PERSONAL PENSION (TOP UP PLAN) APPLICATION TO INCREASE CONTRIBUTIONS FOR OFFICE USE ONLY. Agency Number

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1 PERSONAL PENSION (TOP UP PLAN) APPLICATION TO INCREASE CONTRIBUTIONS Agency Number FOR OFFICE USE ONLY

2 Arranged by: Application to increase contributions Did your adviser give you advice in respect of this increase? Advice given Advice not given (If you have not already set up a Top Up Plan to receive your top-ups, please complete form instead of this one.) If you have applied to HM Revenue & Customs for Enhanced Protection/ Fixed Protection from any potential lifetime allowance tax charge, such protection will normally be lost on any payment to a pension plan. For further information, please seek financial advice. This form should be read in conjunction with the product literature issued at the start of your plan. Please write in BLOCK LETTERS and tick the appropriate boxes. Please complete Section A and B fully and the relevant parts of Sections C. F. before you sign the Declaration. Your employer should fill in Section C parts 3 and/or 4, if appropriate, before signing the Declaration by the Employer. If you wish to transfer the value of another pension plan into this Scottish Widows pension plan, please do not use this form. Instead, please request a Transfer Application from Scottish Widows. Please return the completed form to the address below the Declaration, quoting your Plan number. A. ELIGIBILITY NOTES TO SECTION A (1) Habitual residence means your permanent residential address. We can only accept applications from a limited number of overseas countries. If you are not resident in the United Kingdom, please speak to your financial adviser or contact us to confirm your eligibility. (2) To be eligible to make personal contributions you must be resident in the United Kingdom or otherwise entitled to tax relief on your payments. You must be aged less than 75 to increase contributions to a Personal Pension and in order to further determine your eligibility, please provide the following information: 1. Country of habitual residence (see note 1) 2. Nationality And, if you are not resident in the United Kingdom: (see note 2) I am a Crown employee, or the husband, wife or registered civil partner of a Crown employee, who has general earnings from overseas Crown employment. (please tick box if applicable) or I have earnings which are chargeable to United Kingdom Income tax. (please tick box if applicable) B. YOUR DETAILS NOTES TO SECTION B (1) This should be your permanent residential address. We will send all correspondence to this address. Please ensure the postcode is provided. 1. Your Top Up Plan number 2. Title Mr Mrs Miss Ms Other (please specify) 3. First name(s) 4. Surname 5. Home address Postcode Country 1

3 NOTES TO SECTION C (1) The Money Purchase Annual Allowance (MPAA) is currently 10,000. The MPAA applies to you if you have flexibly accessed your pensions from us or any other provider and have received any of the payments listed below from 6 April 2015 onwards: a payment from a flexible access drawdown fund (also known as a flexi-access drawdown fund); a payment from a capped drawdown fund which would exceed existing capped drawdown limits; a pension encashment (also known as an uncrystallised funds pension lump sum); a payment under a flexible annuity contract; a pension payment from a money purchase scheme which has fewer than 11 other pensioner members; a stand-alone lump sum from a money purchase arrangement where you were entitled to primary protection with a right to take a lump sum of greater than 375,000. The MPAA applies to all contributions you pay (or that are paid on your behalf e.g. employer contributions and death-in-service premiums) each year to all money purchase pension schemes of which you are a member. If the MPAA applies to you and your contributions exceed it, you will be liable to pay a tax charge based on your highest rate of income tax. The MPAA does not apply if you have taken only income from a capped drawdown plan; tax-free cash (pension commencement lump sums) when using your plan to purchase an annuity or drawdown plan; or small pots taken as a cash lump sum. In these circumstances, the higher annual allowance applies to you. (2) Your contributions are paid net of basic rate tax. If you are adding regular contributions for the first time, please contact Scottish Widows for details of the minimum levels that apply. (3) If you increase your monthly contribution, your new contribution will normally be collected on the next monthly due date after Scottish Widows has received this form. If your contributions are currently yearly you will have to pay a proportion of the increase if it is not made at the anniversary of your plan. (4) You must pay by direct debit. If, however, your employer is paying any part of your regular contribution they must complete the Direct Debit Instruction. This is available from Scottish Widows. This will enable Scottish Widows to collect your, and your employer s, contributions. If you are making any contributions, your employer will deduct the amount from your salary. The minimum above applies to the total of your, and your employer s, contributions. C. INCREASE TO RETIREMENT CONTRIBUTIONS There is no maximum limit on how much can be paid to your plan, although we can only accept contributions from you that are eligible for tax relief*. Relief is available on contributions which don t exceed your UK relevant earnings, or 3,600 if higher. *If you are a Scottish taxpayer the tax relief you will be entitled to will be at the Scottish Rate of income tax, which may be different from the rest of the UK in the future. The Treasury sets an annual allowance on the amount that can be paid into all your registered pension schemes without incurring a tax charge. Higher earners will have a lower annual allowance limit, called the Tapered Annual Allowance. Your annual allowance may also be limited to the Money Purchase Annual Allowance if you have flexibly accessed a pension with us or any other provider. (see note 1) Please speak to your financial adviser if you are unsure about how much you can pay. Have you flexibly accessed any pensions with us or any other provider? (see note 1) Yes No If Yes - Date of first payment Increases to your retirement contributions 1. Regular Contribution. (see notes 2 5) a) What net increase in your regular contributions do you want to pay? OR b) If you are commencing regular contributions for the first time what net contribution do you want to pay? i) Would you like us to collect the contribution Yearly? or Monthly? ii) What day and month do you want your contributions to commence? (DD MM) (see note 6) 2. Single Contribution. (see note 7) What net single contribution do you want to pay? Please enclose a cheque for the single contribution. Increase to your employer s contribution (DD MM YYYY) Your employer should fill in this Section if they wish to increase their contribution or start paying contributions. If paying contributions for the first time your employer must fill in a Direct Debit Instruction. 3. Regular Contribution by Employer. (see note 8) a) What gross increase in monthly contributions do you now want to pay? OR b) If you are commencing regular contributions for the first time what gross contribution do you want to pay? (i) Would you like us to collect the contribution Yearly? or Monthly? (ii) What day and month do you want your contributions to commence? (DD MM) (1 28) (see note 5) 4. Single Contribution by Employer. What gross single contribution do you want to pay? (see note 7) 2

4 D. INDEXATION OF CONTRIBUTIONS (5) Where contributions are being collected and being paid via your employer s bank account, the payment date will be set by them. To comply with the late payment rules set by The Pensions Regulator payments which are made through your employer s bank account must reach Scottish Widows by the 19th of the month following the deduction from your salary. For all other cases please choose a payment date up to the 28th of the month. (6) If you have paid regular contributions into your existing pension, payments to this Top Up Plan should have the same payment and renewal date as that plan. (7) Your contributions are paid net of basic rate tax. Please contact Scottish Widows for details of the minimum levels that apply. Single contributions are normally invested on the same day as Scottish Widows receives them. The Single payment must be paid by cheque, payable to Scottish Widows. When writing a cheque, it will help to prevent fraud if you include additional information on the Payee Line, especially if you are not personally paying the cheque in, for example you may be sending the cheque by post. When writing a cheque to Scottish Widows you should include your name and policy number on the Payee Line. For example Scottish Widows re: your name, your reference policy number. Remember to draw a line through unused space on the cheque so extra numbers or names cannot be added. (8) Employer contributions are paid gross. The minimum increases are: 20 for monthly contributions or 240 for yearly contributions. If you are adding regular contributions for the first time, please contact Scottish Widows for details of the minimum levels that apply. NOTES TO SECTION D (1) If you have already chosen indexation to the pension contributions, the existing indexation will apply to the increased contribution. (2) If you did not choose indexation at the outset and you are selecting indexation now, it will apply to the total contribution, not just the increase in contribution. (3) Fixed increases may be at any rate between 5 pa and 20 pa (whole percentages only). NOTES TO SECTION E (1) For information on the funds available to you, please refer to our separate investment literature also refer to our website at (2) With-Profits is not available for advised top-up plans. Would you like the contributions to increase automatically each year? (see notes 1 & 2) Yes No If Yes, what level of increase do you want? Retail Prices Index Average Weekly Earnings Index At a fixed rate (see note 3) E. INVESTMENT INSTRUCTIONS Important note: If you have previously selected a Lifestyling Switching option or a Pension Investment Approach, then this option will apply to your new payment, and you should not complete this section. How do you want the increase in your contribution invested? For regular contributions in the same way as your current regular contributions? For single contributions on the basis of your current fund value split? OR please show below how you would like the additional contributions to be invested. (see note 1) You can invest in up to 10 funds at any one time. We may change the selection of funds that we make available. There may be restrictions on the amount you can invest in certain funds. Please contact us for details of any restrictions that apply. If you are currently using a Lifestyle Switching option or Pension Investment Approach, and opt to invest this increase into a range of funds instead, the option/approach will end. Your existing plan value will remain invested in the funds it was invested in under the Lifestyle Switching option/pension Investment Approach, but no further switches will be made. Fund name Regular Single Total OR you can select one of the following options You can choose a Lifestyle Switching option or You can choose a Pension Investment Approach. If either of these is selected, it will apply to the whole plan i.e. to the existing plan value and for all future contributions. As you get closer to retirement, we will automatically gradually adjust and move your plan into lower risk investments. 3

5 Lifestyle Switching Options Please tick one of the following boxes if you wish to select a Lifestyle Switching Option. For full details please refer to our Guide to Lifestyle Switching (reference 41426). Cautious Lifestyle Balanced Lifestyle Opportunity Lifestyle OR Pension Investment Approaches Please tick one of the following boxes if you wish to select a Pension Investment Approach. For full details please refer to our Pension Investment Approaches Guide (reference 45770IG) and Premier Lifestyling Options Guide (reference 55126). Adventurous Adventurous Adventurous Balanced Balanced Balanced Cautious Cautious Cautious Premier Adventurous Premier Adventurous Premier Adventurous Premier Balanced Premier Balanced Premier Balanced Premier Cautious Premier Cautious Premier Cautious F. ADVISER CHARGES IMPORTANT PLEASE COMPLETE This section should be completed if you have received advice on your contribution increases and you have agreed with your financial adviser that Adviser Charges are to be deducted from the plan. Please detail below the charges you have agreed with your financial adviser for advice and/or services in respect of this top-up plan: Initial Adviser Charge(s) Initial Adviser Charges are for the advice and/or services provided by your financial adviser in incrementing this Top-Up Plan. Total initial Adviser Charges to be deducted from this plan: Regular Contributions Single Contributions Initial Adviser Charge Type Initial Adviser Charge Type Monetary Amount Percentage of contribution Monetary Amount Percentage of contribution Charge Frequency Charge Frequency Single instalment Single instalment Monthly Yearly Charge Term Charge Term Number of instalments (maximum 60 months or 5 years) N/A 4

6 Ongoing Adviser Charge(s) Ongoing Adviser Charges are for ongoing advice and/or services provided by your financial adviser. These charges will also apply to any other contributions of the same type that you subsequently make to this plan, unless you tell us otherwise. Regular Contributions Single Contributions Charge Type Charge Type Fund related Monetary Amount Percentage of contribution Fund related Monetary Amount Charge Frequency Charge Frequency Monthly Yearly Charge Term Number of instalments Lifetime of the plan Monthly Yearly Charge Term Number of instalments Lifetime of the plan MARKETING OPT-OUT Our policy on Data Protection is included in the additional sheet Important notes for applications. Lloyds Banking Group companies may use your information to contact you by mail, telephone, or text message about products and services that may be of interest to you. If you do not wish to receive this information please tick this box. 5

7 DECLARATION BY THE MEMBER I apply to make the increases shown on this application. a) I declare that i) to the best of my knowledge and belief all the statements I have made in this application, whether or not in my own handwriting, are correct and complete. I have not kept back any material information. ii) for the purposes of obtaining tax relief, total contributions paid by me, or by another individual on my behalf, to the Scheme, and any other registered pension schemes of which I am a member, will not in any tax year exceed the higher of the basic amount (currently 3,600 gross), and 100 of my relevant UK earnings. iii) contributions paid by me, or by another individual on my behalf, which are paid net of basic rate tax, will change if the basic rate of tax changes, to maintain the then total contribution to the Scheme. iv) I will inform Scottish Widows if I am no longer entitled to receive tax relief on my contributions to the Scheme. I will do so by the later of: 5 April in the tax year in which I ceased to be entitled to tax relief; and 30 days after the date I ceased to be entitled to tax relief. v) I will inform Scottish Widows within 30 days if: my employment status, or my employer, should change from that indicated in this application, or I stop residing in the United Kingdom. vi) If any Adviser Charge(s) are to be deducted from my plan: I confirm that any Adviser Charge(s) deducted from this plan as detailed in this application, are the charges I have seen set out in an illustration and agreed with my financial adviser, for this plan. I confirm that these Adviser Charge(s) are for advice and/or services provided wholly in respect of this plan by my financial adviser. I agree to Scottish Widows deducting these Adviser Charge(s) from this plan and subsequently paying them to my financial adviser. I understand that any fund related Ongoing Adviser Charges agreed will also apply to any other contributions of the same type that I subsequently agree to make. b) I have received the Important Notes for Applications document. For your own benefit and protection, please read each of the statements in that document before you sign this application. Scottish Widows will rely on them when administering your contract. If you do not understand any point, please let us know. Signature Date (DD MM YYYY) You can get a copy of the completed application, Scheme Rules and Policy Provisions from Scottish Widows. DECLARATION BY THE EMPLOYER We confirm that we want to pay the contributions shown in Section D. (Including any automatic increases to regular contributions shown in Section E of the application). Signature Position of signatory For and on behalf of the Employer Date (DD MM YYYY) Return to : Scottish Widows Client Services 15 Dalkeith Road Edinburgh EH16 5BU 6

8 Scottish Widows Limited. Registered in England and Wales No 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 /16

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