of a payslip for the current year, or 2 a declaration from your employer that you have a source of earnings in the UK e) An occupational pension scheme is an employer s pension scheme which promises to provide you with a pension or a pension and a lump sum on your retirement It does not include: 1 this scheme or any other stakeholder or personal pension scheme even if your employer makes payments to it; 2 any scheme which pays benefits only on your death; or 3 any scheme which is not registered with HM Revenue & Customs The scheme is not necessarily run directly by your employer It may be a scheme for employees within a particular trade or industry run by a representative body and to which your employer makes payments Note Two Payments When you increase existing payments all other aspects of your Plan remain the same You can refer to your original Application form Standard Life can send you a copy of this If you have an employer who also wants to make payments to your Plan, the minimum figures are your own and your employer s added together You do not have to complete a Direct Debit if your employer is deducting payments from your salary and forwarding them to us If your employer is making regular payments, both your payments should be made on the same day and in the same way If you have elected to have your payments increase every year you will always be notified of any increase before you pay it If your employer has chosen to increase their payments automatically your own payments will increase at the same rate The payments specified in this form will be used to start 1,000 policies unless you already have 1,000 policies to receive your regular and single payments (Each policy is an arrangement for the purposes of the rules of the Scheme) If you (or your employer) start to make any regular payments or make a single payment after these polices are set up, those payments will normally be applied to these policies Page 10 of 16 May 2018

11 Notes (continued) Note Three Your Investments If you select one of our Lifestyle profiles, your assets will automatically be moved, currently free of charge, into less volatile funds in the years before your Selected Pension Age The Lifestyle Profiles are fully explained in the booklet Lifestyle Profiles: Retail Pension Fund (GPEN41) If your existing Plan is not invested in one of our Lifestyle profiles and you want to select this for your new payments, then the existing Plan will also have to be invested that way (with the exception of investments in the with profits funds) If the existing Plan is invested in one of our Lifestyle profiles, new payments will be invested in the same way A complete list of funds can be found in the booklet How to choose the right investment options for your pension (GPEN4R) Until your application is accepted, Standard Life s liability is limited to a return of the payments you have made Note Four Payment Protection The cost of protecting your payments is made by cancelling units in your fund each month If you have payment protection but decide later that you do not want it, you can stop it by writing to Standard Life Filling in your Direct Debit Instruction You should complete the Direct Debit Instruction if: you have chosen to start paying regular monthly or yearly payments by Direct Debit, or you wish to increase the amount of regular payments you currently make by Direct Debit, and your bank details have changed Your employer should complete the Direct Debit Instruction if: they have chosen to make regular payments by Direct Debit, or they have chosen to increase the amount of regular payments they currently make by Direct Debit, and their bank details have changed, or they have agreed to collect your own payments from you and pay them directly to us If a Direct Debit Instruction is required, please ensure that it is signed and dated before returning it to Standard Life, with your completed Application May 2018 Page 11 of 16

12 Completing your Direct Debit Instruction Completion of your Direct Debit Instruction 1 Complete this form to instruct your Bank/Building Society to make payments directly from your account 2 If the due date falls on a weekend or Bank Holiday, your account will be debited within two working days 3 Please ensure that the Instruction is signed and dated and the Direct Debit Guarantee is detached before the Instruction is returned to Standard Life Instruction to your Bank or Building Society to pay by Direct Debit Issued by: Standard Life, Standard Life House, 30 Lothian Road, Edinburgh EH1 2DH Please supply the following details: The Manager Originator s identification no For Standard Life official use only This is not part of the Instruction to your Bank or Building Society Name and full postal address of your Bank or Building Society branch Name(s) of Account-holder(s) Postcode Bank or Building Society Account No Branch Sort Code Reference Number Please refer to the top right hand corner of your cheque book Your Instruction to the Bank/Building Society, and Signature Please pay Standard Life Direct Debits from the account detailed in this instruction subject to the safeguards assured by the Direct Debit Guarantee I understand that this Instruction may remain with Standard Life and, if so, details will be passed electronically to my Bank/Building Society Signature Date (DD/MM/YYYY) Signature required Page 12 of 16 May 2018

13 Financial Adviser s details Intermediary Reference Number Name of contact (maximum 25 characters) Location Basis of sale Whole of market Other If Other, please specify Was advice given? Advice No Advice (eg Execution only) Money laundering FCA or Authorisation number Money laundering form completed and attached May 2018 Page 13 of 16

14 Page 14 of 16 May 2018

15 May 2018 Page 15 of 16

16 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 wwwstandardlifecouk Standard Life Aberdeen, images reproduced under licence All rights reserved May 2018 Page 16 of 16 The Direct Debit Guarantee This Guarantee is offered by all banks and building societies that accept instructions to pay Direct Debits If there are any changes to the amount, date or frequency of your Direct Debit Standard Life International will notify you 5 working days in advance of your account being debited or as otherwise agreed If you request Standard Life International to collect a payment, confirmation of the amount and date will be given to you at the time of the request If an error is made in the payment of your Direct Debit by Standard Life International or your bank or building society you are entitled to a full and immediate refund of the amount paid from your bank or building society If you receive a refund you are not entitled to, you must pay it back when Standard Life International asks you to You can cancel a Direct Debit at any time by simply contacting your bank or building society Written confirmation may be required Please also notify us Important, please tear off and keep safely

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