Date. Uniform Pension Statement. Our registration number. Dear.,

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1 Date Re Our registration number Uniform Pension Statement Dear., Enclosed is your annual Uniform Pension Statement covering your participation in the Pension Scheme of <name company>. This statement shows the situation for your pension as at 31 December Why have you been sent this statement? It is important to pension administrators that you are fully informed of your pension situation. This is why the pension administrators jointly developed the UPS, the Uniform Pension Statement. This overview provides an insight into your income upon retirement. You can also see what the consequences are if you become incapacitated for work or if you die. Of what does the Uniform Pension Statement consist? The UPS consists of two components. The first component contains an overview of your personal details and the retirement income. You can also see the details on which our pension calculations are based, followed by the explanatory notes. These notes provide an explanation of the UPS. Please note: any recently submitted changes may not yet be incorporated in the Pension Statement. Sometimes more than one pension statement from De Amersfoortse If your Pension Scheme consists of a number of components or if you have more than one Pension Scheme, it is possible that you receive more than one UPS from us. Low current interest rates This UPO shows pension indications. The amounts specified here are examples. The pension indications in this UPO are based on the current purchasing rates and a 4% interest rate. This is a statutory interest rate. The rate may be higher or lower than the interest rate applied in the current rates. The current interest rate is below 4%. If you would have to purchase a retirement pension today (or have purchased one recently), you will see that the pension benefit for life you purchase/purchased is lower than indicated in this UPO. Please take this into consideration. De Amersfoortse Verzekeringen is a trade name of

2 Page 2 Changes to the Pension Scheme in This statement shows the status of your pension as at 31 December Thus it does not take into account any amendment to your Pension Scheme as a consequence of the statutory changes to the maximum pension accrual after 31 December If the Pension Scheme has been amended with effect from 1 January 2015, you will see the consequences in the next Pension Statement. Do you have any questions? If you have any questions about this letter or would like more information, then please contact us via My Amersfoortse. Alternatively, you can send an to werknemerspensioen@amersfoortse.nl. We will be happy to help you. With kind regards, Fleur Rieter, Pensions Director P.S. Save the UPS with your pension documents. De Amersfoortse Verzekeringen is a trade name of

3 Page 3 Uniform Pension Statement Position as at Pension administrator Pension Agreement Employer Registration number De Amersfoortse Defined Contribution Scheme KEEP YOUR PENSION STATEMENT IN A SAFE PLACE. ALSO BE SURE TO READ THE EXPLANATORY NOTES. THESE FORM AN INTEGRAL PART OF THE UNIFORM PENSION STATEMENT. For whom is this Pension Statement intended? For you For your partner J. Upo Drie born on P. Upo Drie born on For your children (if any) What is your pension's investment value? You have a defined contribution scheme in which investments are made for your pension. On your retirement date, the investment value is used to purchase pension benefits. It is not yet clear what the investment value will be on your retirement date. Investment value on 31/12/2014 6, Potential investment value when you reach age 67 with a fictive return rate of 4%: - if your current employment contract terminated on 31/12/ , if you continue working in your current job 140, Please remember that the potential investment amounts stated above are based on an illustrative return rate of 4%. The final value on your retirement date may therefore be higher or lower. What pension can you expect? Please note: All stated benefits are gross annual amounts. This means that social security contributions and tax are still payable on these amounts. Your pension is paid in monthly instalments. This overview does not contain any information on your AOW (General Old Age Pensions Act) pension. If you would like to know more about the AOW pension, please visit for a comprehensive overview of your pensions and AOW entitlements. This statement shows the status of your pension as at 31 December Thus it does not take into account any amendment to your Pension Scheme as a consequence of the statutory changes to the maximum pension accrual after 31 December If the Pension Scheme has been amended with effect from 1 January 2015, you will see the consequences in the next Pension Statement.

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5 Page 4 Upon retirement The amounts specified here are examples. We do not yet know what the investment value will be on your retirement date and how much pension you will be able to buy. The indicative pension amounts are based on the current purchase rates and an interest rate of 2.2% at retirement date. Pension forecast upon termination of employment With the possible investment value amounting to 14, at age 67, the annual pension set out below can be purchased: from age 67 for as long as you live Pension forecast if you remain with your current employer With the forecast investment value amounting to 140, at age 67, the annual pension set out below can be purchased: from age 67 for as long as you live 6, The amount of these pensions is not certain. Your pension may be higher or lower. See the explanatory notes for further information. You have a defined contribution scheme in which investments are made for your pension in an investment-linked insurance, and you are entitled to guaranteed pension at age 67. Accrued pension as at 31/12/2014 You will in any case receive from age 67 for as long as you live Indicative amount of pension you may achieve If you continue working in your current job until you reach the age of 67, you will receive from age 67 for as long as you live 6, The amount of these pensions is not certain. Your pension may be higher or lower. See the explanatory notes for further information. Please note: a divorce can affect the amount of the pension you receive. Also see the explanatory notes. The amounts shown above take into account a divorce, if applicable, if you received confirmation from us about the allocation of money in or before In the event of your death Please note: the payments in the event of your death may be less or not be applicable if you leave the company before your retirement date. See the explanatory notes for further information. In the event of your death prior to your retirement date Your partner receives from the date of your death for as long as he/she lives 78, Your children (if any) receive (per child) from the date of your death to the date he/she reaches the age of 21 16, The amount of these pensions is not certain. Your pension may be higher or lower. See the explanatory notes for further information.

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7 Page 5 Indicative pension in the event of your death after your retirement date The potential investment value of 140, would allow your partner to receive the following benefit. This is based on the current purchase rates and an interest rate of 2.2% at retirement date. Your partner receives 4, from the date of your death, for as long as he/she lives In the event of post-retirement death, your children (if any) will not receive any benefit. You have a defined contribution scheme in which investments are made for your pension in an investment-linked insurance, and you are entitled to guaranteed pension at age 67. In the event of your death after your retirement date Your partner receives 4, from the date of your death, for as long as he/she lives In the event of post-retirement death, your children (if any) will not receive any benefit. Please note: divorce or termination of cohabitation will affect the benefit amount your partner receives if you die. Also see the explanatory notes. The amounts shown above take into account a divorce, if applicable, if you received confirmation from us about the allocation of money in or before Upon occupational disability In the event of occupational disability, you will not receive any supplement to the state benefit under the Work and Income (Capacity for Work) Act (WIA). Please see the explanatory notes for more information, including information about the effect occupational disability has on subsequent accrual of your pension. Is your pension retaining its value? No supplements are granted for the accrued pension entitlements and pensions in payment. No supplements are granted to Retirement Pensions and Partner s Pensions purchased with the capital. Increase in the Partner's Pension The Partner s Pension will annually increase by 3% compared to the previous year. The Partner s Pension will increase for the first time precisely one year after the starting date. Increase in the Orphan's Pension The Orphan s Pension will annually increase by 3% compared to the previous year. The Orphan s Pension will increase for the first time precisely one year after the starting date. De Amersfoortse Verzekeringen is a trade name of

8 Page 6 On what information is your pension statement based? Commencement of employment 01/01/2013 Commencement of participation 01/01/2013 Commencement of pension accrual 01/01/2013 Part-time percentage 100% Wage 298, Pensionable earnings 298, Offset 13, Pension basis 285, Defined contribution as a percentage of the pension basis 2.7% Defined contribution 7, The amounts shown above take into account a divorce, if applicable, if you received confirmation from us about the allocation of money in Factor A (for your tax returns) Would you like to know how much room you have under tax rules to top up your pension with annuities? You will need a figure for your annual pension accrual (factor A) to find out. Pension accrual (Factor A) in See the explanatory notes for further information. Do you have any questions? For more information, please contact us via My Amersfoortse. Alternatively, you can send an to werknemerspensioen@amersfoortse.nl. We will be happy to help you. Please find a comprehensive overview of your pensions and AOW entitlements, and indicative net pension amounts on This is useful if you also participated in other pension schemes through your previous employer(s). This Pension Statement was prepared with due care. We based it on the information available to us and your Pension Rules. The Pension Rules are ultimately decisive. You can download the Pension Rules via My Amersfoortse. De Amersfoortse Verzekeringen is a trade name of

9 Page 7 Explanatory notes to the Uniform Pension Statement Defined contribution scheme What information does the Uniform Pension Statement give you? The Uniform Pension Statement provides clear insight into your benefits on retirement and in the event of occupational disability. The statement also contains the benefits your partner and/or children, if applicable, will receive in the event of your death. You will receive a pension statement once a year. We advise you to file this statement together with the statements you receive from other pension administrators. This will provide you with a clear overview of your pension situation. You can find a summary of all your pensions with the different pension administrators at You will find general pension information at What events might affect your pension? Some events in your life affect your pension. For example occupational disability and your death. Their effect can be seen in the pension statement. But also getting married, getting divorced and changing your job will affect your pension and any Surviving Dependants Pension. Your Pension Rules contain more details on this subject. You can request or download a copy from My Amersfoortse. Do you have any questions? If so, please contact us via My Amersfoortse or your insurance advisor. What Pension Scheme do you have? This Pension Scheme is a defined contribution scheme. This means that the contribution that your employer makes available to you for the accrual of your pension for the period after your retirement date is fixed in advance. What is your pension's investment value? Investment value as at 31 December 2014 In investment-linked insurance policies, contributions are invested in funds. The policy provider buys investment units in these funds. The value of an investment unit is determined by the share price of the underlying fund. You can find more information about the value of the investments at My Amersfoortse. Indicative amount of investment value at retirement date upon termination of employment This is a calculation of the possible investment value based on the returns shown on the pension statement. This figure is an example. The actual return depends on how the value of the investments evolves. The final investment value may therefore be higher or lower. For the purpose of this calculation we have assumed that your employment contract was terminated on 31 December 2014, and that no further contributions are paid after that date. Possible investment value at retirement date if you continue working This is also a calculation of the possible investment value based on the returns shown on the pension statement. In performing this calculation, we have assumed that you will continue working and that contributions will continue to be paid until your retirement date, without any changes. This return is also an example. The actual return depends on how the value of the investments evolves. The investment value may therefore be higher or lower. De Amersfoortse Verzekeringen is a trade name of

10 Page 8 What pension can you expect? The benefits specified in the pension statement are gross annual amounts. This means that social security contributions and tax are payable on them. Upon retirement Pension forecast This is a calculation example showing the annual pension that you could receive given the potential investment value. The calculations are based on the current purchasing rates and the interest rate shown on the pension statement. This concerns an example interest rate that is determined annually in October, following the interest rate in the market at that time as closely as possible. As annual interest rates fluctuate, this annually leads to different pension indications. Purchase rates can also change over time. When you come to purchase your pension, we will use the tariffs and interest rate in force at the time. You will start receiving your pension on the first day of the month in which you reach the retirement age. You have a defined contribution scheme in which investments are made for your pension in an investment-linked insurance, and you are entitled to guaranteed pension at age 67. Pension accrued up to 31/12/2014 This is the annual pension that you have accrued up to 31/12/2014. If you stop working on 31 December 2014, then this is the sum you may at least expect upon retirement. No indexation is granted on this pension. Indicative amount of pension you may achieve This is a calculation example showing the annual pension that you can receive from the annual pension you will receive as from age 67. This amount includes two components: the pension accrued up to 31/12/2014. This is a guaranteed amount; the pension that you are still accruing if you continue working up to age 67 and continue accruing pension unchanged. This amount is not fixed. At that moment, the exact amount of pension that can be purchased is uncertain. This depends on the interest rates at the time of purchasing the pension. Divorce In case of a divorce or the termination of a registered partnership, you may have made arrangements with your ex-partner concerning the division of your pension. If the desired allocation was submitted to us and confirmed by us, we will pay your ex-partner the share that was agreed upon from your retirement. Upon pay-out, this share is deducted from the pension indicated at retirement. This means you will receive a lower amount of pension than stated in the UPS. Please see for additional information about pensions and divorce. De Amersfoortse Verzekeringen is a trade name of

11 Page 9 In the event of your death Your children and/or partner (if any) will only receive benefits if you are still working for your employer at the time of your death. Are you planning to stop work? If so, you can decide to convert part of your Retirement Pension into a pension payable to your partner on your death. Your partner is the person that as at 31/12/2014: is your spouse; or is your registered partner; or conducts a joint household with you on a permanent basis. The definition of a 'joint household on a permanent basis' can be found in your Pension Rules. Upon post-retirement death Upon post-retirement death, your partner is entitled to a benefit. Your partner is the person that at your retirement date: is your spouse; or is your registered partner; or conducts a joint household with you on a permanent basis. The definition of a 'joint household on a permanent basis' can be found in your Pension Rules. Upon occupational disability Accrual of your pension continues as long as you are occupationally disabled. The amount of accrual depends on your occupational disability rate. If you are on sick leave longer than two years (the statutory period of 104 weeks) and if you have been declared at least 35% occupationally disabled, you are eligible for an occupational disability benefit. You will receive this benefit from the Employee Insurance Agency (UWV) on behalf of the government, under the terms of the WIA. The level of this benefit depends on your degree of occupational disability and your income before you became occupational disabled. Is your pension retaining its value? No supplements are granted for the accrued pension entitlements and pensions in payment. No supplements are granted to Retirement Pensions and Partner s Pensions purchased with the capital. Increase in the Partner's Pension The Partner s Pension will annually increase by 3% compared to the previous year. The Partner s Pension will increase for the first time precisely one year after the starting date. Increase in the Orphan's Pension The Orphan s Pension will annually increase by 3% compared to the previous year. The Orphan s Pension will increase for the first time precisely one year after the starting date. On what information is your pension statement based? The information below is used to calculate the amounts shown on the pension statement. Commencement of employment This is the date on which you started working for your current employer. De Amersfoortse Verzekeringen is a trade name of

12 Page 10 Commencement of participation This is the date on which you joined this Pension Scheme. Commencement of pension accrual This is the date on which you started to accrue pension in this Pension Scheme. Part-time percentage This is your working hours expressed as a percentage of a full-time position. Example: someone works half days (20 hours a week) and a full-time position involves working 40 hours. The part-time percentage in this case is 50%. Pensionable earnings This is the portion of your gross salary that counts towards your pension accrual. The Pension Rules determine which elements of the salary count for pension accrual and are therefore regarded as pensionable earnings. The pensionable earnings are stated on a full-time basis. Offset This is the part of your pensionable earnings on which you do not accrue any pension. That is because once you reach the relevant statutory age, you will receive AOW state pension benefits. The offset is stated on a full-time basis. Pension basis These are your pensionable earnings minus the offset. The pension you accrue is based on this amount. The pension basis is stated on a full-time basis. Accrual percentage This is the percentage of the pension basis you accrue in pension each year. Defined contribution as a percentage of the pension basis This is an age-dependent or fixed percentage of your pension basis. The percentages by age category are contained in your Pension Rules. Defined contribution This is the total amount paid in contributions each year. Part of the contribution is used to insure a fixed pension sum. The other portion is used to accrue a pension capital. Factor A (for your tax returns) You may need the amount shown on your pension statement for your tax return for the year Have you received multiple pension statements? If so, you have to add up the Factor A amounts shown on these pension statements. Do you want to calculate your tax allowance for annuities? In that case, please use the Annuity Premium Calculator available from the Dutch Tax and Customs Administration. This is available from Do you have any questions? For more information, please contact us via My Amersfoortse. Alternatively, you can send an to Our address is werknemerspensioen@amersfoortse.nl. We will be happy to help you! De Amersfoortse Verzekeringen is a trade name of

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