Pension Trader Account application

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1 Pension Trader Account application This is an application form to open a Pension Trader Account. Please read this application form in conjunction with your Barclays Stockbrokers Terms of Use and the Terms and/or any agreement between you and us. Definitions contained in this application form shall have the same meaning given to them in the Terms and/or any agreement between you and us. The Trustee, Administrator and the Member must complete and sign this application form. Please fill in the details we ask for (apart from those that are clearly not applicable) and return it to: High Value Servicing Team, Barclays, Tay House, 300 Bath Street, Glasgow, G2 4LH. Barclays Stockbrokers can only accept applications from schemes registered with HM Revenue & Customs and those with an appointed Trustee. Please complete in BLOCK CAPITALS. Section 1 Scheme name Scheme Correspondence Address LIBERTY SIPP LIMITED, HMRC registration number RN THE EXCHANGE, BANK STREET, BURY Postcode BL9 0DN Please note we require a certified copy of HMRC s Acknowledgement of Registration The Correspondence address will receive details of transactions and corporate actions. All Sterling assets will be held on behalf of the Trustee(s) as the legal owner(s) within our nominee account and monies will only be accepted or remitted in accordance with Trustee s instructions. Section 2 Member details Title Address Nationality Country of permanent residence Date of birth D D / M M / Y Y Y Y Phone number Postcode address Stockbrokers

2 Section 3 Scheme Trustee details LIBERTY TRUSTEES LIMITED Address LIBERTY SIPP LIMITED, THE EXCHANGE, BANK STREET, BURY Postcode BL9 0DN Contact person(s) FCA of HMRC Registration No RN Phone number address Section 4 Administrator details Company name LIBERTY SIPP LIMITED Company address LIBERTY SIPP LTD, THE EXCHANGE, BANK STREET, BURY Postcode BL9 0DN Contact person(s) User ID for Account Linking FCA of HMRC Registration No RN Phone number address Section 5 Managing your income Please select how the account will receive its income below. The account will automatically be set up with a Cash Management Service (CMS) account for settling trades. Please select one option only. Automatic Dividend Reinvestment (ADR) - Please use income paid to the CMS account to buy shares using ADR. SCRIP - Please add shares received in lieu of cash to the account. Cash - Please always accept cash dividends and credit the CMS account. Section 6 SIPP Bank account details Please provide the SIPP bank account details to where funds should be transferred. of bank of scheme bank account Sort code Initial size of deposit Account number

3 Section 7 Compliance reporting Are you required to report trades to your employer? (please tick as appropriate) Yes No Company Address You understand that if you provide false or inaccurate information and a fraud is identified we will pass this information onto the fraud prevention agencies. If you are interested in hearing more about how this information may be used you can contact us on * or please refer to your Barclays Stockbrokers terms. Post code Declaration and Authority By completing this Compliance Reporting section I confirm I am an employee of the named Company or a spouse/ civil partner of that employee. I instruct Barclays Bank PLC to send any information held by Barclays Stockbrokers including but not limited to, transaction(s) and holding(s) in my Account(s) to the named Company. Barclays Bank PLC will send the information to the Company according to Barclays Data Privacy Policy, and I consent to that data transfer. I also understand and acknowledge that the Company will process the information received in accordance with their own policies. In this Application Form and pursuant to the SIPP Trading Account Terms and Conditions (or any other agreement between you and us), we will be provided with personal data within the meaning of the Data Protection Act You agree that we may use, and disclose to other members of the Barclays Group for their use, such information for the purposes of providing the Service and for marketing products and services of the Barclays Group. You confirm that Barclays Stockbrokers is entitled to rely on any instruction provided using the security information it requires from time to time. You understand that if you want to appoint a User to issue instructions on your behalf, you must provide such information relating to that User as Barclays Stockbrokers may from time to time require. By signing this declaration, you agree/confirm/declare that: You wish us to be appointed to provide the Service and to accept instructions from you in relation to your account as outlined in this Application Form and the Pension Trader Terms of Use & SIPP Trading Account Terms and Conditions (or other agreement between you and us). To the extent required to comply with the governing terms of the SIPP, you (in your capacity either as beneficiary or as co-trustee of the SIPP) either appoint us to provide the Service or consent to the Trustee and Administrator appointing us to provide the Service. You confirm that the information given is true and complete and authorise us to make any credit reference and other enquiries in accordance with our normal procedures in connection with this application. You understand that credit reference agencies will maintain a record of our searches and the information we give them and that the record may be used by other lenders assessing credit applications from you and members of your household and for debt tracing. You understand that if the Trustee and/or the Administrator requests changes to the agreement between us, commencement of the Service may be delayed or prevented. You understand that this is our standard client agreement upon which we intend to rely. For your own benefit and protection you should read these terms carefully before signing them. If you do not understand any point please ask for further information. By signing below, the Trustee and Administrator agree/ confirm that they wish us to provide the Service as outlined in this Application Form and that we may accept instructions from the member and any other relevant user in relation to the member s account.

4 Scheme Trustee Signatory Administrator Authorised Signatory Signature Signature Date D D / M M / Y Y Y Y Date D D / M M / Y Y Y Y Access Level Read only Dealing authority Access Level Read only Dealing authority Read-only access including: Viewing the selected accounts online Receiving information about the selected accounts by telephone. Dealing authority access including: Buying and selling any investments Giving any necessary instructions in the event of corporate actions on these investments Giving any instructions concerning the operation of the Cash Management Service. Member s signature Signature Date D D / M M / Y Y Y Y

5 Telling you about products and services to be completed by the SIPP Member Important Your Personal Information Credit reference agencies We may use credit reference and fraud prevention agencies to help us make business decisions about providing you with financial services. A short guide to what we do and how both we and they will use your information is set out in the Terms. Our full privacy notice is available on our website or from your usual contact. By confirming your agreement to proceed you are accepting that we may each use your information in this way. Using your personal information We will collect and use information about you as described in the Terms and our privacy notice. This will include: collecting and using information about how you use and manage your account, informing you about products and services, collecting and using biometric information to uniquely identify you, transferring your information within our group and to service providers located in the UK or worldwide; and using information relating to your medical, health, lifestyle and ethnic background and any criminal offences (alleged or otherwise), to administer your products and services and to identify products or services that may be of interest to you. Cookies that collect personal information may be used on our websites (further information is available in the cookies policy on our websites). Accessing your data You can request certain information we hold about you by writing to us. A fee may be charged for this service, as permitted by appropriate law or regulation. Telling you about products and services As part of our service, we will keep you informed about products and services (including those of third parties) that may be of interest to you. Barclays Wealth and Investment Management will not give your personal data to any third parties for their marketing purposes. You can choose NOT to receive marketing communications from Barclays Wealth and Investment Management and other members of the Barclays Group, by ticking the appropriate boxes below: Telephone Text message Mail You can choose to receive specific content from us which does not affect your choice above. For example, if you chose to receive a service which includes the provision of information from us, then you will continue to receive such communications until you end that service. We may also contact you from time to time to obtain your feedback on our service and for other research purposes. When we do so, you can inform us that you do not wish to receive future requests of this type.

6 Our opening hours are 8am to 6.30pm Monday to Thursday, 8am to 6pm on Friday (excluding bank holidays) and 9.30am to 12.30pm on Saturday. Call costs may vary please check with your telecoms provider. Calls may be recorded so that we can monitor the quality of our service and for security purposes. For more information, please visit our website at Barclays offers wealth and investment management products and services to its clients through Barclays Bank PLC and its subsidiary companies. Barclays Stockbrokers is a trading name of Barclays Bank PLC (Registered No Registered VAT No ) which is a member of the London Stock Exchange and ISDX. Barclays Bank PLC is registered in England and authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. The registered address is 1 Churchill Place, London E14 5HP. Item Ref: IBIM3204. May 2014

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