CanRetire Application Transfer Out PIP Pension Investment Plan Flexible Drawdown Plan Fixed Term Income Plan (Guaranteed Maturity Value) Transfer funds out of to another UK registered pension scheme
Please read the notes on this page If you wish to transfer an overseas pension scheme please call us on 0345 606 0708 and ask for an overseas transfer application form instead The rest of these notes apply if you wish to transfer out of to another UK registered pension scheme. The Origo Options service When to complete this form Ask the administrator of your receiving scheme if they use the Origo Options service. If they do, they may be able to request the payment from us online, without the need for you to complete this application form. We can only process a transfer of the full value of your plan using this service. Complete this application If the administrator of your receiving scheme does not use the Origo Options service or you only want to transfer part of the value of your plan (see Part 3 below for when you can do this). This application will only cover a transfer to one UK registered pension scheme. How to complete this form Part 1 Part 2 Part 3 Part 4 Personal details complete your personal and other details Receiving scheme details tell us where you want to transfer to Insert details of the receiving UK registered pension scheme. Transfer request tell us the amount you want to transfer from your plan(s) Pension Investment Plan (PIP) Complete A to transfer the full value of your plan; or Complete B to transfer part of the value of your plan (only available if you have reached age 55). Flexible Drawdown Plan () Complete A to transfer the full value of your plan; or Complete C to transfer part of the value of your plan by surrending one or more individual drawdown elements, but not all of them. You cannot transfer part of a drawdown element. Fixed Term Income Plan () Complete A to transfer the full Guaranteed Maturity Value (GMV) on or after reaching the plan Maturity Date. You cannot transfer out at any other time and you cannot transfer out part of the GMV. Declarations you are required to make read, sign and date the Member s declaration in this part. Part 5 Send this application to the administrator of your receiving scheme to complete Part 5 If you have a professional adviser, they will usually arrange this for you. Warning: Receipt of these requirements is not a guarantee we will make a transfer payment. If we have any doubts about the transfer we will ask for further requirements to satisfy due diligence before the transfer payment is made. Our requirements These must be satisfied before we can make any transfer payment. From you 1. Parts 1, 2, 3 & 4 of this application fully completed, signed and dated. Please note that in order to comply with our regulatory obligations we may ask for documents to verify the identity and residential address of our individual policyholders. In the absence of such documents, we may use credit reference agency searches to verify your identity and address. Please note that this will not affect your credit rating. We reserve the right to ask for further documentation to confirm your identity and address. From the receiving scheme 1. Part 5 of this application fully completed, signed and dated; and 2. A current copy of their scheme s details page from www.online.hmrc.gov.uk showing the scheme s Pension Scheme Tax Reference (PSTR), pension scheme name and the name of the scheme administrator. We will only accept applications with original signatures. We cannot accept photocopies, certified copies or applications sent by fax or email. Will will only make and send a payment direct to the receiving pension scheme, not to a third party. Please return the completed form with all the requirements to: Pension Benefits, Limited, Place, Potters Bar, Hertfordshire, EN6 5BA Contact us by: Telephone 0345 6060708 Email customer.services@canadalife.co.uk 2
Please complete in block capitals and tick small boxes where appropriate Part 1 Personal details Member Title (Mr, Mrs, Miss, Ms, other) Surname Forename(s) in full Main residential address (including postcode) Postcode Telephone numbers (including STD codes) Daytime Evening Mobile E-mail address Date of birth (DD/MM/YYYY) Gender Male Female National Insurance Number Court orders Divorce/ Dissolution of a civil partnership Are there any existing or proposed attachment (earmarking) orders or pension sharing orders made/to be made against the pension funds covered by this application? Yes No If Yes, please provide details. If the order has been made please provide copies of the court sealed documents with this application. 3
Please complete in block capitals and tick small boxes where appropriate Part 2 Receiving scheme details Full name of the receiving scheme Name of scheme trustees/administrators Part 3 A Transfer request I wish to transfer the full value of my plan(s): Insert plan number(s) PIP (Only the full Guaranteed Maturity Value and only at the maturity date) B I wish to transfer part of the value of my PIP: Insert plan number PIP (Only available if you have reached age 55) Insert the amount you wish to transfer Tick to take amount proportionately across all unit funds OR Tick to take amount proportionately across up to five unit funds and Insert the fund names (five maximium) C I wish to Transfer part of the value of my full drawdown element(s) only: (You cannot transfer part of the value of a drawdown element) Insert plan number(s) Insert the element number(s) you wish to surrender. Insert the approximate amount for transfer If you don t know the element numbers call 0345 606 0708 or email customer.services@canadalife.co.uk 4
Please complete in block capitals and tick small boxes where appropriate Part 4 Member s declaration to ( means Limited) Transfer out request and discharge Please transfer the funds from the plan(s) listed in the way I have requested in Part 3 of this application, to the scheme named in Part 2. I understand that any transfer payments from my Pension Investment Plan and/or my Flexible Drawdown Plan, will be calculated/units cancelled using unit prices on the next available price date following receipt of all s requirements. I understand that any transfer payments from my Fixed Term Income Plan(s) are limited to the amount of the Guaranteed Maturity Value (GMV) shown on the policy schedule(s). I agree that the payment(s) made as requested shall: in the case of a full transfer of funds under section A of Part 3 of this application, discharge s obligations to make any further payments under the plan(s); and in the case of a partial transfer of funds under sections B or C of Part 3 of this application, discharge s obligations to make any further payments from the part(s) of the plan(s) that have been transferred. For the avoidance of doubt I understand that this release shall not prevent me from bringing any claims for any act or omission by that is not related to Canada Life s obligation to make payments under the plan(s). Entitlement, bankruptcy and court/receiving orders I confirm that I am entitled to the proceeds of the plan(s) from which I am making this transfer request. I have not been declared bankrupt before 29 May 2000. Apart from any court orders noted in Part 1 on divorce or dissolution of a civil partnership, I confirm that there are no other court/receiving orders held or proposed against the plan(s). Financial crime statement I accept that in order to comply with regulatory obligations, may require documents to verify my identity and residential address. In the absence of such documents, may use credit reference agency searches to verify my identity and address. I understand that this will not affect my credit rating and I accept that reserves the right to ask for further documentation to confirm my identity and address. Accuracy of information and complying with this form I accept sole responsibility for the payment of any additional tax charges or penalties and any claims, losses and expenses that may incur as a result of any incorrect information provided by me in this application or any failure on my part to comply with any aspect of this application. About your decision Have you received advice from an authorised adviser? Yes No Have you used the Pension Wise service? Yes No Member s Signature Date 5
Please complete in block capitals and tick small boxes where appropriate Notes Part 5 The name of the transferring scheme is The CanRetire Personal Pension Scheme. The scheme administrator is Limited. The scheme s HMRC Pension Scheme Tax Reference (PSTR) is 12010973. The transfer payment(s) will comprise of the following, depending on the plan(s) held by the member: Uncrystallised funds from their Pension Investment Plan(s); and/or Crystallised funds from their Flexible Drawdown Plan(s) () or Fixed Term Investment Plan(s) (), which are post 6 April 2015 flexi-access drawdown products. The plan(s) the member is transferring from are listed in Part 3 of this form. A transfer payment from a may include funds which are held in different arrangements. None of these arrangements can be combined and each should be invested in a separate empty arrangement in your scheme. A transfer payment from a may derive from (and therefore form part of) the member s flexi-access drawdown funds being transferred from their or may be a separate arrangement. We will give full details on making the transfer payment. We will also pass on any relevant information about previous Benefit Crystallisation Events in this scheme when making the payment(s). To be completed by the receiving scheme The purpose of this part of the form is so that the receiving scheme can provide with: The details we need to be satisfied that the receiving scheme is a UK registered pension scheme. Confirmation from the receiving scheme s trustees/administrator/provider s life office that they are willing and able to accept the transfer payment(s) from. Insert the transferring plan number(s) Receiving scheme details Full name of the receiving scheme Name of scheme trustees/administrators HMRC Pension Scheme Tax Reference Copy of HMRC s on-line Scheme details page* Please tick to show this is enclosed with this application. The transfer payment may be delayed if we do not receive it. * A current copy of your scheme s details page from www.online.hmrc.gov.uk showing the scheme s Pension Scheme Tax Reference (PSTR), pension scheme name and the name of the scheme administrator. Receiving scheme s BACS payment details will only make payment to an account in the name of the scheme trustees, the scheme administrator or the scheme provider s life office. Bank/Building society name and address (including postcode) Postcode Account number (must be 8 digits, including any leading zeros) Account name (We will pay the BACS payment to this account name) Roll number (for building society accounts only) Sort code Your reference to appear with payment 6
Please complete in block capitals Part 5 continued Receiving scheme declaration We confirm the following: The receiving scheme is a registered pension scheme. We and the receving scheme will comply with all legislation governing the receipt and application of the transfer payment including where appropriate setting up separate arrangements within our scheme for each flexi access drawdown arrangement being transferred to us. The transfer payment will be used to provide benfits to the member under the receiving scheme. The member is already or will become a member of the receiving scheme as a result of the transfer payment. The information we have provded in this application is true and complete. In the event that this declaration has not been complied with, we will indemnify Limited for any losses, including taxation or fines caused due to any transfer payment being made. Receiving Scheme address (including postcode) Postcode Telephone number E-mail address Signature(s) Name (s) Position (s) Date Company stamp (if applicable) 7
Limited, registered in England no. 973271. Registered office: Place, Potters Bar, Hertfordshire EN6 5BA. Telephone: 0345 6060708 Fax: 01707 646088 www.canadalife.co.uk Member of the Association of British Insurers. Limited is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. This paper is made from recycled materials ID6757 416R