Online Accounts. Power of Attorney application form. Personal details. Donor. 1st Attorney. 3rd Attorney. 2nd Attorney

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1 Online Accounts Power of Attorney application form Please read these notes before you fill in this form The account will be operated strictly in accordance with the instructions confirmed within the Power of Attorney document. The Power of Attorney document must accompany the application. This must be the original document or a certified copy. The account must be for the donor s personal use not for or on behalf of a business, charity, club or association. The funds must belong to the donor. The donor must be 16 or over, a UK resident and use a UK address for all correspondence. All attorneys must be 18 years or over. For legal reasons we must check the identity of all attorneys if they do not have an account with Virgin Money already (see below). Please note, we may also need to check the identity of the donor. The account can only be operated by post via our Main Office. Virgin Money is obliged to confirm the identity of all investors. Please refer to the Confirmation of identity form within the Customer Information section of the Savings homepage at virginmoney.com or contact us for further information. Please insert the name of the account you wish to apply for: Please complete all sections in black ink using block capitals and put a in the appropriate boxes. If any section is incomplete we may not be able to open your account. Personal details Title: Mr, Mrs, Ms, Miss Other (please specify) Surname First Name(s) in full Date of Birth (dd/mm/yyyy) Nationality Address (including postcode) Please note that all communications will be sent to the first attorney s address Donor 1st Attorney Home telephone number Daytime telephone number (if different from above) Title: Mr, Mrs, Ms, Miss Other (please specify) 2nd Attorney 3rd Attorney Surname First Name(s) in full Date of Birth (dd/mm/yyyy) Nationality Address (including postcode) Please note that all communications will be sent to the first attorney s address Home telephone number Daytime telephone number (if different from above)

2 Personal details (continued) Do you have any existing savings accounts with Virgin Money? If Yes please provide details of your account number(s) Donor 1st Attorney Yes No Yes No Do you have any existing savings accounts with Virgin Money? If Yes please provide details of your account number(s) 2nd Attorney 3rd Attorney Yes No Yes No Nominated bank account All withdrawals from the Online account must be sent to a nominated bank account. This account must be suitable for receipt of electronic payments (i.e. a Current Account). Bank or building society deposit type accounts cannot be used as the nominated account. Please check with the bank or building society that they are able to accept electronic payments. Please advise us of the details of the account you wish to use. This must be an account in the name of the donor. Bank name Address Bank sort code Account number Payee s name(s) Payee s reference (if any)

3 Interest How would you like your interest paid? (tick one choice only) 1. Added annually to the account 2. Added monthly to the account 3. Annually to another Virgin Money account in the name of the donor 4. Monthly to another Virgin Money account in the name of the donor 5. Annually to the donor s bank 6. Monthly to the donor s bank Bank name Address Please provide details of the Virgin Money account the interest is to be transferred: Please provide details of the bank to which the interest is to be transferred, if different to your nominated account. Bank sort code Account number Payee s name(s) Payee s reference (if any) Tax arrangements Please note: Interest will normally be paid on the due date (please refer to the terms and conditions and Summary Box). However, where interest is to be paid to an external bank account, it will be received up to three business days after the due date. Interest will be paid net of income unless the donor is registered to receive gross interest. If the donor is a non-tax payer and is eligible to register for gross interest you will need to complete a HM Revenue & Customs form R85. If you require a form R85 to be sent to you, please tick here. Alternatively, a form R85 can be downloaded from the Customer Info section of the Savings homepage. Registration for an existing or previous account cannot be automatically applied to this account without a new form R85.

4 Tax residency Please ensure all applicants complete this section Donor Where are you resident for tax purposes? Please place an X in one box only. For example, if you are a US citizen or resident, please select UK and another country and enter United States within Country of Tax Residence. United Kingdom only (if ticked, go to the next section) United Kingdom and another country Please list the country/countries in which you are tax resident outside the United Kingdom, along with the corresponding Tax Identification Number (TIN)/Tax Reference Number. If you need additional space, please use a blank sheet of paper. Country of Tax Residence Tax Identification Number (TIN)/Tax Reference Number Attorney 1 Where are you resident for tax purposes? Please place an X in one box only. For example, if you are a US citizen or resident, please select UK and another country and enter United States within Country of Tax Residence. United Kingdom only (if ticked, go to the next section) United Kingdom and another country Please list the country/countries in which you are tax resident outside the United Kingdom, along with the corresponding Tax Identification Number (TIN)/Tax Reference Number. If you need additional space, please use a blank sheet of paper. Country of Tax Residence Tax Identification Number (TIN)/Tax Reference Number Attorney 2 Where are you resident for tax purposes? Please place an X in one box only. For example, if you are a US citizen or resident, please select UK and another country and enter United States within Country of Tax Residence. United Kingdom only (if ticked, go to the next section) United Kingdom and another country Please list the country/countries in which you are tax resident outside the United Kingdom, along with the corresponding Tax Identification Number (TIN)/Tax Reference Number. If you need additional space, please use a blank sheet of paper. Country of Tax Residence Tax Identification Number (TIN)/Tax Reference Number Attorney 3 Where are you resident for tax purposes? Please place an X in one box only. For example, if you are a US citizen or resident, please select UK and another country and enter United States within Country of Tax Residence. United Kingdom only (if ticked, go to the next section) United Kingdom and another country Please list the country/countries in which you are tax resident outside the United Kingdom, along with the corresponding Tax Identification Number (TIN)/Tax Reference Number. If you need additional space, please use a blank sheet of paper. Country of Tax Residence Tax Identification Number (TIN)/Tax Reference Number

5 Initial deposit How will you be opening your account? a) By cheque Please confirm the amount Please enclose the cheque with the completed application form, identity item(s) (if necessary) and Power of Attorney document. In the interest of security please make cheques payable to Virgin Money plc for the account of (insert account holder(s) name(s)) and crossed A/c Payee only. b) By electronic transfer i.e. Faster Payments Service (FPS), Bankers Automated Clearing Service (BACS), or Clearing House Automated Payment System (CHAPS) You must return the completed application form, identity item(s) (if necessary) and Power of Attorney document. We will then advise you of your account number and provide bank details to quote to your bank or building society for the transfer to take place. c) By transfer from an existing Virgin Money account in the donor s name Please confirm the existing account number Please confirm the amount To transfer the full balance, insert TO CLOSE Please note that closing interest will normally be added to the existing account before the transfer takes place. Please ensure that the Power of Attorney document and, if applicable, the existing passbook(s) are enclosed. Please note that the terms and conditions, any notice period, charge and other withdrawal restrictions relative to the existing account will apply. Using your personal information The personal information you supply to us as well as information we already hold, may be used in a number of ways, for example, To assess and process this and future applications; To verify your identity; To prevent fraud and money laundering; To manage your account(s); For management of arrears and debt collection; For audit purposes, research and statistical analysis; and To identify other products and services which might be suitable for you (with your consent). (a) We may share your information with, and obtain information about you from credit reference agencies and fraud prevention agencies as outlined above. This may include details of any previous or subsequent names. (b) If false or inaccurate information is provided and fraud is identified, details will be shared with fraud prevention agencies and this information may be accessed and used by law enforcement to prevent fraud and money laundering. For further details as to how your information held by fraud prevention agencies may be used please see below. (c) In addition to the above we will not ordinarily disclose information to other organisations except to help prevent fraud and money laundering, where we are required by law, permitted under the Data Protection Act, required by the Financial Services Compensation Scheme (and its verification solution provider) or in order to process your application. Where we pass on information, it will be looked after with the same level of care. You declare that you are entitled to disclose information about all joint applicants and/or anyone else referred to by you and authorise us to search, link and/or record information at credit reference agencies about you and anyone else referred to by you. For further information on how your information may be used by credit reference agencies, fraud prevention agencies, and ourselves, visit our website or contact Freepost, Virgin Money, The Data Protection Officer, NEA3780, Newcastle upon Tyne, NE3 4ZE. You can obtain a copy of the information we hold about you (for a fee) by writing to the above address. You also have a right to have any inaccuracies deleted or corrected. Help us to make you better off Virgin Money would like to keep you up-to-date by post, fax, telephone, or other electronic means with the latest money help and news, as well as customer offers including those from around the Virgin Group and our other partners. If you would rather we did not do this, please tick the box below. It is easy to change your mind at any time, and we promise not to bombard you. I would prefer NOT to be contacted:

6 Declaration (If there is more than one attorney all must read and sign this declaration, if the donor is able to sign he/she should also read and sign this declaration.) 1. I/We declare that the information I/we have given on this form is true and accurate and I/we will inform Virgin Money without delay, of any changes in my/our circumstances affecting any information in this form. 2. I/We declare that the donor is a permanent UK resident(s), subject to UK tax legislation (Channel Islands and Isle of Man excluded) and will inform Virgin Money if they cease to be so resident. 3. The investments made into this account are invested by me/us on behalf of the donor who is the sole beneficial owner. 4. I/We have read and agree to be bound by the terms and conditions of this account. 5. I/We understand that you may, for my/our security, record telephone conversations for the purpose of recording transactions that I/we wish to complete. 6. I/We confirm that funds withdrawn will be used for the purpose for which the Power of Attorney is granted. Financial Services Compensation Scheme (FSCS) declaration I/We have received and read the Financial Services Compensation Scheme booklet (attached to this form) which contains an Information sheet and Exclusions list and provides details of the protection provided by the FSCS. Please sign below to confirm you have read and agree to the Use of personal information and Declaration sections. Please ensure that you print your name and address clearly on the back of any initial cheque deposit you send to us. Cheques should be made payable to Virgin Money for the account of (insert account holder(s) name(s)) and crossed A/c Payee only. Cash must not be sent through the post. Signatures Donor (if able to sign) 1st Attorney Date 2nd Attorney Date 3rd Attorney Date Date Alternative format If you require this in an alternative format such as Braille, large print, audio or interpreter services, please call our Disability Awareness Team on Lines are open 9am to 5pm business days. Calls are charged at your service provider s prevailing rate. Alternatively, our text phone number is or you can contact us at These contact details should not be used for general enquiries relating to your account. Confirmation of identity Virgin Money takes suitable steps to check the identity of its investors and may telephone to confirm application details. We regret that it will not be possible to open an account unless suitable proof of identity is provided - funds will be returned if suitable proof of identity is not provided. For office use only Cashier Code Date rec & reg Input checked Date Cheque Sort code Account number 1 NA61 Tax details 2 Virgin Money plc Registered in England and Wales (Company No ). Registered Office Jubilee House, Gosforth, Newcastle upon Tyne NE3 4PL. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. VMP162V5 (valid from )

7 Information sheet and Exclusions list The Financial Services Compensation Scheme

8 Virgin Money is covered by the Financial Services Compensation Scheme (FSCS). To help you understand the protection the scheme offers, this booklet contains details provided by the Prudential Regulation Authority. Please read the Information sheet on pages 2 and 3 carefully. The scheme does have a small number of exclusions and these are listed on page 4. Information sheet Basic information about the protection of your eligible deposits Eligible deposits in Virgin Money plc are protected by: Limit of protection: If you have more eligible deposits at the same bank/ building society/credit union: If you have a joint account with other person(s): Reimbursement period in case of bank, building society or credit union s failure: Currency of reimbursement: To contact Virgin Money plc for enquiries relating to your account: To contact the FSCS for further information on compensation: More information: the Financial Services Compensation Scheme ( FSCS ) 1 75,000 per depositor per bank/building society/ credit union 2 The following trading names are part of your bank: Virgin Money plc Virgin Money All your eligible deposits at the same bank/ building society/credit union are aggregated and the total is subject to the limit of 75, The limit of 75,000 applies to each depositor separately working days 4 Pound sterling (GBP, ) or, for branches of UK banks operating in other EEA Member States, the currency of that State. Virgin Money plc Jubilee House Gosforth Newcastle upon Tyne NE3 4PL Tel: * Financial Services Compensation Scheme 10th Floor Beaufort House 15 St Botolph Street London EC3A 7QU Tel: or

9 Additional information 1. Scheme responsible for the protection of your eligible deposit Your eligible deposit is covered by a statutory Deposit Guarantee Scheme. If insolvency of your bank, building society or credit union should occur, your eligible deposits would be repaid up to 75,000 by the Deposit Guarantee Scheme. 2. General limit of protection If a covered deposit is unavailable because a bank, building society or credit union is unable to meet its financial obligations, depositors are repaid by a Deposit Guarantee Scheme. This repayment covers at maximum 75,000 per bank, building society or credit union. This means that all eligible deposits at the same bank, building society or credit union are added up in order to determine the coverage level. If, for instance a depositor holds a savings account with 80,000 and a current account with 20,000, he or she will only be repaid 75,000. This method will also be applied if a bank, building society or credit union operates under different trading names. Virgin Money plc also trades under Virgin Money. This means that all eligible deposits with one or more of these trading names are in total covered up to 75,000. In some cases eligible deposits which are categorised as temporary high balances are protected above 75,000 for six months after the amount has been credited or from the moment when such eligible deposits become legally transferable. These are eligible deposits connected with certain events including: (a) certain transactions relating to the depositor s current or prospective only or main residence or dwelling; (b) a death, or the depositor s marriage or civil partnership, divorce, retirement, dismissal, redundancy or invalidity; (c) the payment to the depositor of insurance benefits or compensation for criminal injuries or wrongful conviction. More information can be obtained under Limit of protection for joint accounts In case of joint accounts, the limit of 75,000 applies to each depositor. However, eligible deposits in an account to which two or more persons are entitled as members of a business partnership, association or grouping of a similar nature, without legal personality, are aggregated and treated as if made by a single depositor for the purpose of calculating the limit of 75, Reimbursement The responsible Deposit Guarantee Scheme is the Financial Services Compensation Scheme, 10th Floor Beaufort House, 15 St Botolph Street, London, EC3A 7QU, Tel: or , It will repay your eligible deposits (up to 75,000) within 20 working days until 31 December 2018; within 15 working days from 1 January 2019 until 31 December 2020; within 10 working days from 1 January 2021 to 31 December 2023; and within 7 working days from 1 January 2024 onwards, save where specific exceptions apply. Where the FSCS cannot make the repayable amount available within 7 working days, it will, from 1 June 2016 until 31 December 2023, ensure that you have access to an appropriate amount of your covered deposits to cover the cost of living (in the case of a depositor which is an individual) or to cover necessary business expenses or operating costs (in the case of a depositor which is not an individual or a large company) within 5 working days of a request. Again, there are specific exceptions to this obligation. In the case of a depositor which is a large company, where the FSCS cannot make the repayable amount available within 7 working days, it will, from 3 July 2015 until 1 December 2016, ensure that you have access to your covered deposits within fifteen working days of a request containing sufficient information to enable it to make a payment, save where specific exceptions apply. In the case of a depositor which is a small local authority, where the FSCS cannot make the repayable amount available within 7 working days, it will, from 3 July 2015 until 1 June 2016, ensure that you have access to your covered deposits within fifteen working days of a request containing sufficient information to enable it to make a payment, save where specific exceptions apply. If you have not been repaid within these deadlines, you should contact the Deposit Guarantee Scheme since the time to claim reimbursement may be barred after a certain time limit. Further information can be obtained under Other important information In general, all retail depositors and businesses are covered by Deposit Guarantee Schemes. Exceptions for certain deposits are stated on the website of the responsible Deposit Guarantee Scheme. Your bank, building society or credit union will also inform you of any exclusions from protection which may apply. If deposits are eligible, the bank, building society or credit union shall also confirm this on the statement of account. 3

10 Exclusions list A deposit is excluded from protection if: (1) The holder and any beneficial owner of the deposit have never been identified in accordance with money laundering requirements. For further information, contact your bank, building society or credit union. (2) The deposit arises out of transactions in connection with which there has been a criminal conviction for money laundering. (3) It is a deposit made by a depositor which is one of the following: credit institution financial institution investment firm insurance undertaking reinsurance undertaking collective investment undertaking pension or retirement fund 1 public authority, other than a small local authority. The following are deposits, categories of deposits or other instruments which will no longer be protected from 3 July 2015: deposits of a credit union to which the credit union itself is entitled deposits which can only be proven by a financial instrument 2 unless it is a savings product which is evidenced by a certificate of deposit made out to a named person and which exists in a Member State on 2 July 2014 deposits of a collective investment scheme which qualifies as a small company 3 deposits of an overseas financial services institution which qualifies as a small company 4 deposits of certain regulated firms (investment firms, insurance undertakings and reinsurance undertakings) which qualify as a small business or a small company 5 refer to the FSCS for further information on this category For further information about exclusions, refer to the FSCS website at 1 Deposits by personal pension schemes, stakeholder pension schemes and occupational pension schemes of micro, small and medium sized enterprises are not excluded 2 Listed in Section C of Annex 1 of Directive 2014/65/EU 3 Under the Companies Act 1985 or Companies Act See footnote 3 5 See footnote 3 * Calls to 03 numbers cost the same as calls to 01 or 02 numbers and they are included in inclusive minutes and discount schemes in the same way. Calls may be monitored and recorded. Virgin Money plc - Registered in England and Wales (Company No ). Registered Office - Jubilee House, Gosforth, Newcastle upon Tyne NE3 4PL. Authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority VM8584V2 4

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