Application for Investment in a Pooled Pension Fund by a Defined Contribution Scheme

Transcription

1 Application for Investment in a Pooled Pension Fund by a Defined Contribution Scheme Before returning this form to Threadneedle Pensions Limited, please complete this tick-list: The following details have been completed overleaf: HMRC/PSTR Number Full Scheme name Level of authority of authorised signatories Names, positions and signatures of authorised signatories Scheme bank account particulars Signature by all Appointed directors Date of signatures Certified copy documentation enclosed Confirmation Letter regarding contributions and non-assignment of members interests Certified copy of Scheme Trust Deed or Rules and any variation(s) thereof Certified copy of Deed(s) of Appointment/Resignation of Trustees or Trustee Directors Certified copy of Certificate of Incorporation and Memorandum and Articles of Association of Trust Company (if applicable) Evidence of HMRC/PSTR approval (HMRC website screen print) Page 1 of 6

2 Please complete this Application Form and send it to your Threadneedle Pensions Limited ( Threadneedle ) Client Account Manager at the following address: Threadneedle Pensions Limited 60 St Mary Axe London EC3A 8JQ We recommend that you read the managed pension fund insurance policy ( Policy ) and Privacy Statement, provided with this Application Form, carefully before completing this Application Form. If you have any queries about filling out this Application Form, please contact Client Account Management at the above address, or on +44 (0) SCHEME DETAILS Full name of Scheme Address of Scheme Contact address (if different from above) HMRC Reference Number Scheme year end DETAILS OF TRUST COMPANY (if applicable) Full name of Corporate Trustee Address Company Number Secretary Directors ADMINISTRATOR DETAILS (if applicable) Full name of Administrator Address of Administrator Page 2 of 6

3 CONSULTANT DETAILS (if applicable) Full name of Consultant Address of Consultant AUDITOR DETAILS (if applicable) Full name of Auditor Address of Auditor FCA CLIENT CATEGORISATION We have classified you as a Professional Client for the purpose of the FCA Rules in relation to the provision of services under the Policy. Please contact us if you believe this classification is incorrect. REPORTS Please indicate which of the following reports you would like to receive: If you do not complete this box we shall assume you require this information to be sent to the Scheme s main contact. address(es) Quarterly Investment Report Yes No Contract Notes Yes No Monthly Valuation Report Yes No Page 3 of 6

4 INITIAL ALLOCATION We advise that the initial investment will be allocated as follows: Fund Adventurous Cautious Balanced Mixed Multi-Asset Managed Equity Global 60/40 Equity Global Equity UK Equity Fund North American Equity Japanese Equity Pacific Basin Equity UK Bond Index-Linked Bond Long Dated Gilt Corporate Bond Gilt Bond Pre-Retirement UK Equity High Alpha UK Smaller Companies European Equity Property UK Cash BANK ACCOUNT DETAILS We authorise Threadneedle to make remittances of sterling to the following bank account: Bank Name and Branch Account Name Account Number/IBAN Sort Code Page 4 of 6

5 DECLARATION The Trustee of the Scheme, acting by its board, requests Threadneedle to issue a Policy in the name of the Scheme and declares that: or We, being all the Trustees of the Scheme, request Threadneedle to issue a Policy in the name of the Scheme and we declare that: (Please tick the box next to the statement that applies to you). 1. the Policy, including its Schedules, this Application Form, and any endorsement or amendment to any of these documents made in writing and signed by an authorised signatory of Threadneedle, will form the basis of the contract with Threadneedle; 2. we are acting within the powers of the Trust Deed and the Rules of the Scheme (where applicable) and that Threadneedle is entitled to assume that the Trustees are acting within the powers granted to them under the Trust Deed and Threadneedle will be in no way liable for any loss or damage caused by any failure by the Trustees to comply with their obligations in this respect; 3. the Scheme is seeking to be or has been registered in accordance with Section 153 of the Finance Act 2004, or deemed registered in accordance with Paragraph 1 Schedule 36 of the Finance Act 2004 (as amended) and the registration has not been withdrawn; 4. the benefits to be provided under the Policy will correspond with liabilities arising in terms of the Scheme; 5. Threadneedle may need to make appropriate checks including on the Trustee(s), the Scheme, its members, and, where applicable, the officers of the Trustee in order to satisfy its statutory money laundering obligations and that where external agencies are involved in making these checks, these agencies may keep a record of their enquiries; 6. Threadneedle will be entitled to assume that the resolutions provided evidencing changes to the list of authorised signatories and/or Trustees continue in full force until such time as Threadneedle receives a certified copy of subsequent resolutions amending or rescinding the same; 7. Threadneedle is hereby appointed to be our agent to sign a letter of direction for stamp duty purposes should we decide to contribute assets other than cash to the Scheme fund; 8. (a) we have received appropriate investment advice from our third party adviser(s) in relation to our investment; (b) we have read, understood and consent to the terms of Threadneedle s Privacy Statement; 9. (a) Member contributions are deductions by salary; (b) The Scheme rules do not permit assignment of a member s interest; and 10. (a) for and on behalf of the Trustee(s) and any living individuals whose personal data is supplied by the Scheme to Threadneedle or its delegates, that the Trustee(s) (and/or officers of the Trustee) of the Scheme or their delegates shall in all respects and at all times comply with then current UK data protection legislation including but not limited to the Data Protection Act 1998 and the Privacy and Electronic Communications (EC Directive) Regulations 2003 and all related or subordinate legislation in so supplying any personal data to Threadneedle or its delegates; (b) Threadneedle is entitled to reserve the right (as it does) to act as a data controller in relation to any personal data which it or its delegates receive under this provision from the Trustee(s) of the Scheme or its/their delegates; and (c) the Trustee(s) of the Scheme agree to keep Threadneedle and/or any of its delegates fully indemnified for and against any liability howsoever arising from a breach of this provision. Signed for and on behalf of the Scheme and, in respect of declarations 11(a) and (b), in the individual signatories personal capacity also: By Title Trustee/Director/Secretary (Please delete as applicable) Date / / Signed for and on behalf of the Scheme and, in respect of declarations 11(a) and (b), in the individual signatories personal capacity also: By Title Trustee/Director/Secretary (Please delete as applicable) Date / / Page 5 of 6

6 AUTHORISED SIGNATORIES** Name Official Position Purposes / Level of Authority (delete as appropriate) Specimen Signature **The list of authorised signatories should include the names, titles, signatures and level of authority of every individual who will give instructions to Threadneedle on behalf of the Trustees or Directors of the Trust Company. We authorise Threadneedle to accept and act upon instructions, from any (please indicate number of signatures required) of the authorised signatories listed in the table above, on behalf of the Scheme for the purposes specified in the table. Alternatively, you may provide us with a certified copy of the Scheme s Authorised Signature list, if available. If we intend for a third party, such as our consultant, to be authorised to issue instructions to Threadneedle on our behalf, we will confirm this is writing to Threadneedle. We acknowledge that having made such confirmation, Threadneedle shall not be required to check from time to time whether such third party is still authorised to issue instructions on our behalf, and therefore we commit to tell Threadneedle if we, for example, change our consultant. For details on placing deals, please refer to the Operational Procedures for clients dealing in Pooled Pension Funds DB Schemes. To find out more visit threadneedle.com Threadneedle Pensions Limited Registered in England and Wales, No Registered Office: 60 St Mary Axe, London EC3A 8JQ. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. threadneedle.com Issued T14456 Page 6 of 6