FIXED GIFT TRUST SUITABLE FOR NEW APPLICATION OR EXISTING POLICIES This trust does not allow for any part of the trust fund, or any income, to be paid for the benefit of the settlor Policy Number: Life Assured Name: Life Assured Date of Birth:
Please refer to the notes in the margin when completing this form. Boxes A E should be completed clearly and correctly as described. Box F should be completed only if the law of Scotland is to apply. Any amendments or correction of errors made before the deed is signed should be initialled by you and the additional trustees. Once completed, the Gift Trust should be signed by the settlor and the additional trustees in the spaces provided on the last page. Note that the settlor (or each settlor) should sign once only. Signatures should be witnessed by an independent person who should sign and then print his or her full name and address. Notice of the assignment, where relevant, should be given to the appropriate insurance company by production of the completed deed. BOX A DATE OF GIFT TRUST In Box A, insert the date of your application (new investments), or if the policy is already in force, insert the date the last person signs for example, 29/03/2011. Note that where the policy is already in force, the date in Box A must not be earlier than the commencement date (or the latest commencement date) of the existing policy or policies. The settlor is the person who is creating the trust or making the assignment. You should insert your full name and address in Box B. Date (DD MM YYYY) BOX B SETTLOR First Settlor (s) Second Settlor (s) In Box C, insert the full names and addresses of the persons who have agreed to act with you as trustees. As settlor, you are automatically a trustee and do not need to repeat your details here. BOX C ADDITIONAL TRUSTEES First additional trustee We recommend that you appoint at least one additional trustee. Where more than two additional trustees are required, these should be appointed by separate deed after the Gift Trust is established. Full details of all of the additional trustees are required for prevention of money laundering purposes. Occupation Please provide your TIN: 1
BOX C ADDITIONAL TRUSTEES (continued) Second additional trustee Occupation Please provide your TIN: Insert only the detail(s) of the person(s) you wish to benefit and, if more than one, the percentage share (whole numbers only). Please note: the chosen beneficiaries and the share in which they benefit cannot be changed once the Gift Trust is established. If there is more than one beneficiary and no percentage share is indicated or the shares do not add up to 100%, each beneficiary will take an equal share BOX D BENEFICIARY OR BENEFICIARIES First beneficiary Please provide your TIN. 2
BOX D BENEFICIARY OR BENEFICIARIES (continued) Second beneficiary Please provide your TIN. Third beneficiary Please provide your TIN. 3
BOX D BENEFICIARY OR BENEFICIARIES (continued) Fourth beneficiary Please provide your TIN. 4
BOX D BENEFICIARY OR BENEFICIARIES (continued) Share (%) First beneficiary Second beneficiary Third beneficiary Fourth beneficiary Total 100% Please complete either Part A or Part B of Box E as appropriate. If you are making an application for a new policy, you should insert the date of your application and the name of the product you are applying for in Part A of Box E for example 29/03/2011, Investment Bond or Investment Portfolio Bond. If you wish to place an existing policy in trust, you should insert details of the policy or policies to be assigned to the Gift Trust in Part B of Box E for example Investment Bond or Investment Portfolio Bond AB00123, Clerical Medical Investment Group. BOX E POLICY OR POLICIES TO BE ASSIGNED Please complete Part A if you are making an application for a new policy Application date Application number Product name Please complete Part B if the policy is already in existence Product name Policy number Issued by If you would like the law of Scotland to apply to your Gift Trust, you (or both of you, if more than one settlor) should sign in Box F and state the date and place of signing. Otherwise Box F should be left blank and the law of England and Wales will apply. The law of Scotland would normally be selected only if the settlor(s) is/are resident or domiciled in Scotland. BOX F LAW OF SCOTLAND TO APPLY (Settlor (if more than one, both settlors) should sign here only if the law of Scotland is to apply to these trusts) It is important that you appoint at least one additional trustee to act with you as soon as possible, so that the trust will be effective under the law of Scotland. 5
THIS ASSIGNMENT AND/OR DECLARATION OF TRUST is made on the date shown in Box A above BETWEEN the Settlor described in Box B above and the Settlor and the Additional Trustees described in Box C above. NOW THIS DEED WITNESSES as follows: DEFINITIONS 1 In this trust form 1.1 the Settlor means the person or persons named in Box B above 1.2 the Trustees means the Settlor and the person or persons named in Box C above and/or the other trustee or trustees for the time being of this trust 1.3 the Beneficiary means the person or persons named in Box D above and no other person or persons 1.4 the Policy means the life insurance policy or bond (and if more than one each policy or bond) described in or issued pursuant to the application described in Box E above 1.5 the Trust Fund means 1.5.1 all the benefits rights and interests of the Trustees under and in the Policy and all moneys assured by or payable under it 1.5.2 all property at any time added to this trust by way of further assignment to the Trustees or retention of income or capital accretion and 1.5.3 all property for the time being representing the property described in 1.5.1 and 1.5.2 1.6 Corporate Trustee means a trust corporation or other company authorised to undertake trust business 1.7 the Company means any company which is a subsidiary (as that term is defined in section 1159 of the Companies Act 2006) of Lloyds Banking Group plc DECLARATION OF TRUST AND/OR ASSIGNMENT OF POLICY TO THE TRUSTEES The Settlor requests the Company to issue the policy to the Trustees to be held by them subject to the terms of the trust set out below or, where the Policy has already been issued to the settlor, the Settlor hereby assigns the Policy to the Trustees to be held by them on the said terms TRUST PROVISIONS 3.1 The capital and income of the Trust Fund shall be held in trust for the Beneficiary absolutely 3.2 If more than one person is the Beneficiary the Trust Fund shall be held in trust in the percentage shares specified in Box D above or if no such shares are specified or if the shares specified do not total 100% then in equal shares absolutely 3.3 The Trustees shall have the power either to pay any sum falling due to any Beneficiary who has not attained the age of legal capacity to the parent or other guardian of such Beneficiary or to retain such sum and apply the whole or part of the income therefrom or the capital thereof for the maintenance education or benefit of such beneficiary as the trustees in their discretion determine with power to retain unexpended income until such beneficiary attains said age when the same shall be paid to him or her 3.4 Section 31 Trustee Act 1925 shall not apply to this trust 3.5 The Trustees shall at the request of any Beneficiary but at the cost of all Beneficiaries transfer the Trust Fund as that Beneficiary shall direct in relation to the share or shares specified in Box D above subject only to the Beneficiary having attained the age of legal capacity TRUSTEES POWERS 4 Subject to the right of all Beneficiaries acting together unanimously to direct otherwise the Trustees shall have the following additional powers: 4.1 to invest in policies of life insurance or any other kind of investment (heritable or moveable real or personal including wasting assets and whether income-producing or not) in any part of the world as if they were absolute owners beneficially entitled (and without any need to diversify investments) 4.2 to vary manage and deal with investments from time to time in their absolute discretion with power to dispose of or enter into any arrangement with respect to any of their rights as holders of any insurance policy or other asset as if they were absolute owners beneficially entitled and in particular (but without limiting the foregoing) in the case of any insurance policy to exercise any of the options and powers conferred by it and to encash surrender sell convert or otherwise dispose of it or any part of it or any of their rights as holders of it as they may in their discretion think fit 4.3 to accept as a good and sufficient discharge a receipt given by any parent or guardian of any Beneficiary who has not attained the age of legal capacity in respect of capital or income payable to or for the benefit of such Beneficiary 6
4.4 to delegate in any way and to any extent to any persons or corporations (including a Trustee) wherever situate or resident the exercise of any of the powers of the investment or management of the property for the time being forming part of the Trust Fund and to allow any such property to be registered in the name of or to be held by any person firm or corporation as nominee for the Trustees and to hold any investments in certificated or uncertificated form 4.5 to carry on the administration of this trust in any part of the world as the Trustees think fit CONFLICTS OF INTEREST 5.1 ANY transaction by the Trustees which is authorised by this trust or by the general law may take place even though one or more of them acts in a dual capacity but only if there is at the time at least one of them who does not act in a dual capacity and who is satisfied that its terms are fair and for the purpose of this sub-clause 5.1 a person acts in a dual capacity if he or she is an individual who takes part in a transaction both in his or her capacity as one of the Trustees and in a personal capacity or takes part in his or her capacity as one of the Trustees in a transaction which involves a company of which he or she is a director or shareholder or a partnership of which he or she is a member 5.2 ANY transaction by the Trustees which is authorised by this trust or by the general law may take place even though one or more of them acts in a dual capacity and for the purposes of this sub-clause 5.2 a person acts in a dual capacity if he or she takes part in a transaction both as one of the Trustees and in another fiduciary capacity as a trustee of another trust or settlement or as someone s personal representative or executor 5.3 Subject to the above or as otherwise expressly provided any Trustee may join or concur in exercising any power or discretion hereby or by law given to the Trustees even though he or she may have a direct personal or other interest in the mode or result of exercising the power or discretion TRUSTEES LIABILITY 6 No Trustee shall be liable for any loss or damage to the capital or income of the Trust Fund which arises through the exercise in good faith of any power given by this trust or by the general law and none who acts gratuitously shall be liable for any such loss or damage unless it arises through an act or omission which amounts to fraud or wilful neglect or default TRUSTEES CHARGING CLAUSES 7.1 Any Corporate Trustee shall be entitled in addition to reimbursement of its proper expenses to remuneration for its services in accordance with its published terms and conditions for trust business in force from time to time 7.2 Any Trustee acting as a trustee in a professional or business capacity other than the Settlor shall be entitled to charge and be paid all usual professional or other charges for business done services rendered or time spent by him or her or his or her firm in the administration of this trust including acts which a Trustee not engaged in any profession or business could have done personally APPOINTMENT OR REMOVAL OF TRUSTEES 8.1 The power to appoint new or additional trustees shall be vested in the Settlor during his or her lifetime 8.2 A person may be appointed as a Trustee even if neither resident nor domiciled nor carrying on business nor incorporated in the United Kingdom 8.3 The power of appointing additional trustees shall not be exercisable only because a Trustee remains out of the United Kingdom for more than 12 months 8.4 The Settlor shall during his or her lifetime have power to dismiss any Trustee by giving 30 days notice in writing to such Trustee so long as there shall be at least one Corporate or two individual Trustees remaining 8.5 Where there is more than one Settlor the power to appoint or dismiss a trustee shall be exercised jointly during the joint lifetime of the Settlors and by the survivor during the survivor s lifetime PAYMENT ON INSTRUCTION OF TRUSTEES 9 The receipt of the Trustees or any person or persons or organisation nominated in writing by the Trustees jointly for the purpose of receiving payment of any monies shall be a discharge to the person making the payment for the payment of such monies and that person shall thereafter be under no obligation or duty to be concerned with the application of such monies GOVERNING LAW 10 This trust shall be governed by the laws of England and Wales and the construction effects and administration of this trust shall be subject to the jurisdiction of and in accordance with English law PROVIDED THAT if the settlor has signed Box F above the trusts declared shall be governed by the laws of Scotland and administration of these trusts shall be subject to the jurisdiction of and in accordance with Scots law and construed accordingly 7
SIGNED and DELIVERED AS A DEED by the said Settlor s name Settlor s signature in the presence of Witness name Witness signature Witness address SIGNED and DELIVERED AS A DEED by the said Trustee s name Trustee s signature in the presence of Witness name Witness signature Witness address DISCLAIMER This document is produced by Scottish Widows as a standard form for use with life assurance policies only. It is a document with legal significance which may affect the rights, obligations and tax position of the settlor and beneficiaries. You should not sign this form unless you understand its effects and are satisfied that it achieves your objectives. Your attention is drawn particularly to clause 6 which exempts the trustees from liability in some circumstances. Scottish Widows strongly recommends that independent professional advice is sought if there are any doubts about the form or its consequences. 8
DATA PRIVACY NOTICE Your personal information will be held by Scottish Widows Ltd which is part of the Lloyds Banking Group. More information on the Group can be found at www.lloydsbankinggroup.com This privacy notice contains key information about how we will use and share your personal information and the rights you have in relation to this. If you want to know more please access our full privacy notice at www.scottishwidows.co.uk/legalprivacy or ask us for a copy. We will use your personal information: to provide products and services, manage your relationship with us and comply with any laws or regulations we are subject to (for example the laws that prevent financial crime or the regulatory requirements governing the products we offer). for other purposes including improving our services, exercising our rights in relation to agreements and contracts and identifying products and services that may be of interest. To support us with the above we analyse information we know about you and how you use our products and services, including some automated decision making. You can find out more about how we do this, and in what circumstances you can ask us to stop, in our full privacy notice. Your personal information will be shared within Lloyds Banking Group and other companies that provide services to you or us, so that we and any other companies in our Group can look after your relationship with us. By sharing this information it enables us to better understand our customer s needs, run accounts and policies, and provide products and services efficiently. This processing may include activities which take place outside of the European Economic Area. If this is the case we will ensure appropriate safeguards are in place to protect your personal information. You can find out more about how we share your personal information with credit reference agencies below and can access more information about how else we share your information in our full privacy notice. We will collect personal information about you from a number of sources including: information given to us on application forms, when you talk to us in branch, over the phone or through the device you use and when new services are requested. from analysis of how you operate our products and services, including the frequency, nature, location, origin and recipients of any payments. from or through other organisations (for example card associations, credit reference agencies, insurance companies, retailers, comparison websites, social media and fraud prevention agencies). in certain circumstances we may also use information about health or criminal convictions but we will only do this where allowed by law or if you give us your consent. You can find out more about where we collect personal information about you from in our full privacy notice. We may be required by law, or as a consequence of any contractual relationship we have, to collect certain personal information. Failure to provide this information may prevent or delay us fulfilling these obligations or performing services. The law gives you a number of rights in relation to your personal information including: the right to access the personal information we have about you. This includes information from application forms, statements, correspondence and call recordings. the right to get us to correct personal information that is wrong or incomplete. in certain circumstances, the right to ask us to stop using or delete your personal information. from 25th May 2018 you will have the right to receive any personal information we have collected from you in an easily re-usable format when it s processed on certain grounds, such as consent or for contractual reasons. You can also ask us to pass this information on to another organisation. You can find out more about these rights and how you can exercise them in our full privacy notice. We may also collect personal information about other individuals who you have a financial link with. This may include people who you have joint accounts or policies with such as your partner/spouse, dependents, beneficiaries or people you have commercial links to, for example other directors or officers of your company. We will collect this information to assess any applications, provide the services requested and to carry out credit reference and fraud prevention checks. You can find out more about how we process personal information about individuals with whom you have a financial link in our full privacy notice. In order to process your application we may supply your personal information to credit reference agencies (CRAs) including how you use our products and services and they will give us information about you, such as about your financial history. We do this to assess creditworthiness and product suitability, check your identity, manage your account, trace and recover debts and prevent criminal activity. We may also continue to exchange information about you with CRAs on an ongoing basis, including about your settled accounts and any debts not fully repaid on time, information on funds going into the account, the balance on the account and, if you borrow, details of your repayments or whether you repay in full and on time. CRAs will share your information with other organisations, for example other organisations you ask to provide you with products and services. Your data will also be linked to the data of any joint applicants or other financial associates as explained above. 9
You can find out more about the identities of the CRAs, and the ways in which they use and share personal information, in our full privacy notice. The personal information we have collected from you and anyone you have a financial link with may be shared with fraud prevention agencies who will use it to prevent fraud and money laundering and to verify your identity. If fraud is detected, you could be refused certain services, finance or employment. Further details of how your information will be used by us and these fraud prevention agencies, and your data protection rights, can be found in our full privacy notice. If you apply to us for insurance, we may pass your details to the relevant insurer and their agents. If a claim is made, any personal information given to us, or to the insurer, may be put onto a register of claims and shared with other insurers to prevent fraudulent claims. It is important that you understand how the personal information you give us will be used. Therefore, we strongly advise that you read our full privacy notice, which you can find at www.scottishwidows.co.uk/legalprivacy or you can ask us for a copy. If you have any questions or require more information about how we use your personal information please contact us using https://www.scottishwidows.co.uk/secure/forms/contact_us/individual_customers/policy-enquiries You can also call us on 0345 300 2244. If you feel we have not answered your question Lloyds Banking Group has a Group Data Privacy Officer, who you can contact on 0345 300 2244 and tell us you want to speak to our Data Privacy Officer. 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. 51080 07/18