Deed of Appointment and/or Retirement of trustees. The purpose of this deed is to appoint and/or retire trustees (with their consent).

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1 This deed may be used for policies issued by: Canada Life Limited Canada Life International Limited CLI Institutional Limited Canada Life International Assurance (Ireland) DAC Deed Appointment and/or Retirement trustees Deed The purpose this deed is to appoint and/or retire trustees (with their consent). This deed is provided as a draft to be considered by you and your pressional adviser. It is provided solely for general consideration. Notes No fewer than two trustees should remain to administer the Trust. The deed must be completed by the person(s) who has/have the power appointment (the Appointor) under the terms the Trust (this is normally the Settlor but may also be the Trustees you will need to refer to the Trust deed).

2 Please complete in BLOCK CAPITALS and tick small boxes where appropriate In this deed the singular includes the plural and the masculine includes the feminine (and vice versa) where the context so admits. Deed Appointment This Deed is made on the / / You must date this deed using the date that the last person signs BY The Appointor(s) named below in Part 1; The Continuing Trustee(s) (if any) named below in Part 2; The Retiring Trustee(s) (if any) named below in Part 3; and The New Trustee(s) (if any) named below in Part 4 WHEREAS 1. This deed appointment is in addition to and in accordance with the Declaration Trust (the Trust ) for the policy (the Policy ) shown in the Schedule below. 2. The Appointor, the Continuing Trustees (if any) and the Retiring Trustees (if any) are the current trustees the Trust. 3. The Appointor has the power to appoint new trustees. 4. The Continuing Trustee(s) (if any) want to remain as a trustee. 5. The Retiring Trustee(s) (if any) does not wish to remain as a trustee and wants to be discharged from the trusts created by the Trust. 6. The Appointor would like to appoint the New Trustee(s) (if any) to be a trustee the Trust to act jointly with him and the Continuing Trustee(s) (if any). NOW THIS DEED WITNESSES 1. The New Trustee(s) (if any) is appointed to act jointly with the Appointor and the Continuing Trustee(s) (if any) as Trustees for all purposes the Trust. 2. The Appointor agrees to the Retiring Trustee(s) (if any) being discharged from the Trust and from now, the Retiring Trustee(s) (if any) is discharged. Schedule Canada Life Limited Canada Life International Limited CLI Institutional Limited Canada Life International Assurance (Ireland) DAC Description policy(ies) Policy number(s) Policy date(s) 2 Deed Appointment and/or Retirement trustees

3 Please complete in BLOCK CAPITALS Part 1 The Appointor(s) (full name Appointor(s)) (address) Part 2 The Continuing Trustee(s) (full name Continuing Trustee(s)) (address) Part 3 The Retiring Trustee(s) (full name Retiring Trustee(s)) (address) Part 4 The New Trustee(s) / / / / (full name New Trustee(s)) Nationality Date birth (day, month, year) (address) We certify that: This instrument falls within Category A in the Schedule to the Stamp Duty (Exempt Instruments) Regulations Data Protection Notice The information you have provided in this form will be used in accordance with our data protection notice. A copy the relevant notice for Canada Life Limited can be found on or by request on , those for both Canada Life International Limited and CLI Institutional Limited can be found on and for Canada Life International Assurance (Ireland) DAC on or by request on Deed Appointment and/or Retirement trustees 3

4 Please complete in capital letters Signatures In witness the parties have executed this deed on the day and year mentioned above. Signed and delivered as a deed by the Appointor Print name Appointor Signature Appointor Signed and delivered as a deed by the Appointor Print name Appointor Signature Appointor Signed and delivered as a deed by the Continuing Trustee (if any) Print name Continuing Trustee Signature Continuing Trustee 4 Deed Appointment and/or Retirement trustees

5 Please complete in capital letters Signed and delivered as a deed by the Continuing Trustee (if any) Print name Continuing Trustee Signature Continuing Trustee Signed and delivered as a deed by the Retiring Trustee (if any) Print name Retiring Trustee Signature Retiring Trustee Signed and delivered as a deed by the Retiring Trustee (if any) Print name Retiring Trustee Signature Retiring Trustee Deed Appointment and/or Retirement trustees 5

6 Please complete in capital letters Signed and delivered as a deed by the New Trustee (if any) Print name New Trustee Signature New Trustee Signed and delivered as a deed by the New Trustee (if any) Print name New Trustee Signature New Trustee Please note that in order to comply with our regulatory obligations we may require documents to verify the identity and residential address individual policyholders, including trustees. We may use credit reference agency searches to verify the identity and address. Please note this will not affect anyone s credit rating. We reserve the right to ask for further documentation to confirm this. 6 Deed Appointment and/or Retirement trustees

7 Data Protection Notice Any personal information you may provide to Canada Life International Limited (CLI) or CLI Institutional Limited (CLII) as data controller will be treated in accordance with the Isle Man Data Protection Act Any personal information that you may provide to Canada Life International Assurance (Ireland) DAC (CLIAI) as data controller will be treated in accordance with the Data Protection Acts 1998 and Any personal information that you may provide to Canada Life Limited (CLL) as data controller will be treated in accordance with the Data Protection Act (CLI, CLII, CLIAI & CLL together will be defined as Canada Life in this notice). By signing this form you consent to Canada Life using and sharing your personal information as set out in this notice including, without limitation, the processing sensitive personal data. If submitting personal information about another person, by signing this form you confirm that you have their consent to provide such information to Canada Life and for their information to be used as set out in this notice. Using personal information Canada Life uses personal information to undertake any activity relating to its policies, products and services and, where relevant, to process applications, set-up and administer policies, products and services and handle any claims. Given the global nature Canada Life s business, it may be necessary to transfer information to countries outside the European Economic Area ( EEA ) in order to provide Canada Life s services. Sharing personal information Canada Life may share personal information: with other Canada Life group companies including those outside the EEA; with its relevant reassurers; with other companies, organisations and associations and/or credit reference agencies in order to prevent, detect or investigate financial crime or fraud; with approved service providers including providers medical services and opinions; with relevant industry bodies such as the Association International Life Offices, if appropriate; with the Isle Man Financial Services Authority; with the Central Bank Ireland; with the UK Financial Conduct Authority; with the UK Prudential Regulation Authority; with any other regulators with competent jurisdiction; with the Isle Man Financial Services Ombudsman Scheme; with Ireland s Financial Services Ombudsman s Bureau; with the UK Financial Ombudsman Service; with any other applicable financial services ombudsman schemes or supervisors; and in any circumstances if permitted or required to do so by law or if Canada Life has consent to do so. Where the information is being released to any the above, Canada Life may use electronic communications. Relevant industry bodies may share information about you collected by other insurance companies with the Company. Canada Life will not use your information to advise you other products and services fered by third parties or companies within the Canada Life marketing group. Accessing personal information A person whose personal information is held by Canada Life has various rights including the right to: have any incorrect personal information corrected; and/or access the personal information Canada Life holds for which a fee may be charged. To do so and/or if you need more information, please contact Canada Life. Requests and queries should be addressed to each company as appropriate: The Data Protection Officer Canada Life International Limited Canada Life House Isle Man Business Park Douglas Isle Man IM2 2QJ The Data Protection Officer CLI Institutional Limited Canada Life House Isle Man Business Park Douglas Isle Man IM2 2QJ The Data Protection Officer Canada Life International Assurance (Ireland) DAC Irish Life Centre Lower Abbey Street Dublin 1 The Data Protection Officer Canada Life Limited Canada Life Place Potters Bar Hertfordshire EN6 5BA Deed Appointment and/or Retirement trustees 7

8 Canada Life Limited, registered in England no Registered fice: Canada Life Place, Potters Bar, Hertfordshire EN6 5BA. Telephone: Fax: Member the Association British Insurers. Canada Life International Limited, registered in the Isle Man no Registered fice: Canada Life House, Isle Man Business Park, Douglas, Isle Man IM2 2QJ. Telephone: +44 (0) Fax: +44 (0) Member the Association International Life Offices. CLI Institutional Limited, registered in the Isle Man no C. Registered fice: Canada Life House, Isle Man Business Park, Douglas, Isle Man IM2 2QJ. Telephone: +44 (0) Fax: +44 (0) Member the Association International Life Offices. Canada Life International Assurance (Ireland) DAC, registered in Ireland no Registered fice: Irish Life Centre, Lower Abbey Street, Dublin 1, Ireland Telephone: +44 (0) Fax: +44 (0) Member the Association International Life Offices. Canada Life Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Canada Life International Limited and CLI Institutional Limited are Isle Man registered companies authorised and regulated by the Isle Man Financial Services Authority. Canada Life International Assurance (Ireland) DAC is authorised and regulated by the Central Bank Ireland. This paper is made from recycled materials CTU R

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