Non-UK Transfer T2.5. Instructions for filling in this form

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n-uk Transfer T2.5 Discharge form You need to fill in this to confirm that you want to transfer your benefits, or part of your benefits, to another pension arrangement based outside of the United Kingdom. The form is needed to give the trustees information that will allow the scheme s administrator, Premier, to transfer your pension and, if appropriate, pay the overseas transfer charge to HM Revenue and Customs. The transfer form includes sections which you and your new scheme will need to fill in. The transfer will only take place once all sections have been fully filled in and sent to us. Once a transfer takes place it cannot be reversed. Fill in this form using BLOCK CAPITALS and black ink. Mark answers with an X. Instructions for filling in this form You (transferring member) You must fill in and sign section A. When you have filled in the form send it to: Premier PO Box 108 BLYTH NE24 9DY You should also return your statement of entitlement which we gave you when you left the scheme. When we receive the filled-in discharge form and all supporting documents we have asked for, we will usually transfer the pension within four weeks. If there are any mistakes or missing information on the form or supporting documents, the transfer will be delayed. Both you and your receiving arrangement are responsible for meeting all of the conditions of the transfer. We and the trustees will not set up, arrange or advise on the transfer or help you fill in these transfer documents. You and your personal advisers are responsible for the transfer process. i Receiving arrangement (pension scheme you are transferring to) Section B must be filled in by the receiving arrangement. One of their authorised representatives must sign the sections when they have filled them in. The receiving arrangement must also give us a copy of their Qualifying Recognised Overseas Pension Scheme (QROPS) acceptance letter. If they fail to provide any of these documents, the transfer will not take place. We strongly recommend that, if you have not already done so, you get independent financial advice before transferring a pension. T2V3 Page 1 of 12

T2.5 n-uk Transfer Section A - Member s section Your details Transferring scheme name ( the Scheme ) Membership reference First names Surname Date of birth Home phone / / Mobile phone Email address Certificate of benefits I have enclosed my original certificate of benefits which provides details of the entitlement available to me from the Scheme. I have not enclosed my original certificate of benefits as I no longer have this document. Receiving scheme (where you are transferring to) Name of your new scheme Address Postcode - Policy reference Transfer options - mark one option with an X Option 1 - Transfer all pension rights. I want you to transfer all pension rights held under the Scheme to my new pension arrangement. Option 2 - Transfer non-protected rights only I want you to transfer only my non-protected rights to my new arrangement. I understand that by choosing this option, the Scheme will keep part of my benefits. Protected rights are the benefits built up in the Scheme as a results of contracting-out of the State Second Pension (S2P), formerly known as SERPS (State Earnings Related Pension Scheme). Some pension schemes still retain special conditions that are attached to how these benefits can be used. Option 3 - Transfer Additional Voluntary Contribution ( AVCs ) funds only I want you to transfer only my AVC funds to my new arrangement. I understand that by choosing this option, this Scheme will keep part of my benefits. Page 2 of 12 n-uk Transfer [T2.5] v1.2/vember 2017 2017 Premier Pensions Management Ltd

n-uk Transfer T2.5 Section A - Independent advice i Independent financial advice Defined benefit (final salary) schemes - if your transfer is above 30,000 then it can only go ahead if you have taken independent financial advice. Your adviser is required to confirm in writing to you that: you have received advice regarding a transfer from a defined benefit (DB) arrangement to a defined contribution (DC) arrangement; that they have the required authorisations under the relevant legislation to provide advice on the transfer of safeguarded benefits (DB); the reference number of the company or business in which the adviser works; and the subject matter of the letter should clearly state that advice is being provided to you in respect of your safeguarded benefits in the Scheme. You are required to provide a copy of this confirmation before your transfer can take place. Name of financial adviser Address of financial adviser Postcode - FCA registration number Phone number Email address i Pension scams Pension scams are on the increase. You may have already been targeted. The scammers have a variety of tricks to catch you out. They may: claim that you can access your pension pot before age 55 approach you out of the blue over the phone, via text message or in person door-to-door entice you with upfront cash offer a free pension review or try to lure you in with so-called one-off investment opportunities. The scammers may even pretend that the Government has asked them to contact you. What they won t tell you is that you ll probably never see your pension pot again. Don t be fooled by their promises. Check the facts before you make an irreversible decision. A lifetime s savings can be lost in a moment. These questions are designed to help us identify if you have been targeted by a pension scam. If you think you may have been targeted by this type of scam, call The Pensions Advisory Service on 0300 123 1047 before you sign this declaration or any other paperwork. If you have already accepted an offer, from a different pension, call Action Fraud now on 0300 123 2040. n-uk Transfer [T2.5] v1.2/vember 2017 2017 Premier Pensions Management Ltd Page 3 of 12

T2.5 n-uk Transfer Section A - Avoiding scams Pension scams Have you been told you can get access to this pension before age 55? Have the risks of pension transfers been fully explained to you by your advisers? Have you received policy documents from your new provider? Has any documentation from your new provider been missing or not forthcoming? Will you be taking any money from the new pension scheme straight away? Did you decide to transfer after receiving cold calls, unsolicited emails or text messages about your pension? Are you aware, that in the vast majority of cases, accessing your pension before the age of 55, will result in significant tax charges? Have you been offered a cash bonus or incentive for transferring your pension? Have you been encouraged to speed up this transfer or been offered benefits based on very limited timescales? Are you being pressurised into making this transfer? Are you aware that a transfer is irreversible and that once it goes ahead your benefits cannot be reinstated into this scheme? Has the new pension scheme been advertised to you using any words like load, savings advance, cash incentive, bonus, loophole, or preference shares? Your declaration and signature Please pay my transfer value to the provider of the new receiving arrangement/scheme. I have been given a statement of this value. I understand and agree that: 1. the actual amount to be transferred may be more or less than the statement of value if either a guarantee period has ended, or some or all of the value is made up of money purchase benefits where the value is derived from underlying investments which are not guaranteed; 2. once the transfer takes place, it cannot be reversed; 3. upon payment of the transfer value by the Trustees no benefits shall be payable under the Scheme to me, my Spouse, family and dependants or any other person claiming in respect of me and all liability relating to my membership of the Scheme will be discharged. I have consulted with my Spouse, family and other dependants in relation to the decision I have made. I undertake to indemnify the Trustees against any and all claims which may be made against the Trustees arising in any way from, or in connection with, my membership of the Scheme and/or the payment of the transfer value; 4. the benefits payable from the new receiving arrangement/scheme may be more or less that the benefits that would have been payable from the Scheme had I left them in there; and 5. the Trustees will not be responsible for ensuring that the transfer value is applied under the new receiving arrangement/scheme nor for the amount or type of benefits to be provided by the new receiving arrangement/scheme in return for the transfer value. 6. The receiving arrangement/scheme may not be regulated in any way by UK law and as a consequence there may be no obligation under that law on the receiving arrangement/scheme or its trustees (if relevant) or its administrators to provide any particlar value or benefit in return for the transfer payment. I have received a statement from the receiving arrangement/scheme showing the benefits to be awarded in respect of the transfer payment and the conditions (if any) on which these could be forfeited or witheld. If the receiving arrangement/scheme is an occupational pension scheme, I am in employment to which that scheme relates. 7. I have read and understood the information about pension scams and the overseas transfer charge, on pages 5, 6 and 9 of this form. 8. I understand that the Trustees strongly encourage me to follow the independent financial advice I have received. I accept that the Trustees have no responsibility to check such financial advice or otherwise to second-guess my circumstances and choice of transfer. 9. I understand that if I am within one year of my normal retirement age under the Scheme this is not a statutory transfer payment. Signature (the Scheme member) X Date / / Page 4 of 12 n-uk Transfer [T2.5] v1.2/vember 2017 2017 Premier Pensions Management Ltd

? Thinking of doing something with your pension pot? Before you go any further, read these five tips to protect yourself from scammers 1 If you think you ve been scammed act immediately If you've already signed something you're now unsure about, contact your pension provider straight away. They may be able to stop a transfer that hasn't taken place yet. Then call Action Fraud on 0300 123 2040 to report it. If you have doubts about what to do, ask The Pensions Advisory Service for help. Call them on 0300 123 1047 or visit the TPAS website at www.thepensionsadvisoryservice.org.uk for free pensions advice and information. If you're aged 50 or over and have a defined contribution pension (a pension not based on your final salary), Pension Wise is there to help you investigate your retirement options. Visit the Pension Wise website at www.pensionwise.gov.uk to find out more. 2 Cold called about your pension? Hang up! Unsolicited phone calls, text or emails about your pension are nearly always scams. Scammers will often claim they re from Pension Wise or other government-backed bodies. These organisations would never phone or text to offer a pension review. 3 Deals to look out for Beware of unregulated investments offering guaranteed returns. These include exotic sounding investments like hotels, vineyards or other overseas ventures, and deals where your money is all in one place and therefore more at risk. Visit the FCA s Scamsmart website at scamsmart.fca.org.uk to see if the deal you re being offered is a known scam, or has the hallmarks of a scam. Don t be rushed into making a decision. Scammers will try to pressure you with time limited offers or send a courier to your door to wait while you sign documents. Take your time to make all the checks you need even if this means turning down an amazing deal. Page 5 of 12

4 Using an adviser? Make sure they re registered with the FCA Scammers sometimes pose as financial advisers. Check your adviser is registered on the FCA website at www.fca.org.uk/register, and that they re authorised to give advice on pensions. If you deal with someone who is not regulated you may not be covered by the Financial Ombudsman Service or Financial Services Compensation Scheme if things go wrong. And don t be taken in by smart websites or brochures professional-looking marketing materials are not a guarantee of a company s authenticity. 5 Don t let a friend talk you into an investment check everything yourself People have fallen for scams because they d been recommended by a friend. Do your homework, even if you consider yourself or your friend to be financially savvy. False confidence can lead to getting stung and with a pension, it might be years before you discover you ve been scammed. What do you need to look out for? If you re thinking of transferring your pension, ask yourself these questions, and call TPAS on 0300 123 1047 if you have any doubts The company Did you get cold called? Is the firm or individual FCA registered? And are they authorised to give advice on pensions? Have there been complaints about the adviser, firm or investment? Do a thorough internet search. Also check on forums and social media for mentions. Is their address a PO Box or a serviced office? Again, do a thorough internet search of the address to check. Can you contact the business at their registered office? Is the contact number a mobile number? The deal Are you being offered guaranteed returns? Are the investments regulated by the FCA? Check at scamsmart.fca.org.uk What are the tax implications? As well as losing your life savings, you could also get a huge tax bill. Visit www.pension-scams.com Page 6 of 12

n-uk Transfer T2.5 Section B - Receiving arrangement Transferring member s details Transferring scheme name Member reference First names Surname Transfer value quoted Receiving arrangement s details Receiving scheme name Type of arrangement Policy number Qualifying Recognsied Overseas Pension Scheme (QROPS) Other (please state) This could change if a guarantee period has expired or if the transfer is from a Defined Contribution scheme. QROPS reference Date QROPS registered Q R O P S / / Receiving arrangement s bank details Please enclose a copy of your HMRC QROPS approval certificate. Name of bank Address of your bank Country Currency to send payment in* Bank routing (if applicable) Bank Swift BIC / ID Account number IBAN (EEA payments) Sort code (UK payments) - - ACH Number (USA payments) Reference to quote n-uk Transfer [T2.5] v1.2/vember 2017 2017 Premier Pensions Management Ltd Page 7 of 12

T2.5 n-uk Transfer Section B - Receiving arrangement i All international payments sent by Premier unless explicitly instructed and agreed in advance will be sent in the local currency of the receiving bank. International payments sent in this way are not subject to any transaction or processing fees. The receiving bank may deduct fees for receiving payments from the UK depending on their individual policies. Premier and the pension scheme trustees are not responsible for arranging, agreeing or paying any local charges or deductions applied by your receiving or routing bank. Registered office of receiving arrangement Address Company stamp Receiving arrangement s warranty When you pay us ( the recognised transfer value ) for the member, we agree to the following. That the Receiving Arrangement is an HMRC approved Qualifying Recognised Overseas Pension Scheme or other approved arrangement that can accept a transfer of pension benefits from an approved UK pension scheme. That the Recognised Transfer Value will be applied in the acquisition of transfer credits or will be applied by us to provide money purchase benefits for and in respect of the Member as allowed under the rules of the Receiving Arrangement. That only such part of the Recognised Transfer Value which you notify to us as being equal to the Member s contributions to the Transferring Scheme will be treated as a contribution made by him to the Receiving Arrangement. That we are able and willing to accept the transfer value in respect of the Member. Signed on behalf of the receiving arrangement I the authorised representative of the receiving arrangement, confirm that the information provided is true and accurate. By signing the discharge form I confirm, on behalf of the receiving arrangement, we accept the warranty related to this transfer. This form must be returned along with a copy of your arrangement s QROPS HMRC approval letter. We will reject applications to transfer without this documentation. Receiving scheme name Signature X Date / / Page 8 of 12 n-uk Transfer [T2.5] v1.2/vember 2017 2017 Premier Pensions Management Ltd

n-uk Transfer T2.5 HM Revenue and Customs i Overseas transfer charge The overseas transfer charge applies to certain transfers from a registered pension scheme to a QROPS, or from a QROPS (or former QROPS) to another QROPS. This includes the transfer of all pension rights including pension credit rights received from a pension sharing order following a divorce and all pensions in payment. Where a transfer is not liable to the overseas transfer charge when it is made the tax charge can still become due for a period up to five tax years after the transfer where there is a change in your circumstances. Similarly, where the overseas transfer charge is paid on a transfer a change in your circumstances in the five tax years following the transfer may mean the tax charge can be reclaimed from HM Revenue and Customs. The amount of the overseas transfer charge is 25% of the transferred value. If none of the following five conditions are met your transfer will be subject to the overseas transfer charge: 1. you are resident in the same country in which the QROPS receiving the transfer is established 2. you are resident in a country within the European Economic Area (EEA) and the QROPS is established in a country within the EEA 3. the QROPS is set up by an international organisation for the purpose of providing benefits for or in respect of past service as an employee of the organisation and you are an employee of that organisation 4. the QROPS is an overseas public service pension scheme and you are an employee of an employer that participates in the scheme 5. the QROPS is an occupational pension scheme and you are an employee of a sponsoring employer under the Scheme. If the overseas transfer charge is due, we will deduct the 25% tax from your transferred value before making the transfer. Complete form APSS263 Your transfer application must be returned to us along with HM Revenue and Custom s form APSS263. The transfer will not go ahead until this form is received back with your completed transfer discharge form. Form APSS263 has been included within this transfer application pack. Form APSS263 gives us the information we need to transfer sums or assets held within this registered pension scheme to a Qualifying Recognised Overseas Pension Scheme (QROPS). We will need this information before proceeding with your transfer request and HM Revenue & Customs may ask to see this. n-uk Transfer [T2.5] v1.2/vember 2017 2017 Premier Pensions Management Ltd Page 9 of 12

Qualifying Recognised Overseas Pension Schemes Member information for pension scheme administrators About this form Use this form to give your scheme administrator the information they need to transfer sums or assets held within a registered pension scheme to a Qualifying Recognised Overseas Pension Scheme (QROPS). You must provide this information to your scheme administrator within 60 days of your transfer request. The scheme administrator will need this information before proceeding with your transfer request and HM Revenue & Customs may ask to see this. Tax charges There are circumstances in which you may have to pay UK tax on this transfer or later payment out of the overseas scheme even if you are not resident in the UK. Please note if you don t provide this information to your pension scheme administrator within 60 days of your transfer request, your transfer will be subject to the overseas transfer charge. You can find more information about transferring to an overseas pension scheme on gov.uk at www.gov.uk/government/collections/overseas-pension-schemes About you 1 Your full name Title 5 If the address given in the previous question is not in the UK, please give your last principal address in the UK Last name First name(s) Postcode Country 2 National Insurance number 6 If your principal residential address is outside the UK, please give the date you left the UK DD MM YYYY If you have contacted Jobcentre Plus and are not entitled to a National Insurance number, please state the reasons and give any HMRC reference number that you have received If you don t have a previous UK address, please tick this box 7 Your contact phone number 3 Your date of birth DD MM YYYY 4 Your principal residential address This must not be c/o the scheme manager and must not be a PO Box number unless this is necessary due to the country of residence Country APSS263 Page 1 HMRC 01/17

About the QROPS receiving the transfer 8 HMRC reference number This is the QROPS reference number, allocated to the scheme by HMRC, when the notification that it met the requirements to be a recognised overseas pension scheme was acknowledged QROPS 9 Name of QROPS 12 Is the QROPS receiving the transfer an occupational pension scheme? If, please go to question 13 If, please go to question 15 13 Is the QROPS receiving the transfer an overseas public service scheme? The QROPS you are transferring to will know if they fall within the definition of an overseas public service scheme, as per the definition at regulation 3(1B) SI2006/206 If, please go to question 14 10 Address of QROPS If, please go to question 15 Country 11 Country in which QROPS is established and regulated 14 Is the QROPS receiving the transfer an international organisation? The QROPS you are transferring to will know if they fall within the definition of an international organisation, as per the definition at regulation 2(5) SI2006/206 If, please go to question 21 If, please go to question 15 Your employment details 15 Name of your employer 18 Date your employment began DD MM YYYY 16 Your job title 19 Do you know your payroll tax reference number? If, please go to question 21 17 Address of your employer If, please go to question 20 20 Payroll tax reference number Postcode Country Page 2

Acknowledgement 21 Have you been told that you can access some or all of the value of this transfer, either directly or indirectly before you reach the age of 55? To the best of my knowledge and belief the information given in this form is correct and complete. Signature 22 I am aware that: Date DD MM YYYY In some circumstances a transfer of funds might not be a recognised transfer and may be treated as an unauthorised payment giving rise to a liability to pay tax in the UK In some circumstances a future payment made or treated as made by a QROPS may be treated as an unauthorised payment giving rise to a liability to pay tax in the UK I understand that in some circumstances a transfer of funds might give rise to a liability to pay tax in the UK I undertake to pay tax to HMRC and provide information relating to taxable transfers Page 3