Trval lump sum R5.1 Optons form Once you have flled n ths form, please return t wth the documents we have requested. You can ether post or emal the form and the documents to us. Premer PO Box 108 BLYTH NE24 9DY admn@premercompanes.co.uk Fll n ths form usng BLOCK CAPITALS and black nk. Mark answers wth an X. We wll already have sent you a quote, showng the possble trval lump sum avalable to you from ths penson. Ths optons form relates to that quote. Please provde your membershp reference number below, along wth your chosen retrement date. We cannot process your applcaton wthout ths nformaton. Please note that f you are marred or n a cvl partnershp, your husband, wfe or cvl partner also have to agree to ths trval lump sum beng pad by fllng n the declaraton on page 6. Membershp reference Your chosen retrement date If you choose to trvally commute a penson (take t as a cash lump sum), you have one year to complete ths process for all of your pensons. If you have never trvally commuted a penson before, and do so now, the retrement date you state below wll be your chosen nomnaton date for HM Revenue & Customs purposes. You then have one year from ths date to contact all of your other penson provders to commute your pensons (f ths s what you want to do). Trval lump sum quoted Please confrm the trval lump sum quoted on the llustraton. Ths amount could change f your date of retrement, the factors used to value the lump sum or the value of your money-purchase funds change. For your own beneft, we recommend you read your penson scheme s explanatory booklet before you decde how to take your penson. If you are not sure whether takng ths trval lump sum s n your nterests, you should take ndependent fnancal advce. R5V1 Page 1 of 8
R5.1 Trval lump sum About the retrement optons form Please fll n all sectons of the form and return t to us along wth copes of any two of the followng three documents: 1. Passport (photo page) 2. Drvng Lcence (photocard lcence) 3. Brth certfcate Parts of the opton form nclude questons set by HM Revenue & Customs whch you must answer. We cannot pay your benefts unless you answer all questons and sgn the declaraton at the end of the form. About you Your detals Mr, Mrs, Mss, Ms, Dr Frst names Surname Date of brth Sex Male Female Martal status Sngle Marred or n a cvl partnershp Dvorced or dssolved Date of marrage, dvorce, separaton or partner s death Separated Wdowed Address Postcode - Home phone Moble phone Emal address Natonal Insurance number Page 2 of 8
Trval lump sum R5.1 Payment detals Please confrm the account detals of where you want to have your lump sum pad to. Ths must be an account of whch you are ether the only or jont account holder. Lump sum amount Name of bank or buldng socety Address of you bank or buldng socety Postcode Sort code - - - Account number Account holders (names) Buldng socety roll number Only fll n the followng secton f you want your lump sum to be pad to an overseas bank account. Our partner, Western Busness Solutons, process all non-uk payments. For ths purpose we wll share your personal nformaton wth them. Ths wll nclude detals of your bank account. Payment s sent to your recevng bank n the local currency of the country n whch your overseas account s based. We do not offer any assurances, warrantes or guarantees over exchange rates whch can change each hour. We wll not be legally responsble for any local charges, fees or commsson taken by your recevng bank. Overseas account detals Terms and condtons I confrm that I have read and accept the terms and condtons about payng pensons to overseas accounts. Country Local currency Account holders (names) Bank SWIFT, BIC or ID IBAN (EEA only) Account number Bank name Bank address Page 3 of 8
R5.1 Trval lump sum Detals of your other pensons You wll not be able to take a trval lump sum f you have prevously swapped a small penson for a cash lump sum (trval commutaton) that would have been gven on or after 6 Aprl 2006 and that was pad more than ago. Queston 1 Have you ever taken all of a penson as a lump sum? Ignore any partal lump sums, we only want to know f you have gven up all of your penson for a lump sum n the past. No - go to queston 2. Yes - please fll n the followng secton wth detals of lump sums taken. Detals of lump sums pad to you Provde us wth detals below of each lump sum you have taken from each one of your penson schemes. Amount of lump sum pad Date lump sum pad to you Queston 2 Ignorng the State Penson, are you recevng any other pensons? You should gnore the State Penson and any husband s, wfe s, cvl partner s or dependants pensons beng pad to you. No - go to queston 3. Yes - please fll n the followng secton wth detals of your other pensons. Pensons currently beng pad to you Provde detals n ths secton of any pensons (other than the State Penson) beng pad to you now. Annual amount of penson Date penson pad from Queston 3 Have you ever transferred a penson out of the UK to another country? No - go to queston 4. Yes - please supply us wth a copy of your transfer statement showng the value and date of the transfer. Go to queston 4. Page 4 of 8
Trval lump sum R5.1 Detals of your other pensons Queston 4 Ignorng the state State penson, Penson, do do you have any other pensons that are not yet beng pad to pad you? to you? Ths ncludes amounts that you have bult up up n n personal pensons or or those wth another employer that have not yet come nto been payment. pad. No - go to declaraton. Yes - please fll n the followng secton wth detals of your other pensons. Pensons bult up elsewhere but not currently beng pad to you Provde detals n ths secton of any pensons (other than the State Penson) that you have bult up n other places. If you have more than three other pensons please provde ths same nformaton about your other pensons on a separate pece of paper and attach t to ths form when you send t back to us. 1. Frst other penson What type of penson s ths? Defned contrbuton (money purchase). Ths ncludes personal pensons. Current value of ths penson fund Defned beneft (fnal salary) Total annual value of ths penson 2. Second other penson What type of penson s ths? Defned contrbuton (money purchase). Ths ncludes personal pensons. Current value of ths penson fund Defned beneft (fnal salary) Total annual value of ths penson 3. Thrd other penson What type of penson s ths? Defned contrbuton (money purchase). Ths ncludes personal pensons. Current value of ths penson fund Defned beneft (fnal salary) Total annual value of ths penson Page 5 of 8
R5.1 Trval lump sum Declaraton Please remember that t s a serous offence to make false statements. The penaltes are severe and could lead to prosecuton. Important nformaton Premer and the Trustees of your penson scheme take prvacy very serously. Informaton use: We use the personal nformaton from ths form and any other nformaton that you gve us to: value your penson, mantan records for the purpose of payment of pensons, penson-related payments, penson communcaton, market research and to analyse statstcs. Informaton sharng: We wll release nformaton dsclosed on ths form to other companes wthn the Premer Pensons Management group of companes (and any future owners), the Trustee s professonal advsers, nsurance companes (where requested by the Trustees of your penson scheme or you), other servce provders who hold or process your data on our behalf and thrd partes to whom we are requred to transfer data by law or regulatory requrements (e.g. government and regulatory authortes). Fraud Preventon: We wll check the detals provded on ths form wth fraud preventon agences. If you gve false or naccurate nformaton and we dentfy fraud, we wll pass your detals to fraud preventon agences. Law-enforcement agences may access and use ths nformaton. We and other organsatons may also access and use ths nformaton to prevent fraud and money launderng, for example, when processng a clam to pay benefts. You can vew our Prvacy Notce here: https:// premeradmnstraton.co.uk/prvacy-notce/ Please contact us f you would lke to vew the Prvacy Notce specfc to your penson scheme. If you are marred or are n a cvl partnershp, your husband, wfe or cvl partner must also sgn the declaraton provded below. By acceptng the trval lump sum, you may be gvng up benefts that would have been pad to your next of kn when you de, so the trustees need to make sure everyone accepts gvng up all future clams for benefts from ths penson scheme. Sgned by you (the scheme member) Agreement I accept the trval lump sum payment as full and fnal settlement of all my penson benefts from ths penson scheme. In acceptng the trval lump sum, I understand that I wll gve up all rghts to any further benefts from ths penson scheme, both now and n the future, ncludng those of my next of kn f I de. Name (prnted) Sgnature and date X Sgned by your husband, wfe or cvl partner Does not apply Agreement Ths does not apply to my crcumstances. I accept the trval lump sum payment as full and fnal settlement of all current and future clams to benefts I may receve from ths penson scheme when my husband, wfe or cvl partner des. Name (prnted) Sgnature and date X Page 6 of 8
Trval lump sum R5.1 Informaton Identfcaton verfcaton Before we pay you any benefts we wll verfy your address and dentty usng an electronc dentty checkng servce. Usng a range of UK publc regsters, and credt agency reports, we wll automatcally verfy your dentty to make sure t matches our records. Ths process wll leave a search footprnt on your credt hstory record but wll not affect your credt ratng. All checks we perform wll be logged as ID check and these have no mpact on your credt ratng. If you do not meet the mnmum requrements of the dentty check we wll wrte to you to obtan further documents and nformaton n order to verfy your dentty. These measures are desgned to protect the penson scheme and ts members from fraudulent clams. If you would lke ths form n a dfferent format, such as large prnt, please contact us on 0800 122 3200 or emal admn@premercompanes.co.uk. Page 7 of 8
R5.1 Trval lump sum Returnng your form Before you send your form to us please make sure you have completed all of the followng steps. Fll n all sectons of the form double checkng mportant numbers and references such as your bank account number. Sgn the form confrmng your acceptance of the retrement quotaton. Enclose or attach copes of two of the three types of dentty documents outlned on page 2. Check wth your other penson provders the amount of penson and cash lumps sums you have already receved and provde ths nformaton on pages 4 and 5. Or, enclose or attach ther statements that confrm the amounts prevously pad to you. Post or emal your form and copes of your documents to us at the followng address. Premer PO Box 108 BLYTH NE24 9DY admn@premercompanes.co.uk Processng your applcaton It wll take about two weeks to process your optons form. We wll wrte to you once your lump sum payment has been setup. If you have any questons about ths form, or need help fllng t n, please contact us. Phone 0800 122 3200 (from outsde the UK +44 20 3727 9850) Emal admn@premercompanes.co.uk Onlne https://premeradmnstraton.co.uk/self-servce/ Page 8 of 8