SIPP Supplemetary Cotributio Applicatio Form (For Modular isipp, James Hay isipp, James Hay Private Cliet SIPP, esipp, Wrap SIPP ad Select SIPP oly) JHAY0251 Applicatio Guide Please complete this form i BLOCK CAPITALS ad black ik. 1 Persoal Details Applicat to complete Mr Mrs Ms Miss Foreame(s) Surame Please tick the most appropriate box below oe box must be ticked: Employed Employer Name Employer address Member umber Natioal Isurace Number Address Pesioer Self-employed Telephoe Carig for oe or more childre uder the age of 16 years I full-time educatio Carig for a perso aged 16 years or over Uemployed 2 Cotributios Applicat to complete Importat: If you have ehaced or fixed protectio ay cotributio made to this SIPP meas you will lose this protectio. You should speak to your Fiacial Adviser. 2a Etitlemet to Tax Relief (please tick oe optio) Applicat to complete (i) I have relevat UK earigs chargeable to icome tax, or geeral earigs from overseas Crow employmet subject to UK tax, i this tax year. (ii) I am, or have bee, residet i the UK at some time durig this tax year. (iii) My spouse or civil parter has for this tax year geeral earigs from overseas Crow employmet subject to UK tax. (iv) I am, or my spouse or civil parter is, i overseas Crow employmet but for this tax year do/does ot have geeral earigs from overseas Crow employmet subject to UK tax. (v) I was residet whe I became a member of the SIPP ad have bee residet i the UK at some time durig five tax years immediately before this tax year. (vi) Noe of the above. If you have ticked (i) or (ii) we will reclaim basic rate tax o your persoal cotributios. If you have ticked (iii), (iv) or (v) we will reclaim basic rate tax o your persoal cotributios up to 3,600 gross. If you have ticked (vi) we will ot reclaim ay basic rate tax relief o your persoal cotributios. Please ote: If you do ot complete this sectio, we will ot be able to determie if you are etitled to have basic rate tax reclaimed o your persoal cotributio ad so will ot be able to reclaim this. JHAY 0251 APR15 LD 1
2b Persoal Cotributios Applicat to complete How much would you like to pay ito your SIPP? Please state the gross amout. If, as per sectio 2a, we are able to reclaim basic rate tax o your persoal cotributios, the amout you actually pay ito your SIPP should be the et amout i.e. gross amout less basic rate tax. Sigle cotributio (gross) Cheques should be made payable to James Hay Pesio Trustees Limited. Regular cotributio (gross) Ay other ame the third party has bee, or is kow by Date of birth Or, Orgaisatio ame Address of third party Frequecy of cotributios Mothly Quarterly Half yearly Aually Start date for regular cotributio paymets If regular cotributio paymets are to be made to your SIPP please forward a completed Direct Debit Madate to us. Please allow 20 Busiess Days for us to set up ay Direct Debit Madate. Will your persoal cotributios be paid to James Hay Partership by a third party, other tha your employer? Yes No If Yes please provide the ame ad address of the third party: Title Mr Mrs Ms Miss Foreame(s) Surame You will eed to supply documetary evidece of the idetity ad address of the third party. If persoal cotributios are received from your employer please forward them the Record of Paymets Due form for completio ad retur it to us. If applicable, we will reclaim basic rate tax o persoal cotributios. The tax reclaim will take betwee 7 11 weeks. Please ote that the value of the reclaim ca oly be ivested oce it has bee paid ito your desigated SIPP Bak Accout ad it has cleared. Importat: If your cotributios i respect of a tax year exceed the aual allowace ( 40,000 for the 2015/16 tax year), the you may be subject to a aual allowace tax charge. It is possible for uused aual allowace to be carried forward for up to three years. You should speak to your Fiacial Adviser about this. Please ote: If you have flexibly accessed your SIPP or ay other moey purchase pesio you may have, you will be subject to the moey purchase aual allowace limit ( 10,000 for 2015/16 tax year). If your cotributios exceed this amout, you may be subject to a aual allowace tax charge. You must iform us if you have flexibly accessed aother moey purchase pesio scheme withi 91 days of doig so. Please ote: The tax treatmet depeds o the idividual circumstace ad may be subject to chage i the future. 2c Employer Cotributios - employer cotact details (if applicable) Applicat to complete Employer s details: Compay ame Cotact ame Coutry of establishmet / icorporatio Registered umber (If applicable) Nature of busiess Correspodece address Telephoe Fax I am happy for James Hay Partership to correspod with my employer directly Yes No If your employer wishes to regularly cotribute to your SIPP please ask them to complete ad sig sectio 2e below. For regular cotributios your employer will also eed to complete a Direct Debit Madate. Where applicable, please eclose ay Direct Debit Madates with this form. Please allow 20 Busiess Days for us to set up Direct Debits. JHAY 0251 APR15 LD 2
2d Employer Cotributios - Sigle Paymets (if applicable) Applicat to complete All employer cotributios are paid gross. How much will your employer pay ito your Pla? Sigle cotributio (gross) 2e Employer s Paymet Record for Regular Cotributios (if applicable) Employer to complete You, the employer, should complete this sectio if you will be makig regular paymets ito your employee s Pla, either deducted from the employee s salary, or from your ow fuds. Regular paymets must be submitted via direct debit. You, the employer, must prepare ad maitai a record of the paymets due to be paid to your employee s pesio. Regular employer cotributio amout (gross) To be siged o behalf of the employer I cofirm that the iformatio i this sectio is accurate ad I will otify you if ay of these details chage. Siged Please sig oce prited ad before sedig to James Hay Partership Regular employee cotributio amout Frequecy of cotributios: Mothly Quarterly Half yearly Aually Date of the first employer cotributio (et) Name Positio Please allow 20 Busiess Days for us to set up the Direct Debit Madate. Ay cotributios due prior to the specified date above should be paid i accordace with sectio 2d of this form. We will use the day of the first cotributio date as the ogoig collectio day for the stated cotributios. The due date for pesio regulator purposes, i relatio to these regular paymets, will always be the 19th day of the followig moth. Date Cotact umber (if differet from details already give) Additioal iformatio o cotributios is available i the otes sectio at the back of this documet. 3 Declaratio Applicat to complete a) I cofirm that to the best of my kowledge ad belief, the particulars give o this Applicatio Form are correct ad complete. b) I udertake to tell James Hay Partership i writig withi 30 days if: There is ay chage i my residecy status There is ay chage i my ame or permaet residetial address. c) I accept that this applicatio determies whether I am etitled to basic rate tax relief at source o my cotributios. d) I agree that the total cotributios to ay registered pesio schemes i respect of which I am etitled to tax relief will ot exceed the higher of: 3,600, or My relevat UK earigs for that tax year. Sigature Please sig oce prited ad before sedig to James Hay Partership Date e) If I am o loger etitled to tax relief o my cotributios I udertake to tell James Hay Partership i writig o later tha: 5 April i the year of assessmet i which this occurs, or Withi 30 days of this chage. f) I accept it is a offece to make false statemets ad that the pealties are severe ad could lead to prosecutio. JHAY 0251 APR15 LD 3
Notes CONTRIBUTIONS Legislatio requires James Hay Partership to moitor paymets ito a persoal pesio scheme by employers from their ow bak accout i respect of the employee, or o behalf of the employee out of deductios from the employee s earigs. The legislatio also states that the employer must specify the Due Date for such paymets. This iformatio is detailed i sectio 2e of the applicatio form. The employer must make sure that the paymets are correct ad paid o time. By law, James Hay Partership must moitor the paymets to esure they are made o time usig the Employer s Paymet Record iformatio provided. We must tell The Pesios Regulator if paymets are missed or received late. The employer may be fied by The Pesios Regulator if late or icorrect paymets are made. For paymets deducted from a employee s earigs, the due date these paymets must be received by James Hay Partership is the 19th of the moth after the ed of the caledar moth i which the cotributios were deducted from the employee s pay. For example if the deductio from the employee s salary is 29 April the due date is 19 May. Checklist of Additioal Documetatio Required EVIDENCE OF A THIRD PARTY S NAME AND ADDRESS (EXCEPT EMPLOYER) IF CONTRIBUTING TO YOUR SIPP If the third party is a idividual, please request a separate Cofirmatio of Verificatio of Idetity from James Hay Partership to be completed by your Fiacial Adviser OR Black ad white photocopies of two documets - oe from list A ad oe from list B. (Items from the same source caot be used twice) Completed Direct Debit Madate if regular cotributios are to be paid by you or your employer (if applicable). Cheque made payable to James Hay Pesio Trustees Limited for sigle cotributios. Your employer has completed ad siged sectio 2e if they are to pay ito your Pla. List A Uexpired passport Uexpired UK old style drivig licece (ot provisioal) Uexpired UK Photocard drivig licece Firearms certificate or shotgu licece EEA of Switzerlad Natioal Idetity Card ad Norther Irelad Voters List B Uexpired UK old style drivig licece (ot provisioal) Uexpired UK Photocard drivig licece Coucil Tax Bill Firearms certificate or shotgu licece Bak Statemet (ot iteret prited) Credit Card statemet (ot iteret prited) Utility Bill (ot mobile phoe, satellite/cable TV or iteret prited bills) HM Reveue & Customs codig/assessmet/ statemet/tax credit If the third party is a uicorporated busiess please supply a photocopy of: Latest reports ad accouts HM Reveue & Customs tax retur or ivoice James Hay Partership is able to provide literature i alterative formats. The formats available are: Large Prit (as recommeded by RNIB), Braille, Audio Tape ad PC Disk. If you would like to receive this documet i a alterative format please cotact us o 0845 850 4455. For the hard of hearig ad / or speech impaired, please use the Typetalk service via 18001 0845 850 4455. James Hay Partership is the tradig ame of James Hay Isurace Compay Limited (JHIC) (registered i Jersey umber 77318); IPS Pesios Limited (IPS) (registered i Eglad umber 2601833); James Hay Admiistratio Compay Limited (JHAC) (registered i Eglad umber 4068398); James Hay Pesio Trustees Limited (JHPT) (registered i Eglad umber 1435887); James Hay Wrap Maagers Limited (JHWM) (registered i Eglad umber 4773695); James Hay Wrap Nomiee Compay Limited (JHWNC) (registered i Eglad umber 7259308); PAL Trustees Limited (PAL) (registered i Eglad umber 1666419); Sathouse Pesioeer Trustee Compay Limited (SPTCL) (registered i Eglad umber 1670940); Sarum Trustees Limited (SarumTL) (registered i Eglad umber 1003681); Sealgrove Trustees Limited (STL) (registered i Eglad umber 1444964); The IPS Partership Plc (IPS Plc) (registered i Eglad umber 1458445); Uio Pesio Trustees Limited (UPT) (registered i Eglad umber 2634371) ad Uio Pesios Trustees (Lodo) Limited (UPTL) (registered i Eglad umber 1739546). JHIC has its registered office at 3rd Floor, 37 Esplaade, St Helier, Jersey, JE2 3QA. IPS, JHAC, JHPT, JHWM, JHWNC, SPTCL, SarumTL ad IPS Plc have their registered office at Triity House, Buckigway Busiess Park, Aderso Road, Swavesey, Cambs CB24 4UQ. PAL, STL, UPT ad UPTL have their registered office at Du s House, St Paul s Road, Salisbury, SP2 7BF. JHIC is regulated by the Jersey Fiacial Services Commissio ad JHAC, JHWM, IPS ad IPS Plc are authorised ad regulated by the Fiacial Coduct Authority. The provisio of Small Self Admiistered Schemes (SSAS) ad trustee ad/or admiistratio services for SSAS are ot regulated by the FCA. Therefore, IPS ad IPS Plc are ot regulated by the FCA i relatio to these schemes or services.(01/14) www.jameshay.co.uk JHAY 0251 APR15 LD 4
SIPP Modular isipp, isipp, Private Cliet SIPP, Select SIPP, esipp ad Wrap SIPP oly Istructio to your bak or buildig society to pay by Direct Debit Please fill i the whole form usig a ball poit pe ad sed it to: James Hay Pesio Trustees Limited Du s House St Paul s Road Salisbury SP2 7BF Name(s) of Accout Holder(s) Service User Number 8 8 0 1 1 3 Referece Bak/Buildig Society Accout Number Brach Sort Code Istructio to your Bak or Buildig Society Please pay James Hay Pesio Trustees Limited Direct Debits from the accout detailed i this Istructio subject to the safeguards assured by the Direct Debit Guaratee. I accept that this Istructio may remai with James Hay Pesio Trustees Limited ad, if so, details will be passed electroically to my bak/buildig society. Name ad full postal address of your Bak or Buildig Society To: The Maager Bak/Buildig Society Sigature(s) Address Date Baks ad Buildig Societies may ot accept Direct Debit Istructios for some types of accout JHAY 0251 APR15 LD This guaratee should be detached ad retaied by the Payer The Direct Debit Guaratee This Guaratee is offered by all baks ad buildig societies that accept istructios to pay Direct Debits If there are ay chages to the amout, date or frequecy of your Direct Debit James Hay Pesio Trustees Limited will otify you 10 Busiess Days i advace of your accout beig debited or as otherwise agreed. If you request James Hay Pesio Trustees Limited to collect a paymet, cofirmatio of the amout ad date will be give to you at the time of the request. If a error is made i the paymet of your Direct Debit, by James Hay Pesio Trustees Limited or your bak or buildig society, you are etitled to a full ad immediate refud of the amout paid from your bak or buildig society If you receive a refud you are ot etitled to, you must pay it back whe James Hay Pesio Trustees Limited asks you to You ca cacel a Direct Debit at ay time by simply cotactig your bak or buildig society. Writte cofirmatio may be required. Please also otify us. JHAY 0251 APR15 LD 5