COFUNDS PENSION ACCOUNT FLEXI-ACCESS DRAWDOWN FORM

COFUNDS PENSION ACCOUNT FLEXI-ACCESS DRAWDOWN FORM Also avalable on the Aegon webste: Cofunds Penson Account Income Payment or Amendments Request Form - start/amend exstng drawdown ncome Cofunds Penson Account Capped Drawdown Form - amend capped drawdown ncome or add further funds nto capped drawdown We recommend that you complete ths form n conjuncton wth your advser/ntermedary. Ths form must be completed when requestng a tax-free lump sum and a penson ncome, f requred, through flex-access drawdown. It s not ntended for annuty purchase, amendng capped drawdown or startng ncome once n drawdown. If you requre a regular ncome please talk to your advser/ntermedary about settng up a regular sell down before completng ths form. Please complete ths form and return t to: Aegon Cofunds Admnstraton, PO Box 1791, Ednburgh, EH12 1PB Secton 1 Clent detals 1A. Exstng clent detals Product number 8 Mr/Mrs/Mss/Ms/Other - please specfy Full forename(s) Surname Date of brth / / Male Female 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. 1B. Spouse s/regstered cvl partner s detals (f applcable) Are you marred or n a regstered cvl partnershp? No (go to Secton 1C) Spouse s/regstered cvl partner s date of brth / / Spouse s/regstered cvl partner s gender Male Female Ths nformaton wll be used to produce your annual statement. 1C. Rsk warnngs We strongly recommend you to seek fnancal advce before proceedng. Please tck below, as approprate: Pror to applyng to take benefts I have taken advce from an authorsed advser. (Please ensure that advser completes Appendx I). Havng consdered the matter, I wll not be seekng fnancal advce and stll wsh to make an applcaton to take benefts. I confrm that I have seen the most recent Key Features Documents, ncludng personal llustraton(s). If you haven t sought advce t s mportant that you consder the rsks that may be assocated wth takng retrement benefts. Please complete the rsk questons n Secton 5 of ths document. 1D. Money Purchase Annual Allowance (MPAA) Please confrm whether you have trggered the MPAA: No Date of MPAA trgger / / Scheme where trgger occurred The MPAA from 6 Aprl 2017 s,000. Cofunds Penson Account Flex-access Drawdown Applcaton Form 1

Secton 2 Lfetme Allowance 2A. Takng retrement benefts Before takng retrement benefts from your penson, we are requred to test the value of your penson aganst the lfetme allowance. We wll not pay any benefts unless ths secton s completed and any documents requred are receved. Please tck the relevant boxes and gve detals as approprate, ncludng detals of your Cofunds Penson Account and all other schemes. I wll be takng benefts from another scheme at the same tme as my Cofunds Penson Account and enclose detals of whch scheme I am takng benefts from frst. I also confrm I have sent the same nformaton to the other scheme (go to Secton 2B). I have not taken any benefts from any regstered penson scheme (go to Secton 2D). Please note Secton 2 does not apply f you re 75 or older or f you re swtchng from capped to flex-access drawdown. I have not taken any benefts from any regstered penson scheme other than my Cofunds Penson Account plans (please go to Secton 2D). 2B. Benefts frst taken before 6 Aprl 2006 I have not taken any retrement benefts whch started before 6 Aprl 2006 (go to Secton 2C) I have taken retrement benefts whch started before 6 Aprl 2006 If you have put any other retrement benefts nto payment after 5 Aprl 2006 please enter the date and the values below at the date gven. If not, please gve the detals as at todays date. / / Total maxmum annual drawdown penson from your Cofunds Penson Account Total maxmum annual drawdown penson from other schemes Total annual ncome from other pensons and annutes If any drawdown pensons have been converted to flexble or flex-access drawdown, please gve the amounts at the date of converson. Please also gve detals of these below: Date of converson Income lmt at converson date Date of last ncome lmt revew before converson 2C. Benefts taken after 5 Aprl 2006 2D. Protecton status / / / / / / / / / / / / I have not taken retrement benefts from any scheme that came nto payment after 5 Aprl 2006 (go to Secton 2D) I have taken retrement benefts from any scheme that came nto payment after 5 Aprl 2006 Date you took retrement benefts Percentage of the lfetme allowance used when takng ths beneft / / % / / % / / % Your scheme admnstrator or nsurance company wll have gven you a statement showng the percentage fgure needed. I do not have a protecton certfcate from HMRC (go to Secton 2E) I have one of the followng types of protecton and enclose a copy of the relevant vald certfcate of protecton: Fxed protecton 2012 Fxed protecton 201 Fxed protecton 2016 - HMRC reference number: HMRC confrmaton enclosed Indvdual protecton 201 Indvdual protecton 2016 - HMRC reference number: HMRC confrmaton enclosed I have prmary protecton and enclose a copy of the vald certfcate of prmary protecton from HMRC. If the certfcate states an amount of tax-free lump sum, please complete the followng: Date / / / / / / Amount of tax-free lump sum pad from benefts taken after 5 Aprl 2006 I have enhanced protecton and enclose a copy of the vald certfcate of enhanced protecton from HMRC (go to Secton 3) I have a lfetme allowance enhancement n respect of a penson credt or an overseas penson and enclose a copy of the vald certfcate from HMRC Cofunds Penson Account Flex-access Drawdown Applcaton Form 2

Secton 2 Lfetme Allowance contnued 2E. Lfetme allowance charge If the total value of your retrement benefts taken, both now and prevously, exceeds your personal lfetme allowance, the excess wll be subject to a lfetme allowance charge. Not applcable As a lfetme allowance excess lump sum (a 55% lfetme allowance charge s payable) As drawdown ncome (a 25% lfetme allowance charge s payable and the payments wll be subject to ncome tax) A combnaton of both, as follows: As lump sum % As drawdown ncome % Secton 3 Flex-access drawdown requrements 3A. What type of drawdown do you requre? Full Swtch from capped to flex-access Partal Value of fund to drawdown or value of tax-free lump sum to be taken Tax free cash assumed to be 25% unless otherwse stated n your protecton status. 3B. How do you wsh to take benefts from your Cofunds Penson Account? Intal gross annual ncome requred Whole fund Nl Other, please specfy amount each year Type of ncome payment Sngle Regular If regular, frequency of ncome Monthly Quarterly Half-yearly 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 a P5. 3C. Optons for makng sngle ncome payments (ncludng tax-free lump sum) 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. 3D. Optons for makng regular ncome payments Opton 1 Largest Value Fund A sale of unts from your largest value fund held wthn your Cofunds Penson Account. You wll only see a record of sell downs n your annual statement. Opton 2 Nomnated Fund You can nomnate a fund from whch unts are to be sold. If, at the tme of calculaton, we cannot rase enough to meet payments from your nomnated fund (or your nomnated fund s not avalable for tradng at that tme), we wll check to see f the requred amount can be rased from your largest value fund. Percentage of Fund manager, fund name and share class Sedol code Income Payment 100 % Cofunds Penson Account Flex-access Drawdown Applcaton Form 3

Secton 3 Flex-access drawdown requrements contnued 3E. Personal bank account to receve the tax free lump sum and ncome payments Please ndcate below 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 Buldng Socety Roll 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. Please select how you would lke your tax free lump sum payment to be made: BACS (Please allow 3-5 workng days) Faster Payments or CHAPS (Normally same day transfer. A fee s charged for ths opton please see the Charges Sheet for detals of the charges) If you requre further tax-free lump sums you wll need to complete a further Flex-access Drawdown Applcaton Form whch can be obtaned from your advser/ntermedary. Secton Expresson of wsh A. 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: I would lke the current benefcares for my non-drawdown funds to apply to the drawdown funds (go to Secton 5, f applcable). I would lke the benefcares below to apply to all of my penson funds. I would lke the benefcares below to apply to my drawdown funds only. Please refer to the Aegon Platform terms and condtons for your plan detals of the dfferent ways death benefts may be receved. B. 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. 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 C or D, 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. Cofunds Penson Account Flex-access Drawdown Applcaton Form

Secton Expresson of wsh contnued C. 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 C 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 Indvdual Date of brth / / Percentage of fund payable to benefcary % 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 Flex-access Drawdown Applcaton Form 5

Secton Expresson of wsh contnued D. Alternatve Benefcares Please only complete ths secton f you wsh to name alternatve benefcares where all of the benefcares you name n Secton C 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 D 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 Indvdual Date of brth / / Percentage of fund payable to benefcary % 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 Flex-access Drawdown Applcaton Form 6

Secton 5 Rsk questons for flex-access drawdown 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? Date Penson Wse servce accessed: / / 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 1 8000 or by emal retre@suffolklfe.co.uk. Guaranteed ncome (not requred for swtches from capped to flex-access drawdown) Annutes offer a guaranteed ncome, but n drawdown there s no guarantee about the amount of ncome you mght be able to take n the future. Ths s because the avalable ncome depends on your fund value, whch s affected by many factors, such as nvestment performance. Are you comfortable wth there beng no guarantee of future ncome n drawdown? No/unsure Tax (not requred for swtches from capped to flex-access drawdown) Asde from your tax free cash enttlement, any money you take from your penson s taxed as ncome. It s added to any other taxable ncome you receve durng the tax year, and mght push you nto a hgher tax bracket. It s also possble that the tax deducted from the payment s not the fnal amount due, you may need to pay addtonal tax at the end of the year. Are you confdent that you fully understand the tax mplcatons of the opton you ve chosen? No/unsure 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? 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? No Benefts Are you aware that takng money from your penson could affect your enttlement to means-tested benefts? 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? /unsure 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. Cofunds Penson Account Flex-access Drawdown Applcaton Form 7

Secton 5 Rsk questons for flex-access drawdown contnued 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 0,000. 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,000. Are you, or anyone on your behalf, lkely to contrbute more than,000 to money purchase pensons n the future? /unsure 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? /not applcable No/unsure Inhertance tax (not requred for swtches from capped to flex-access drawdown) Money taken from your penson becomes part of your estate, whch wll be assessed for nhertance tax purposes on your death. Money n your penson s held outsde your estate and s hghly unlkely to be subject to nhertance tax. Have you consdered the nhertance tax mplcatons of takng money from your penson? No/unsure 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? 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? /unsure 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 Flex-access Drawdown Applcaton Form 8

Secton 6 6A.HM Revenue & Customs warnng Clent declaraton It s a serous offence to make false statements. The penaltes are severe. False statements could lead to prosecuton. 6B. Declaraton (when choosng full or partal drawdown n Secton 3) By sgnng ths applcaton form you are agreeng to amend your contract wth Suffolk Lfe as the provder of the Cofunds Penson Account. Ths s a legally bndng document between you and Suffolk Lfe. Before sgnng the declaraton for your own beneft and protecton you should read carefully the followng: Ths declaraton; Personalsed llustraton; Cofunds Penson Account Charges Sheet; Terms and condtons of the Cofunds Penson Account; Key Features of the Cofunds Penson Account; and Aegon Platform terms and condtons These documents together form the agreement upon whch, Suffolk Lfe Pensons Lmted, as provder of the Cofunds Penson Account, ntend to rely. If you do not understand any pont then please ask your advser/ntermedary. I confrm that I have vewed and agree to be legally bound by the Terms and Condtons of the Aegon platform, ths declaraton, the Cofunds Penson Account Charges Sheet, the Terms and condtons of the Cofunds Penson Account and the Key Features of the Cofunds Penson Account. I elect to receve the maxmum avalable tax-free lump sum unless I confrm to you n wrtng that I want to receve a lower amount. I acknowledge that all flex-access drawdown desgnatons for each penson wll be held n one arrangement. I acknowledge that the valuaton date for enterng flex-access drawdown s the latest of: The date on whch you receve the completed flex-access drawdown applcaton; The date of recept of the fnal transfer n set out n my ntal applcaton form from whch I wsh to take benefts; or The date that I reach the mnmum retrement age I authorse you to deduct the lfetme allowance charge (see Secton 2) from my plan on the date that the funds are desgnated. I confrm, where a tax-free lump sum s payable, that I wll not be recyclng the lump sum as descrbed below. Lump sum recyclng s defned n Schedule 29 of the Fnance Act 200 and s where a taxfree lump sum s pad by a regstered penson scheme and: As a result of ths the amount of the contrbutons from all sources s more than 30% of the contrbutons that mght have been expected based on prevous contrbutons; and The recyclng was pre-planned; and The amount of the total tax-free lump sum pad n the prevous 12 months exceeds 7,500; and The cumulatve amount of the addtonal contrbutons exceeds 30% of the tax-free lump sum payment. I acknowledge that by takng any ncome under flex-access drawdown, contrbutons to all of my money purchase pensons wll be subject to the Money Purchase Annual Allowance, f they are not already. I understand that once all unts have been appled to drawdown and no undrawn unts reman: Any further undrawn transfers wll requre the establshment of a new penson I have suppled all the necessary nformaton and documentaton requested to enable Suffolk Lfe to carry out the lfetme allowance test. I understand that where the sell down opton has been selected, t wll be Aegon and not Suffolk Lfe who shall be responsble for ensurng ths nstructon s processed. 6C. Declaraton (all cases) I elect to receve ncome under flex-access drawdown as set out n Secton 3. I wsh the scheme admnstrator to pay any death beneft n accordance wth ths applcaton and agree to the declaraton theren. I declare that to the best of my knowledge and belef the statements made n all sectons of ths flex-access drawdown form (whether n my handwrtng or not) are correct and complete. I understand that you may undertake a search wth a reference agency for the purposes of verfyng my dentty and age. To do so, the reference agency may check the detals I supply aganst any partculars on any database (publc or otherwse) to whch they have access. They may also use my detals n the future to assst other companes for verfcaton purposes. A record of the search wll be retaned as an dentty search. Clent sgnature Date / / Clent name Cofunds Penson Account Flex-access Drawdown Applcaton Form 9

Appendx I Advser Declaraton Advser detals I am the clent s, named n Secton 1, current advser as known to Aegon. Intermedary name Frm name Ths secton should be completed by a regulated UK advser f advce has been gven on takng benefts. Regulator s reference number for organsaton Regulator s reference number for ndvdual Please complete ths secton, n full, f you are not the clent s current advser as known to Aegon. Telephone number 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 Declaraton (to be completed and sgned f the clent has stated they have sought advce n Secton 1C) Please confrm whether you have provded advce to your clent on takng benefts from the Cofunds Penson Account: I have provded advce to my clent on takng benefts. I have not provded advce to my clent on takng benefts but I have explaned the rsks of drawdown. 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 118072. 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 3, The Leadenhall Buldng, 122 Leadenhall Street, London, EC3V AB. Regstered n England and Wales No. 3965289. Authorsed and regulated by the Fnancal Conduct Authorty (FCA) under FCA Regstraton No. 1973. COF381162 05/18 Cofunds Penson Account Flex-access Drawdown Applcaton Form 10