ADVISED COFUNDS PENSION ACCOUNT DRAWDOWN TRANSFER APPLICATION FORM for new clents Also avalable on the Aegon webste: Cofunds Penson Account Drawdown Transfer Request Form - transfer a scheme from whch you are takng benefts through capped or flex-access drawdown to an exstng Cofunds Penson Account. Cofunds Penson Account Flex-access Drawdown Form - take drawdown ncome or a tax-free lump sum from an exstng plan through flex-access drawdown. The Cofunds Penson Account s provded by Suffolk Lfe. We recommend that you complete ths form n conjuncton wth your advser. Ths form must be completed when you wsh to apply for a new Cofunds Penson Account by transferrng a scheme from whch you are already takng benefts through ether capped or flex-access drawdown. It s not ntended for annuty purchase. Please talk to your advser about settng up sell down optons before completng ths form. Please complete ths form and return t to: Aegon Cofunds Admnstraton, PO Box 17491, Ednburgh, EH12 1PB Before applyng you should make sure you have read the followng documents whch form part of the agreement: Key Features of the Cofunds Penson Account Terms and condtons of the Cofunds Penson Account Charges Sheet Personal Illustraton Suffolk Lfe Prvacy Informaton Notce (for nvestors) In addton to these you wll need to read these mportant documents: Aegon Platform terms and condtons The Fund Key Features Key Investor Informaton Documents The Aegon Platform Key Informaton Document These documents set out the terms of busness of Aegon for holdng your Cofunds Penson Account assets on the Aegon Platform and the key elements of the funds that are to be held wthn your penson account. Secton 1 Clent detals 1A. New clent detals Investor number (f applcable) 3 Mr/Mrs/Mss/Ms/Other - please specfy Full forename(s) Surname Home telephone number Country of resdence Work telephone number We requre evdence of your age before we can pay benefts from your penson, ths wll be obtaned by electronc verfcaton. When completng date felds please use the usual DD/MM/YYYY format. Natonalty Emal address I confrm that I m solely UK resdent for tax purposes and not a US ctzen 4 If you can t confrm and tck the box above, please download and complete the Indvdual Self-Certfcaton Form from the Aegon webste. Date of brth / / Male 4 Female 4 Natonal Insurance Number / / I don t have a Natonal Insurance Number 4 1B. New clent address detals Permanent resdental address Prevous address If tme at current address s less than two years Cofunds Penson Account Drawdown Transfer Applcaton Form 1
Secton 1 Clent detals contnued 1C. Spouse s/regstered cvl partner s detals (f applcable) Are you marred or n a regstered cvl partnershp? 4 No (go to Secton 1D) 4 Yes Spouse s/regstered cvl partner s date of brth / / Spouse s/regstered cvl partner s gender Male 4 Female 4 1D. Source of funds Please tck one or more of the followng whch you ntend to use to fund your Cofunds Penson Account. 4 Transfers from a regstered penson scheme 4 Personal contrbutons 4 Contrbutons from your employer - complete below and Sectons 9D, 9E and 9F for the employer Relatonshp 4 Lottery and other gamblng wnnngs 4 Penson sharng order 4 Contrbutons from another thrd party - complete below and Sectons 5B, 9E and 9F for the thrd party Relatonshp 4 Other, please specfy Ths nformaton wll be used to produce your annual statement. 1E. Antcpated retrement age Please enter an age from 55 to ndcate when you ntend to start takng benefts. Ths does not affect your rght to begn takng benefts at any age permtted. 1F. Employment status Occupaton Please ndcate below whch stuaton s applcable to you (tck one box only): 4 Employed - please provde your employer s detals below. Employer name Employer address If ths feld s left blank we wll assume you ntend to start takng benefts at age 75. 4 Unemployed 4 Recevng a penson chargeable to tax 4 Carng for a person aged 16 or over 4 Carng for one or more chldren under the age of 16 years 4 In full tme educaton 4 Self-employed - f tradng under a dfferent name please wrte t n the box below 4 Other - f you have tcked ths box, please gve detals below Cofunds Penson Account Drawdown Transfer Applcaton Form 2
Secton 1 Clent detals contnued 1G. Money Purchase Annual Allowance (MPAA) Please confrm whether you have trggered the MPAA: 4 Yes 4 No Date of MPAA trgger / / Scheme where trgger occurred The MPAA from 6 Aprl 2017 s 4,000. Secton 2 Scheme to be transferred 2A. Scheme detals Full name of transferrng scheme Type of scheme beng transferred (e.g. personal penson) of scheme admnstrator/ trustee/nsurance company Scheme admnstrator/trustee/ nsurance company address Please check wth the current scheme provder f dscharge forms are requred. If so, please enclose them wth ths form. Polcy/account number (f applcable) Transfer value Is the transferrng scheme a full or partal transfer? Full 4 Partal 4 Is the transferrng scheme a defned benefts penson scheme, for example, a fnal salary scheme? 4 Yes 4 No does the transferrng scheme nclude: Guaranteed Annuty Rates Yes 4 No 4 If you are not sure, please check wth your current scheme. Any other safeguarded benefts that provde a guarantee or promse such as Guaranteed Mnmum Penson (GMP) or guaranteed growth rates Yes 4 No 4 4 I confrm that a sutably authorsed fnancal advser recommended that I transfer the scheme. We wll not accept ths transfer unless you have receved a recommendaton from a sutably authorsed fnancal advser to transfer the scheme. If the advser/ntermedary named n Secton 9 gave ths advce they wll be requred to sgn and complete Secton 9. If they ddn t gve ths advce but you would stll lke to transfer the scheme you are requred to seek transfer advce from an authorsed advser who should confrm ther recommendaton to transfer by completng Appendx I. 2B. Transfer state Are the funds n ths scheme: 4 Your own 4 Inherted from a deceased person f so, are you: 4 A dependant 4 A nomnee 4 A successor 4 Both - If both, please complete a separate copy of Secton 2 for each arrangement beng transferred. Cofunds Penson Account Drawdown Transfer Applcaton Form 3
Secton 2 Scheme to be transferred contnued Is ths scheme: 4 Partal drawdown state below whether the scheme s n flex-access or capped drawdown and complete Secton 3. Value of plan n drawdown Value of plan not n drawdown 4 Flex-access drawdown 4 Capped drawdown we also requre the followng nformaton about the scheme you are transferrng: Reference date / / If you take ncome from members flex-access drawdown, the money purchase annual allowance (MPAA) wll start to apply to you f t does not already. Ths means that contrbutons to your money purchase pensons wll be lmted to 4,000. Maxmum permtted ncome Taxable ncome taken to date n the current reference year Swtch to flex-access drawdown upon transfer to the Cofunds Penson Account? Yes 4 No 4 If yes, and f n Secton 9 your advser has confrmed you have not receved advce on swtchng to flex-access drawdown, t s mportant that you consder the rsks that may be assocated wth takng retrement benefts. We strongly advse you to seek fnancal advce before proceedng, especally f you re unsure how your current or future needs may nfluence your decson. Please complete the rsk questons n Secton 8. 2C. Assets to be transferred 4 The transfer payment wll comprse only cash 4 Assets are to be transferred as nvestments. Please ensure that the current scheme admnstrator permts ths. Please nclude one of the below: 4 A full fund lst ncludng the number of unts and SEDOL codes s enclosed 4 A completed Cofunds Penson Account Investment Transfer Schedule s enclosed Any funds that are not avalable n the Cofunds Penson Account must ether be sold before the transfer s made or reman wth the current scheme. 2D. Transfer Request Declaraton Please note: t s a serous offence to make false statements. The penaltes are severe. False statements could lead to prosecuton. Please read and sgn the declaraton below to authorse the transfer(s): I declare that to the best of my knowledge and belef the statements made n ths secton (whether n my handwrtng or not) are correct and complete. I hereby consent to Suffolk Lfe obtanng detals from the admnstrator/trustee or nsurance company or other penson provder of any scheme, contract or arrangement of whch I am or have been a member n connecton wth the transfer, and authorse the gvng of such detals to Suffolk Lfe. I also consent to my ntermedary obtanng the same detals. Whle Suffolk Lfe wll request transfers n a tmely manner, I understand that Suffolk Lfe s not responsble for the tmely completon of the transfer. I understand that Suffolk Lfe wll not request any n spece transfer untl all of the nformaton requested n the Investment Transfer Schedule has been provded. I wsh for the penson scheme benefts detaled above to be transferred to my Cofunds Penson Account. I understand that a drawdown arrangement can only be transferred n full and not n part. Declaraton to the admnstrator of the transferrng scheme(s): I authorse and nstruct you to transfer funds from the plan(s) as lsted above drectly to Suffolk Lfe. Where you have asked me to gve you any orgnal polcy document(s) n return for the transfer of funds and I am unable to do so, I promse to accept responsblty for any clams, losses and expenses of any nature whch you may ncur as a result of havng made the transfer(s) lsted above. I authorse you to release all necessary nformaton to Suffolk Lfe to enable the transfer of funds to Suffolk Lfe. I authorse you to obtan from, and release to, the fnancal ntermedary named n Secton 9 any addtonal nformaton that may be requred to enable the transfer of funds. If an employer s payng contrbutons to any of the plans as lsted n Secton 2, I authorse you release to that employer any relevant nformaton n connecton wth the transfer of funds from the relevant plan(s). Untl ths applcaton s accepted and complete, Suffolk Lfe s responsblty s lmted to the return of the total payment(s) to the admnstrator of the transferrng scheme(s). Where the payment(s) made to Suffolk Lfe represent(s) all of the funds under the plan(s) lsted n Secton 2, then payment made as requested wll dscharge the admnstrator of the transferrng scheme of all clams and responsbltes n respect of the plan(s) lsted. Where the payment(s) made to Suffolk Lfe represent(s) part of the funds under the plan(s) lsted n Secton 2, then the admnstrator of the transferrng scheme wll be dscharged of all clams and responsbltes only n respect of the part of the plan(s) represented by the payment(s). Declaraton to Suffolk Lfe and the admnstrator of the transferrng scheme(s): I promse to accept responsblty n respect of any clams, losses and expenses that Suffolk Lfe and the admnstrator of the transferrng scheme may ncur as a result of any ncorrect nformaton provded by me or of any falure on my part to comply wth any aspect of ths transfer form. Clent sgnature Date / / Clent name Cofunds Penson Account Drawdown Transfer Applcaton Form 4
Secton 3 Income payment detals 3A. How do you wsh to take benefts from your Cofunds Penson Account? Intal gross annual ncome requred 4 Whole fund 4 Nl 4 Other, please specfy amount each year Type of ncome payment 4 Sngle 4 Regular If regular, frequency of ncome 4 Monthly 4 Quarterly 4 Half-yearly 4 Yearly Month of frst ncome payment / All ncome payments wll be made on the last busness day of the month. We wll contnue to pay the same amount of taxable ncome n future years untl you nform us otherwse. When you frst begn to take ncome, your payments may be subject to an emergency tax code. Ths may result n you ntally payng too much, or too lttle tax to HMRC. We can only accept tax code notfcatons from HMRC drectly, or from an orgnal P45. 3B. Optons for makng sngle ncome payments To make a sngle ncome payment from a Cofunds Penson Account you must ensure that you have enough money avalable wthn the Cofunds Penson Account before submttng ths request. You may have to manually sell funds before submttng ths request otherwse we may not be able to process your request. 3C. Optons for makng regular ncome payments 4 I confrm that I have an actve sell down opton For more nformaton about settng up a sell down opton, please see the Aegon Platform terms and condtons. You wll only see a record of sell downs n your annual statement. 3D. Personal bank account to receve ncome payments Please ndcate below (completng one box only) whch bank account you requre benefts to be pad. BACS, Faster Payments or CHAPS Transfer to your nomnated bank account Bank or Buldng Socety name (s) of account holder(s) Branch Sort Code / / Bank/Buldng Socety Account Number We are only able to make payments to a personal account n your own name, ncludng jont accounts. In addton, payment may only be made to a UK bank account or to an account that can accept BACS, Faster Payments or CHAPS payments. Please speak to your bank f you have any questons as to whether your account s sutable. Income payments wll always be pad by BACS. Buldng Socety Roll Number Cofunds Penson Account Drawdown Transfer Applcaton Form 5
Secton 4 Investment transfer schedule A full valuaton of the fund s enclosed ncludng SEDOL codes. 4 A SEDOL code s requred n order to dentfy the exact nvestment to be transferred. Many nvestments have smlar names and as such we are unable to proceed solely on a fund name. 4A. Investment detals If a full fund valuaton from the current scheme admnstrator s submtted n place of ths schedule, t must contan all of the nformaton requested here. Where full nformaton s not provded as part of a valuaton or va ths schedule, we wll need to request ths agan and the transfer could be delayed. Once we receve the completed schedule we wll check the acceptance of the nvestments wthn the Cofunds Penson Account before requestng the transfer from the current provder. If any nvestment s not acceptable, we wll contact you to dscuss how to proceed. Full name of scheme to be transferred 4 Only nvestments that are currently avalable on the Aegon Platform can be transferred to your clent s Cofunds Penson Account. Full name of nvestment (example) World Equty Z Fund SEDOL number (example) 0157735 Where nvestment s currently held (example) Plan Manager Number of unts/shares held Please contnue on a separate sheet f requred. Cofunds Penson Account Drawdown Transfer Applcaton Form 6
Secton 5 Contrbuton request Ths secton must be completed when you are: (please tck all the applcable opton(s) below) 4 Makng a one-off sngle contrbuton; or 4 Startng a regular contrbuton Please use an Investment strategy nstructon form to tell us how you want to nvest your contrbutons 5A. Contrbutons Personal contrbutons that are wthn 100% of relevant UK taxable earnngs wll receve tax relef at basc rate (hgher and addtonal rate tax reclamable va self assessment where approprate) and count towards the annual allowance for the tax year n queston. For further nformaton see notes below. of ndvdual makng contrbuton(s) Who s fundng the penson? 4 Clent 4 Employer (complete and enclose a separate Cofunds Penson Account Employers Contrbuton Authorty) 4 Thrd party (complete Secton 5B) Personal (net) 1 Employer (gross) Thrd party (net) 1 Sngle contrbutons (Cheque) Sngle contrbutons Aegon General Investment Account cash faclty N/A N/A Total regular contrbutons, ncludng exstng contrbutons Please complete a copy of the Cofunds Penson Account Investment by Drect Debt form n Secton 6 for each regular contrbuton. If there s not suffcent tme to set up the Drect Debt nstructon, payments wll commence the followng month. 1 Net contrbutons are subject to tax relef whch can take between 6 and 11 weeks to reach the product cash faclty. Cheques must be made payable to Cofunds Lmted. For a Buldng Socety cheque or banker s draft your name must appear on the front of the cheque, or on the back of the cheque accompaned by the Buldng Socety s or Bank s offcal stamp and sgnature. Aegon must receve ths form and the completed Drect Debt nstructon 9 workng days before the collecton date of the 1st of the month. 5B. Thrd party detals (f requred) Customer number (f applcable) 3 Mr/Mrs/Mss/Ms/Other - please specfy Full forename(s) Surname Permanent resdental address Relatonshp to applcant Date of brth / / Male 4 Female 4 If ths secton s completed then the thrd party must be verfed n Sectons 9D, 9E and 9F f not prevously verfed. If the ndvdual has changed address n the last three months please provde ther prevous address and postcode on a separate sheet of paper securely stapled to ths form. 5C. Clent Tax Status Please ndcate below whch of the followng apples to you: 4 You are a relevant UK ndvdual A relevant UK ndvdual s one who: Has relevant UK earnngs chargeable to ncome tax for the year; Is resdent n the UK at some tme durng the tax year; Has general earnngs for the tax year from overseas Crown employment subject to UK tax (as defned by Secton 28 of the Income Tax (Earnngs and Pensons) Act 2003); or Is the spouse of an ndvdual who has general earnngs for the tax year from overseas Crown employment subject to UK tax (as defned by Secton 28 of the Income Tax (Earnngs and Pensons) Act 2003). Personal contrbutons that are n excess of 100% of relevant UK taxable earnngs do not receve tax relef and do not count towards the annual allowance for the tax year n queston. 4 You are a non-relevant UK ndvdual You are enttled to contrbute any amount, but you wll not be enttled to receve any tax relef on your contrbutons. Cofunds Penson Account Drawdown Transfer Applcaton Form 7
Secton 5 Contrbuton request contnued 5D. Notes All contrbutons must be made n Sterlng. Under current pensons legslaton there are penaltes f you, your employer and any other thrd party contrbute together more than the annual allowance to all of your pensons unless you can carry forward any annual allowance that you have not used from the prevous three tax years. You wll need to have been a member of a regstered penson scheme n a tax year that you are carryng forward any unused annual allowance from. It wll be your responsblty to calculate the amount avalable to carry forward and we wll apply for tax relef on the full amount of any personal contrbutons made by you or any other thrd party than your employer, unless you notfy us to the contrary. If you have already taken benefts under flexble drawdown from any penson scheme, ncludng your CPA, then you cannot make further contrbutons. Smlarly f contrbutons are made n a tax year then you cannot enter flexble drawdown n that tax year. Please speak to your advser for more nformaton. For employer contrbutons to receve tax relef, they must be wholly and exclusvely for the purposes of trade as defned by ICTA 1988. HMRC have ssued gudance for employers to help defne ths, ncludng pages on the onlne RPSM. Tax relef on personal net contrbutons All relevable personal contrbutons must be made net of basc rate tax, whch Suffolk Lfe wll reclam from HM Revenue & Customs and add to your Cofunds Penson Account. Ths can take up to 11 weeks. Please note that you are requred to nform us n wrtng f the aggregate of all contrbutons made for your beneft s more than 100% of your earnngs to ths and any other penson scheme you may have n a sngle tax year. Penson nput perods The penson nput perod for the Cofunds Penson Account wll end on 5 Aprl each year. Electronc transfers Personal and employer regular contrbutons cannot be accepted electroncally nto the Cofunds Penson Account and should be made by Drect Debt. For sngle contrbutons, please contact us to confrm the bank detals to whch payments should be sent. Aegon requre confrmaton of the bank detals from whch payments wll be made before contrbutons can be processed. Cofunds Penson Account Drawdown Transfer Applcaton Form 8
Secton 6 Investment by Drect Debt Ths form must be completed when settng up or amendng a regular contrbuton to a Cofunds Penson Account. If both you and your employer ntend to make regular contrbutons, please use an addtonal Drect Debt nstructon. Instructon to your Bank or Buldng Socety to pay by Drect Debt Please fll n the whole form usng a ballpont pen and send t to: Aegon Cofunds Admnstraton PO Box 17491 Ednburgh EH12 1PB (s) of account holder(s) or name of corporate bank account Banks and Buldng Socetes may not accept Drect Debt nstructons from some types of account. Branch sort code / / Bank/Buldng Socety account number and full postal address of your Bank or Buldng Socety To the Manager of Bank or Buldng Socety Servce User No. 3 8 8 5 5 1 Reference Number Instructon to your Bank or Buldng Socety Please pay Suffolk Lfe Trustees Lmted Drect Debts from the account detaled n ths nstructon subject to the safeguards assured by the Drect Debt Guarantee. I understand that ths nstructon may reman wth Suffolk Lfe Trustees Lmted and, f so, detals wll be passed electroncally to my Bank/ Buldng Socety. Sgned Date / / Sgned Date / / The Drect Debt Guarantee Ths Guarantee s offered by all Banks and Buldng Socetes that accept nstructons to pay Drect Debts If there are any changes to the amount, date or frequency of your Drect Debt Cofunds Lmted wll notfy you fve workng days n advance of your account beng debted or as otherwse agreed. If you request Cofunds Lmted to collect a payment, confrmaton of the amount and date wll be gven to you at the tme of the request If an error s made n the payment of your Drect Debt, by Cofunds Lmted or your Bank or Buldng Socety, you re enttled to a full and mmedate refund of the amount pad from your Bank or Buldng Socety - If you receve a refund you re not enttled to, you must pay t back when Cofunds Lmted asks you to You can cancel a Drect Debt at any tme by smply contactng your Bank or Buldng Socety. Wrtten confrmaton may be requred. Please also notfy Cofunds. Ths Guarantee should be detached and retaned by the payer. Cofunds Penson Account Drawdown Transfer Applcaton Form 9
Secton 7 Expresson of wsh 7A. Who should receve benefts? You should complete ths secton to tell us who you wsh to receve benefts from your plan f you de. Please confrm how you would lke your benefcares to be updated: 4 I would lke the benefcares below to apply to all of my penson funds. 4 I would lke the benefcares below to apply to my drawdown funds only. Please refer to the Terms and Condtons of the Aegon Platform for your plan detals of the dfferent ways death benefts may be receved. 7B. Declaraton Please read the declaraton before enterng detals of benefcares. On my death, I wsh the scheme admnstrator to pay any benefts from my plan(s) to the benefcares, and n the proporton set out below. I accept that ths s only an expresson of my wshes. I understand that whlst the scheme admnstrator wll pay due consderaton to those wshes, they have absolute dscreton as to the benefcary(es) and to the proportons of benefts pad to each benefcary unless otherwse provded by law. I understand that f the scheme admnstrator chooses a benefcary who has not been named n sectons 7C or 7D, drawdown ncome would normally only be avalable n lmted crcumstances. Therefore, n addton to the above named benefcares, n order to allow the admnstrator to pay drawdown ncome to as wde a range of benefcares as possble and for the purposes of the relevant tax legslaton, I nomnate any ndvdual who s elgble to receve a lump sum on my death under the rules of the scheme. I understand that I can change the benefcares at any tme and that the scheme admnstrator wll refer to the last completed form held. 7C. Detals of Benefcares If you wsh to name more benefcares than the spaces allow for, please contnue on a separate sheet and attach t to ths form. The percentages n Secton 7C should add up to 100%. Indvduals Indvdual 1 Indvdual 2 Date of brth / / Percentage of fund payable to benefcary % Indvdual 3 Date of brth / / Percentage of fund payable to benefcary % Date of brth / / Percentage of fund payable to benefcary % Indvdual 4 Date of brth / / Percentage of fund payable to benefcary % Trusts Trust 1 of trust Trust 2 of trust of trustees where trust s held of trustees where trust s held Date of trust / / Percentage of fund payable to benefcary % Date of trust / / Percentage of fund payable to benefcary % Cofunds Penson Account Drawdown Transfer Applcaton Form 10
Secton 7 Expresson of wsh contnued Charty Charty 1 of Charty Charty 2 of Charty Percentage of fund payable to benefcary % Percentage of fund payable to benefcary % 7D. Alternatve Benefcares Please only complete ths secton f you wsh to name alternatve benefcares where all of the benefcares you name n Secton 7C ether: a. de before you; or b. do not wsh to receve benefts from your plan (for example, for tax plannng purposes). The percentages n Secton 7D should add up to 100%. Indvduals Indvdual 1 Indvdual 2 Date of brth / / Percentage of fund payable to benefcary % Date of brth / / Percentage of fund payable to benefcary % Indvdual 3 Date of brth / / Percentage of fund payable to benefcary % Indvdual 4 Date of brth / / Percentage of fund payable to benefcary % Trusts Trust 1 of trust Trust 2 of trust of trustees where trust s held of trustees where trust s held Date of trust / / Percentage of fund payable to benefcary % Date of trust / / Percentage of fund payable to benefcary % Charty Charty 1 of Charty Percentage of fund payable to benefcary % Charty 2 of Charty Percentage of fund payable to benefcary % Cofunds Penson Account Drawdown Transfer Applcaton Form 11
Secton 8 Rsk questons for capped drawdown to flex-access drawdown swtches Please complete ths secton f you have not sought fnancal advce n enterng flex-access drawdown. The Fnancal Conduct Authorty requres us to make sure you have consdered the potental rsks of accessng your penson benefts. We are requred to ask questons about your crcumstances, so that we can provde warnngs about the rsks whch mght apply to you. Once we have receved your answers to the below questons, we wll send you a statement hghlghtng the potental rsks. If you stll wsh to proceed, you wll need to sgn and return the declaraton on the statement, to confrm that you ve read and understand the rsk warnngs and wsh to proceed. Pensons gudance Penson Wse s a free, mpartal servce from the government whch offers gudance about your penson optons. Penson Wse offers face-to-face and telephone appontments. They also have a webste www.pensonwse.gov.uk. Have you receved gudance from Penson Wse? 4 Yes Date Penson Wse servce accessed: / / 4 No Please note that ths exercse s only ntended to hghlght potental rsks to you - your answers won t affect your optons. We wll not be able to process your retrement benefts untl we have receved ths sgned declaraton. We can accept scanned copes by fax 0370 414 8000 or by emal retre@suffolklfe.co.uk. Investment scams Some nvestment scams encourage people to wthdraw money from ther pensons n order to nvest elsewhere. The schemes can appear very genune, but you rsk losng some or all of your money. Are you aware of how to protect yourself from nvestment scams? 4 Yes 4 No/unsure Debt Are you aware that money taken from your penson could be avalable to credtors n respect of any unpad debts you mght have? 4 Yes 4 No Benefts Are you aware that takng money from your penson could affect your enttlement to means-tested benefts? 4 Yes 4 No Ongong ncome Any money taken from your penson now wll reduce the amount that may be avalable to you n the future. Are you expectng ths penson to provde you wth ncome for the rest of your lfe? 4 Yes/unsure 4 No Means tested benefts nclude, housng beneft, councl tax deductons, ncome support, Unversal Credt, ncome-based jobseeker s allowance and any beneft that pays for long term care. Contrbutons The annual allowance s the maxmum amount that you, or anyone on your behalf, can contrbute to your pensons each year wthout ncurrng a tax charge. It s currently 40,000. If you take ncome whlst n flex-access drawdown, your annual allowance for money purchase pensons, such as your Cofunds Penson Account, wll reduce to 4,000. Are you, or anyone on your behalf, lkely to contrbute more than 4,000 to money purchase pensons n the future? 4 Yes/unsure 4 No Further nvestment If you wthdraw money from your penson to nvest elsewhere, the charges on the new nvestments may dffer from the charges applcable to your penson. The new nvestments are also lkely to be subject to ncome tax and captal gans tax, whereas nvestments n your penson are exempt from these charges. If you plan to nvest your money elsewhere, do you understand the dfference n charges and how ths could affect the value? 4 Yes/not applcable 4 No/unsure Cofunds Penson Account Drawdown Transfer Applcaton Form 12
Secton 8 Rsk questons for capped drawdown to flex-access drawdown swtches contnued Shoppng around There are several ways n whch you can access your penson savngs. Dfferent products, wth dfferent optons and charges, are avalable from varous provders. We recommend that you research the optons avalable to you. Are you happy that you ve researched your optons and have made an nformed choce? 4 Yes 4 No/unsure Benefcares When you de, the remanng money n your penson can pass to benefcares, such as a spouse or other famly members. Any money you take from your penson wll reduce the amount whch may be avalable to them on your death. Are you relyng on ths penson to provde for your benefcares when you de? 4 Yes/unsure 4 No Contact detals We may need to contact you f we have any questons on the nformaton you have gven. Please provde us wth your emal address and a contact telephone number and your preferred hours of contact (durng our openng hours). Emal address Moble telephone number Home telephone number Preferred hours of contact Cofunds Penson Account Drawdown Transfer Applcaton Form 13
Secton 9 Advser detals (for advser use only) 9A. Advser detals Frm Intermedary Regulator s reference number for organsaton Regulator s reference number for ndvdual Telephone number Ths secton should be completed by a regulated UK advser f advce has been gven on scheme transfers. Please complete ths secton, n full, f you are not the clent s current advser as known to Aegon. Fax number Emal address If the regulated organsaton s an apponted representatve or part of a network, please gve detals below. of prncpal or network Regulator s reference number for prncpal or network 9B. Advce gven Dd you advse your clent specfcally to set up the Cofunds Penson Account? Yes 4 No 4 Dd you advse your clent on the sutablty of transferrng any employer-sponsored schemes to the Cofunds Penson Account? Yes 4 No 4 Dd you advse your clent to transfer any safeguarded benefts to the Cofunds Penson Account? Yes 4 No 4 If applcable please could you confrm whether you have provded advce to your clent on takng benefts. 4 I have provded advce to my clent on takng benefts. 4 I have not provded advce to my clent on takng benefts but I have explaned the rsks of takng benefts. If your clent s swtchng from capped to flex-access drawdown please tck of the below: 4 I have provded advce to my clent on swtchng from capped drawdown to flex-access drawdown. 4 I have not provded advce to my clent on swtchng from capped drawdown to flex-access drawdown but I have explaned the rsks of takng benefts. 9C. Declaraton I certfy that I have verfed the dentty of the clent, detaled n ths applcaton, havng: seen the orgnal documents; checked that any requrng a sgnature were pre-sgned; and confrmed that any assocated photograph of the nvestor bore a true lkeness to the applcant. I agree to receve detals of my clent s Cofunds Penson Account by post, fax, va emal and/or the Suffolk Lfe secure portal. I confrm that my/our clent s aged over 18 years. I confrm that any amendments made by myself wll be ntalled and dated. I am an FCA authorsed ndvdual. I understand that Suffolk Lfe wll hold my ttle, full name, busness emal address, contact detals and Fnancal Servces reference number and all communcatons to and from me on Suffolk Lfe s systems for legtmate nterest n the effectve admnstraton of my clent s Cofunds Penson Account. I confrm that I have suppled my clent wth the documents lsted n Secton 11B. You should also read the Suffolk Lfe Prvacy Informaton Notce (for advsers). Ths can be found on Suffolk Lfe s webste www.suffolklfe.co.uk Cofunds Penson Account Drawdown Transfer Applcaton Form 14
Secton 9 Advser detals contnued 9D. Confrmaton of Verfcaton of Identty (CVI) - detals of non-prvate ndvdual Type of employer Employer name Regstered address Regstered number (f applcable) Operatng address Relevant company regstry or regulated market lstng authorty Publc company (quoted) 4 Publc company (unquoted) 4 Prvate lmted company 4 Partnershp 4 Charty 4 Club 4 Socety 4 Trust 4 s of drectors, or equvalent (and dates of brth, f known) Full name Date of brth (f known) / / Full name Date of brth (f known) / / Full name Date of brth (f known) / / s of prncpal benefcal owners wth a shareholdng of over 25% (and dates of brth, f known) Full name Date of brth (f known) / / Full name Date of brth (f known) / / Full name Date of brth (f known) / / Where a thrd party s nvolved, e.g. a payer of contrbutons who s dfferent from the customer, the dentty of that person must also be verfed n Secton 5B, and confrmaton provded n Secton 9E and 9F. Ths secton of the form cannot be used to verfy the dentty of any clent that falls nto one of the followng categores: those who are exempt from verfcaton as beng an exstng clent of the ntroducng frm pror to the ntroducton of the requrement for such verfcaton; those who have been subject to Smplfed Due Dlgence under the Money Launderng Regulatons; or those whose dentty has been verfed usng the source of funds as evdence. 9E. Confrmaton of Verfcaton of Identty (CVI) I/We confrm that the names, addresses and dates of brth contaned n ths applcaton for the clent, employer and thrd party payer (f relevant) have been verfed by me/us, and that the evdence I/we obtaned: Meets the standard evdence n the Jont Money Launderng Steerng Group gudance for the UK fnancal servces sector 4 Exceeds the standard evdence - where the clent s a Poltcally Exposed Person (wrtten detals of the further verfcaton evdence taken are attached to ths applcaton) 4 9F. Advser confrmaton Sgned Date / / Poston FCA Reference Number (Frm) Cofunds Penson Account Drawdown Transfer Applcaton Form 15
Secton 10 Advser chargng (for advser use only) 10A. Intal charge I authorse Cofunds to pay my advser an ntal advce charge, f applcable, of: or % 10B. Ongong charge All nformaton entered below must be consstent wth the charge your advser wll assgn you to. Charge model name Annual percentage rate % or Tered percentage rate % or Monthly fee amount Any Ongong Advce Charge wll be taken monthly n arrears from the product cash faclty. For example, f you wsh to charge 50 per month, please enter 600 as the ongong amount. If you have selected to charge a tered percentage rate please enter the hghest applcable percentage rate that apples to the charge. Secton 11 Clent declaraton 11A. Data Protecton Statement - mportant please read Suffolk Lfe takes your prvacy very serously. Suffolk Lfe uses the personal nformaton collected through ths form, from any other nformaton that you provde to them, and personal nformaton they collect from thrd partes ( your nformaton ) for the reasons and purposes set out n the Suffolk Lfe Prvacy Informaton Notce (for nvestors). Dsclosures: Suffolk Lfe may need to transfer your nformaton to countres outsde the European Economc Area n order to provde our servces to you. Suffolk Lfe may dsclose your nformaton to other companes wthn the Curts Banks group of companes (of whch Suffolk Lfe are a part), banks, nvestment managers and fund provders that are apponted to act for your Cofunds Penson Account, regulatory bodes, law enforcement agences, the current and future owners of our busness and supplers Suffolk Lfe engages to process data on ther behalf. To protect you and Suffolk Lfe from fnancal crme, Suffolk Lfe may need to confrm your data from tme to tme. they may do ths by usng reference agences to search sources of nformaton about you (an dentty search). Ths wll not affect your credt ratng. If ths search fals, we may ask you for documents to confrm your dentty. Access: You have the rght to ask for a copy of your nformaton. To obtan a copy of your nformaton, please wrte to Suffolk Lfe, 153 Prnces Street, Ipswch, IP1 1QJ. Consent: We would lke your consent to provde you wth relevant nformaton about the products and servces wthn the Curts Banks Group, and to share nformatve, relevant and educaton updates such as changes to penson legslaton and regulaton. 4 Please tck the box f you agree to receve ths nformaton. You can fnd nformaton on how Aegon, the platform provder, use and share your clent s personal nformaton, ncludng how long they keep t and detals of ther rghts at customerdashboard.aegon.co.uk/ste-nfo/prvacy-and-cooke-polcy/ 11B. Declaraton I request that the benefts descrbed n or arsng from ths applcaton be provded for me under the Cofunds Penson Account as part of the Suffolk Lfe Approprate SIPP Scheme and n consderaton of ts acceptance I undertake to be bound by the rules of the scheme n force from tme to tme. A copy of the scheme rules s avalable on request. I declare that to the best of my knowledge and belef, once my applcaton s made, the statements made n t (whether n my handwrtng or not) are correct and complete. I am aged over 18 years at the pont I apply for the Cofunds Penson Account. I confrm that I have receved the Key Features of the Cofunds Penson Account, Terms and condtons of the Cofunds Penson Account, Terms and Condtons of the Aegon Platform, Cofunds Penson Account Charges Sheet, Suffolk Lfe Prvacy Informaton Notce and a personal llustraton. I confrm that I have vewed and agree to be legally bound by the Aegon Platform terms and condtons. I confrm that I have vewed the Fund Key Features and the Aegon Platform Key Informaton Document. I accept that Aegon or Suffolk Lfe wll correspond wth the advser who submts my applcaton unless I gve wrtten notce to change that advser. I confrm that I wll contact Aegon to amend my applcaton f needed. I confrm that I am not a ctzen of the Unted States of Amerca. I authorse Suffolk Lfe and Aegon to accept nvestment and all other nstructons n relaton to my penson from my advser. I accept that an addtonal arrangement under my plan s set up to allow the contnuaton of drawdown ncome. Each separate Crystallsed Arrangement transferred n must be mantaned separately and wll ncur ts own set of drawdown fees as stated n the Charges Sheet. I confrm that my total gross contrbutons to all regstered penson schemes n respect of whch I am enttled to tax relef wll not exceed the hgher of 3,600 or 100% of my relevant UK earnngs. I confrm that I am a UK resdent. I have read the Data Protecton Statement on page 17. I understand that ths declaraton, once complete, wll be submtted to Aegon together wth the applcaton form completed by my advser, documents whch wll together consttute my applcaton to Suffolk Lfe Pensons Lmted as admnstrator of the Cofunds Penson Account. I understand that the contract between myself and Suffolk Lfe Pensons Lmted wll be effectve once Suffolk Lfe Pensons Lmted have establshed my Cofunds Penson Account plan and have ssued a Confrmaton Schedule to me. I have suppled the nformaton necessary to submt my applcaton for a Cofunds Penson Account through my apponted fnancal advser. I understand that: Suffolk Lfe wll send a Confrmaton Schedule contanng ths nformaton and send t to me n order for me to check ts accuracy; I have a perod of 30 days from the date I receve the Confrmaton Schedule to advse Aegon of any errors or omssons. Once the 30 day perod has passed, the Confrmaton Schedule wll be deemed accurate; I wll notfy Aegon f I do not receve the Confrmaton Schedule once my Cofunds Penson Account has been establshed. Ths wll be receved shortly after I receve the cancellaton notce; I can at any tme request confrmaton of the detals held by Suffolk Lfe or Aegon n relaton to my penson. I consent to nformaton regardng my Cofunds Penson Account (ncludng my personal data) beng dsclosed to my advser orally, n wrtng (ncludng by emal) or va the Aegon Platform. I undertake to nform Suffolk Lfe n wrtng (wthn 30 days) f: I cease to be a UK resdent or change my country of resdency; I contrbute on aggregate more than 100% of my earnngs to ths and any other penson scheme n any tax year; I cease to have relevant earnngs; I begn to have relevant earnngs agan; There s a change n my employment status; There s a change n my permanent resdental address; I apply for an enhanced lfetme allowance n respect of a penson credt or overseas transfer; I lose or gve up the rght to enhanced or fxed protecton. I undertake to cease makng contrbutons once I reach age 75. 11C. Benefts payable on death I wsh Suffolk Lfe to pay any death benefts to the benefcares and n the proportons set out n my applcaton form. I accept that ths s only an expresson of my wsh and I understand that whlst Suffolk Lfe wll pay due consderaton to that wsh they have absolute dscreton as to benefcares and to the proporton of benefts pad to each benefcary unless otherwse provded by law. I understand that I can change ths expresson of wsh at any tme and that Suffolk Lfe wll refer to the latest completed form held. 11D. HM Revenue & Customs warnng As an applcaton for a Cofunds Penson Account s also used as an applcaton for tax relef at source, t s a serous offence to make false statements. The penaltes are severe. False statements could lead to prosecuton. A copy of ths applcaton s avalable from the scheme admnstrator. Sgnature Date / / Cofunds Penson Account Drawdown Transfer Applcaton Form 16
Appendx I Advser declaraton Advser detals Intermedary name Frm name Regulator s reference number for organsaton Please complete ths secton, n full, f you are not the clent s current advser as known to Aegon. Regulator s reference number for ndvdual Telephone number Fax number Emal address Ths secton must be completed by a sutably authorsed UK advser f advce has been gven n all cases on convertng to flex-access drawdown and/or scheme transfers, f relevant. If the regulated organsaton s an apponted representatve or part of a network, please gve detals below. of prncpal or network Regulator s reference number for prncpal or network Declaraton (to be completed and sgned f the clent has stated they have sought advce contanng safeguarded benefts) Please confrm whether you have provded advce to your clent on scheme transfers nto and/or takng benefts from the Cofunds Penson Account: 4 I have provded advce to my clent on convertng to flex-access drawdown. 4 I have not provded advce to my clent on convertng to flex-access drawdown but I have explaned the rsks of drawdown. 4 I confrm that I have recommended the clent (as named n Secton 1) to transfer hs/her penson scheme(s) contanng safeguarded benefts to the Cofunds Penson Account. Poston n organsaton Advser sgnature Date / / The Cofunds Penson Account s provded by Suffolk Lfe Pensons Lmted (Suffolk Lfe) 153 Prnces Street, Ipswch, Suffolk IP1 1QJ. Regstered n England and Wales number 1180742. Suffolk Lfe s authorsed and regulated by the Fnancal Conduct Authorty (FCA). FCA regstraton number 116298. All assets held n the Cofunds Penson Account are legally owned by Suffolk Lfe Trustees Lmted and are held on the Aegon Platform provded by Cofunds Lmted (Cofunds). Regstered address: Level 43, The Leadenhall Buldng, 122 Leadenhall Street, London, EC3V 4AB. Regstered n England and Wales No. 3965289. Authorsed and regulated by the Fnancal Conduct Authorty (FCA) under FCA Regstraton No. 194734. COF381159 05/18 Cofunds Penson Account Drawdown Transfer Applcaton Form 17