ARMED FORCES STAKEHOLDER PENSION PLAN APPLICATION FORM Member
Agency Number: A6929038 Warning: You must not make false statements when filling in this application; it is a serious offence. The penalties are severe and you could be prosecuted. If you have applied to HM Revenue and Customs for Enhanced or Fixed Protection from any potential lifetime allowance tax change, such protection could be lost on transfer. For further information, please seek financial advice. NOTES (1) Habitual residence in the UK generally means being resident on a regular basis, i.e. year after year. If you require further information, please speak with your financial adviser. (2) If you tick this box, to be eligible to join the Scottish Widows Stakeholder Pension Scheme, you must have earnings chargeable to UK tax in the tax year you apply. Please speak with your financial adviser for further details. (3) This should be your correspondence address. We will send all correspondence to this address. Please ensure the postcode or BFPO is provided. A. ELIGIBILITY To be eligible for this plan you must be aged less than 75 and meet one of the following conditions. Please tick whichever applies. I am a habitual resident in the UK. (see note 1) OR I do not currently reside in the UK but I am a Crown Servant or the husband, wife or registered civil partner of a Crown Servant who has general earnings from overseas crown employment. OR I am not a UK resident but have earnings which are chargeable to UK income tax. (see note 2) If you have been unable to tick any boxes above, you cannot take out a Stakeholder Pension with Scottish Widows. B. YOUR DETAILS Which Service of the Armed Forces do you belong to? (please tick and complete boxes below) RN/RM ARMY RAF Regular Regular if RIR (HSPT) Terms Regular Voluntary Reserve FTRS ADC RFR TA NRPS Army Reserve are you undertaking FTRS ADC RAF Vol Res T RAF Vol Res UAS Serving RAFR or RAuxAF FTRS ADC 1. Your title Mr Mrs Miss Ms Other (please specify) 2. Your surname 3. Your first name(s) 4. Your address (see note 3) Postcode/BFPO Country 1
NOTES (CONT D) (4) Please write in the most appropriate of the following: self employed a pensioner caring for one or more children under 16 caring for a person aged 16 or over in full-time education unemployed other (5) Your National Insurance number can be found on a payslip or P60, or on a tax return. It is essential that you provide it, otherwise we are unable to accept contributions and cannot process your application. If you cannot find your National Insurance number please phone the HM Revenue & Customs National Insurance General Enquiries 0300 200 3500 B. YOUR DETAILS (CONTINUED) Rank Name Initials Service No. Your Unit address (If different from above see note 3) Postcode/BFPO 5. Your phone number Home (please include STD code and country code if applicable) Work 6. Email address Warning: sending personal information by email is not secure. Only include your email address if you agree to Scottish Widows sending you emails. 7. Your date of birth (DD MM YYYY) 8. Your nationality 9. Are you Male Female 10. Marital status Single 11. Employment status Married / in a registered civil partnership Separated Divorced / registered civil partnership dissolved Widowed / a surviving registered civil partner Are you: Employed Other If Other, please specify (see note 4) 12. If you are Employed, please give your employer s name and address Postcode 13. Your National Insurance number (see note 5) 2
NOTES (CONT D) (6) The Money Purchase Annual Allowance (MPAA) is currently 4,000. The MPAA applies to you if you have flexibly accessed your pensions from us or any other provider and have received any of the payments listed below from 6 April 2015 onwards: a payment from a flexible access drawdown fund (also known as a flexiaccess drawdown fund); a payment from a capped drawdown fund which would exceed existing capped drawdown limits; a pension encashment (also known as an uncrystallised funds pension lump sum); a payment under a flexible annuity contract; a pension payment from a money purchase scheme which has fewer than 11 other pensioner members; a stand-alone lump sum from a money purchase arrangement where you were entitled to primary protection with a right to take a lump sum of greater than 375,000. The MPAA applies to all contributions you pay (or that are paid on your behalf e.g. employer contributions and death-in-service premiums) each year to all money purchase pension schemes of which you are a member. If the MPAA applies to you and your contributions exceed it, you will be liable to pay a tax charge based on your highest rate of income tax. The MPAA does not apply if you have taken only income from a capped drawdown plan; tax-free cash (pension commencement lump sums) when using your plan to purchase an annuity or drawdown plan; or small pots taken as a cash lump sum. In these circumstances, the higher annual allowance applies to you. (7) Your payments are taken from your net pay. This is the amount after all taxable deductions have been made. We will add basic rate tax relief to the amount you pay. The minimum monthly payment you can make is 20 net. (8) Please choose a month you wish your contributions to start. These will be paid on the first day of each month. (9) This is the age from which you want your Stakeholder Pension to become payable. This must be between the ages of 55 and 75. B. YOUR DETAILS (CONT D) 14. There is no maximum limit on how much can be paid to your plan, although we can only accept contributions from you that are eligible for tax relief. Relief is available on contributions which don t exceed your UK relevant earnings, or 3,600 if higher. We will claim basic rate tax relief on your behalf, and invest it in your plan. If you are a higher or additional rate taxpayer, you may be able to claim additional tax relief via your self-assessment tax return. Employer contributions are paid gross. The value of the tax benefits of a personal pension depend on your personal circumstances. Both your circumstances and tax rules may change in the future. If you are a Scottish taxpayer the tax relief you will be entitled to will be at the Scottish rate of income tax, which may be different from the rest of the UK in the future. The Treasury sets an annual allowance on the amount that can be paid into all your registered pension schemes without incurring a tax charge. Higher earners will have a lower annual allowance limit, called the Tapered Annual Allowance. Your annual allowance may also be limited to the Money Purchase Annual Allowance if you have flexibly accessed a pension with another provider. (see note 6) Please speak to your financial adviser if you are unsure about how much you can pay. Have you flexibly accessed any pensions with us or any other provider? (see note 6) Yes No If Yes Date of first payment (DD MM YYYY) 15. How much do you want to pay? (see notes 6 and 7) a) Regular monthly payments Net b) When do you want to start paying? 0 1 (01 MM YYYY) (see note 8) This must be a minimum of one month after the application date. c) Single payment 16. What age do you intend to retire? years (see note 9) I wish to pay by payroll deduction NB this is only available for serving Service personnel Please complete the attached Payroll Mandate. or I wish to pay by direct debit To pay by direct debit please complete the attached Direct Debit Instruction. If you make your regular payments by direct debit, not payroll deduction, we can increase them automatically each year. Would you like the regular payments to increase automatically each year? Yes No If Yes, what level of increase do you want? Retail Prices Index Average Weekly Earnings Fixed rate from 5% to 20% % 3
NOTES (CONT D) (10) You can change your investment choice at any time. (11) Each of our Pension Investment Approaches invests using one or more of our Pension Portfolio funds. These Pension Portfolio funds use a varying mix of higher and lower risk investment assets. The Pension Portfolio fund you will initially be invested in will depend on your chosen Pension Investment Approach and the time until your selected pension age. For more details, please see our Pension Investment Approach Guide. C. YOUR CHOICE OF FUNDS Investment selection is a very important decision. You can either choose a Pension Investment Approach in part 1 or indicate your choice of investment fund(s) in part 2. You can t do both. If you don t complete either part, the payments will automatically be invested in our default investment option, which is the Balanced Pension Approach (Targeting Flexible Access). We may change the selection of funds we make available. (see note 10) 1. Pension Investment Approaches This part should only be completed if you wish to select a Pension Investment Approach. (see note 11) Please tick one box. ADVENTUROUS RISK CATEGORY BALANCED RISK CATEGORY CAUTIOUS RISK CATEGORY Adventurous (Targeting Annuity) Adventurous 2 (Targeting Encashment) Adventurous 3 (Targeting Flexible Access) Balanced (Targeting Annuity) Balanced 2 (Targeting Encashment) Balanced 3 (Targeting Flexible Access) Cautious (Targeting Annuity) Cautious 2 (Targeting Encashment) Cautious 3 (Targeting Flexible Access) As you get closer to your selected pension age, we will automatically gradually adjust and move your pension fund into lower risk investment funds. You can choose to stop the gradual adjustments, or even change your investment choice, at any time. Important note: If you are considering using one of our Pension Investment Approaches, please read our Pension Investment Approach Guide to find out details of the investment funds used by each Approach. 2. Fund selection (If not choosing a Pension Investment Approach in part 1) You can invest in up to 10 funds at any one time but may be restricted to a maximum of 30% of each payment being invested in external fund links. Other restrictions may apply on the amount you can invest in certain funds. Please contact us for further details of any restrictions that may apply on the amount that can be invested. For further details of the funds available please refer to our Pension Funds Investor s Guide. (see note 10) Payments Fund % split for regular payments % split for single payment Total 100% 100% 4
D. DECLARATION IMPORTANT PLEASE COMPLETE SCOTTISH WIDOWS STAKEHOLDER PENSION SCHEME (the Scheme) Please ensure that you read the following important statements relating to your policy: a) I understand that an application has been made on my behalf to join the Scottish Widows Stakeholder Pension Scheme and that a policy has been issued in my name. Scottish Widows will run the scheme according to the scheme rules, a copy of these rules are available on request. b) I agree that the information detailed in the application made on my behalf is correct and complete. c) I confirm that I am habitually resident in the UK. d) I authorise Scottish Widows to collect the payments I agree to make, including any transfer payments from other pension arrangements. Where necessary, I consent to Scottish Widows seeking further information from other pension arrangements. e) I agree that if the basic rate of tax changes, Scottish Widows will amend the amount collected, but only to the extent necessary to maintain the total payment. Total payments by me in any tax year will not exceed the higher of 3,600, and my relevant UK earnings. f) I agree to pay contributions which are at least equal to the difference between the contributions my employer is paying and the minimum total contributions required by the Pensions Act 2008 (as amended). I understand that my employer has agreed to ensure that the total of my employer s contributions and my contributions is high enough to cover the minimum total contributions required by legislation. If Scottish Widows realise that the total contributions are not high enough I understand that Scottish Widows will report my employer to the Pensions Regulator who may issue an unpaid contribution notice to my employer requiring my employer pay additional contributions. g) I will inform Scottish Widows within 30 days if I am no longer entitled to receive tax relief. h) I will inform Scottish Widows if I stop residing in the United Kingdom. i) I authorise my employer to appoint and/or change the financial adviser for the policy. j) I agree that my employer, its agents, any agent of mine acting in connection with the plan, and Scottish Widows may exchange such information concerning me as is necessary to effect and administer the plan. k) I have received the Important Notes for Applications document and the Key Features Document. Please read these documents. If you do not understand any point, please let us know. Lloyds Banking Group companies may use your information to contact you by mail, telephone, email or text message about products and services that may be of interest to you. If you do not wish to receive this information, please tick this box. I have received the Important Notes for Applications document and the Key Features document. For your own benefit and protection, please read these documents before you sign this application. Scottish Widows will rely on them when administering your contract. If you do not understand any point, please let us know. Signature Date (DD MM YYYY) A paper copy of the completed application, Scheme Rules and Policy Provisions are available from Scottish Widows. 5
E. NOMINATION FORM To: Scottish Widows PLEASE USE BLOCK CAPITALS Your name Pension plan number (for new policies the Scheme Administrator will insert this when allocated) Your National Insurance number Date of birth (DD MM YYYY) I wish to nominate the person/people listed below to receive any death benefits which become payable under the Pension plan number above. I understand that, in exercising discretion in applying the benefits, the Scheme Administrator will not be bound by this expression of my wishes. Please consider the following person/people to receive death benefits in the percentages shown. Full name Relationship (if any) Address Percentage of benefits This form supersedes any earlier form completed in respect of this policy number. If your circumstances change after submitting this form and you would like to change the nominated beneficiaries please send a new form. Signature Date (DD MM YYYY) 6
DIRECT DEBIT INSTRUCTION INSTRUCTION TO YOUR BANK OR BUILDING SOCIETY TO PAY BY DIRECT DEBIT Please complete to instruct your bank/building society to make payments directly from your account. When completed please return the form to: Scottish Widows, 15 Dalkeith Road, Edinburgh, EH16 5BU Names(s) of Account Holder(s) Originator s Identification Number 8 3 6 6 2 8 Reference Number (for office use only) Account Number Sort Code Name and full postal address of your Bank or Building Society To the Manager INSTRUCTION TO YOUR BANK OR BUILDING SOCIETY Please pay Scottish Widows Limited 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 Scottish Widows Limited and, if so, details will be passed electronically to my Bank/Building Society. Signature(s) Address Date (DD MM YYYY) Postcode Banks and Building Societies may not accept instructions for some types of account. METHOD OF PAYMENT Payments can be made by either payroll deduction or direct debit. Please complete either the payroll mandate or the direct debit mandate. PAYROLL MANDATE I hereby certify that I wish to make payments to the Scottish Widows Armed Forces Stakeholder Pension Plan by payroll deduction. I understand that if there are insufficient funds in my pay account, then this may mean that my monthly payment will not be made. I will, therefore, be responsible for making alternative arrangements with Scottish Widows direct for the payment to be paid. Signature Date (DD MM YYYY) This guarantee should be detached and retained by the Payer 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 Scottish Widows will notify you 10 working days in advance of your account being debited or as otherwise agreed. If you request Scottish Widows 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 Scottish Widows 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 Scottish Widows 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.
EXAMPLE CHEQUE TO HELP YOU FIND THE INFORMATION TO FILL IN YOUR DIRECT DEBIT Example cheque to help you fill in your direct debiting instruction. Bank/Building Society Name and Address Bank/Building Society Sort Code ABC BANK LTD 20-83-45 17 MAIN ST YOUR TOWN Pay JOHN SMITH 277860 208345 0052678 Cheque Number Bank/Building Society Sort Code Account Number Name of Account to be debited Special instructions for Girobank Account Holders Insert 72061 in the first five boxes of the bank sort code. If your account has 9 FIGURES enter the first figure in the last box of the bank sort code, and the remaining 8 FIGURES in the bank account number boxes. If your account has 7 FIGURES enter a ZERO in the last box of the bank sort code. In the bank account number boxes enter a ZERO followed by the 7 FIGURES. 9
Scottish Widows Limited. Registered in England and Wales No. 3196171. Registered office in the United Kingdom at 25 Gresham Street, London EC2V 7HN. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Financial Services Register number 181655. 16938A 04/17