For customers Aegon buyout plan with protected tax-free cash drawdown pension option Please read these notes before filling in this form About this form Words in bold are defined terms that we explain in the Definitions section. Where you see this icon *, we re asking you to send additional material with this form. This form enables you to take drawdown pension under your existing Aegon buyout plan. You must take all your benefits under the Aegon buyout plan at the same time. You should complete this form if under your Aegon buyout plan: n you have entitlement to more than 25% tax-free cash, and n you want to vest your benefits, and, n you then want to make an immediate drawdown pension to drawdown pension transfer (drawdown to drawdown transfer) to a One Retirement account or Aegon Retirement Choices Self-Invested Personal Pension (ARC SIPP). Use this form with an application to set up a One Retirement account or ARC SIPP to receive a drawdown to drawdown transfer or an application for a drawdown to drawdown transfer to your existing One Retirement account or ARC SIPP. The first time you take income from your drawdown pension plan it will trigger the money purchase annual allowance, if you ve not already triggered it. You shouldn t complete this form if: you have an entitlement to 25% or less tax-free cash, in which case you should complete an application for One Retirement or ARC SIPP. Give full information When you answer a question, you must give all relevant information. This means you must completely and accurately disclose all of the facts when answering each question. Check details already filled in If any details are already completed (based on what you ve told a financial adviser), check these before you sign the declaration. If any details are incorrect or incomplete, please change them, initial the changes and contact a financial adviser. Arrangements under your One Retirement account or ARC SIPP Whether you re applying for a new One Retirement account or ARC SIPP or adding funds to your existing One Retirement account or ARC SIPP, you re applying for one or more arrangements under each Aegon buyout plan set out in 2.1. Each arrangement of drawdown pension entered into under the Aegon buyout plan will be transferred and applied under a new equivalent arrangement under your One Retirement account or ARC SIPP. We ll secure an annuity from guaranteed minimum pension and/or reference scheme test benefits and pay tax-free cash from your Aegon buyout plan, move the balance into drawdown pension under your Aegon buyout plan and then immediately transfer the drawdown pension money to your One Retirement account or ARC SIPP. When you re applying for a new One Retirement account or ARC SIPP Each arrangement will be identified by a separate wrapper number. Once we ve received this form and the request for a transfer to your One Retirement account or ARC SIPP, we ll transfer your drawdown pension arrangement to the Aegon Self Invested Personal Pension Scheme. When you re adding a transfer to an existing One Retirement account or ARC SIPP We ll set up each tranche of drawdown pension with a separate cash facility under its own arrangement with a separate reference number under the Aegon Self Invested Personal Pension Scheme. Page 1 of 10
1. Personal details Please give your personal details. Name Address Please send us a certified copy of your passport or driving licence as proof of your age and identity *. For more details and/ or options please see section 5. Date of birth (dd/mm/yyyy) National Insurance number Postcode 2. Taking benefits from your Aegon buyout plan We ll settle your tax-free cash when we ve received all the information to enable us to make payment of the tax-free cash and are in a position to carry out the drawdown to drawdown transfer. This includes receiving the request for the drawdown to drawdown transfer from the receiving scheme. Your funds will remain invested until that time. 2.1 Existing plan details Aegon buyout plan number(s) 2.2 Tax-free cash and income payments Maximum, or We ll calculate your maximum tax-free cash available from your Aegon buyout plan. Once we ve secured any annuity requested in 2.3 and paid your tax-free cash, the remaining fund will go into drawdown pension under your Aegon buyout plan, for immediate transfer to a One Retirement account or ARC SIPP. The terms of your One Retirement account detail how any income payments will be made. Aegon buyout plan with protected tax-free cash drawdown pension option Page 2 of 10
2. Taking benefits from your Aegon buyout plan continued Only complete 2.3 if you have a guaranteed minimum pension (GMP) and/or reference scheme test benefits (RST). 2.3 Who do you want to buy your annuity from? Please enclose a certified copy of your spouse s/civil partner s passport or driving licence as proof of their age and identity *. For more details and/ or options please see section 5. Aegon please give details below: Quote date (dd/mm/yyyy) Quote option number Type of benefit GMP (pre-6 April 1988) GMP (post- 5 April 1988) Pension Spouse or civil partner s pension RST money Any open market value paid from this Policy must be used to buy a compulsory purchase annuity (CPA) with the receiving insurer. If you decide to buy your pension from another company, the open market option fund must provide at least the same level and benefit of pension currently payable from this Policy as a guaranteed minimum pension (GMP). Another provider using the open market option, please give details below: Receiving insurer s name Reference Address Bank account name Bank account number Sort code Postcode Declaration by the receiving insurer This declaration must be completed by the receiving scheme where you re not buying the annuity from Aegon. In this declaration, we means the trustees or the scheme administrator (as the case may be) of the receiving scheme. We confirm that the benefits will be paid in line with the provisions of the Aegon buyout plan. We confirm that the pension payments will be paid in line with the provisions for the deduction of income tax (for example, PAYE) required by the Finance Act 2004. Date (dd/mm/yyyy) Signed on behalf of the receiving insurer 7 7 Aegon buyout plan with protected tax-free cash drawdown pension option Page 3 of 10
3. Lifetime allowance Under HM Revenue & Customs (HMRC) rules, there are special tax charges for people with large pension funds. If your total funds from all your pensions aren t more than your lifetime allowance you won t have to pay this charge. 3.1 If you ve registered for protection with HMRC, please provide us with a copy of your protection certificate and indicate opposite what kind of certificate you ve enclosed *. 3.2 Is the total value of all benefits being vested (with Aegon or other providers) equal to or less than the standard lifetime allowance in the tax year in which you receive your taxfree cash and/or move money into drawdown pension? 3.3 Is the total value of your Aegon buyout plan equal to or less than 500,000? Certificate for enhanced protection Certificate for fixed protection 2012 Certificate for fixed protection 2014 Certificate for individual protection 2014 Certificate for primary protection Other certificate (for example relating to a pension credit as the result of a divorce settlement or to a transfer from a recognised overseas pensions scheme) Yes go to 3.3 No complete the lifetime allowance form which can be found online or on request. Yes please tell us what your available percentage of standard lifetime allowance is % No complete the lifetime allowance form which can be found online or on request. Aegon buyout plan with protected tax-free cash drawdown pension option Page 4 of 10
4. Your bank details Please give your bank details. We ll pay your tax-free cash and annuity (if applicable) to the same bank account unless you tell us otherwise in writing. Any drawdown income will be paid to the bank account that you ve detailed for your One Retirement account or ARC SIPP. Please enclose a certified copy of a bank statement for this account which has been sent to your home address within the past 12 months, and also shows your home address *. For details see section 5. Bank/Building society name Address Bank account number Sort code Account number Name of account holder Building society roll number (if appropriate) Postcode 5. How we confirm your identity We must confirm your identity when you take pension benefits we can t progress your payment without doing this. That s why we ask you to provide us certified copies of your original documents. 5.1 What you need to do next You can choose one of two options for confirming your identity Option 1 Send us a postal bank statement which is less than 12 months old for the account where you want your money paid to (we don t accept internet bank statements) *. This statement must have been sent to, and also show your home address. We also need a certified copy of one of the following documents *: Current passport Current photo card driving licence (full or provisional) National identity card Identity card issued by the Electoral Office for Northern Ireland Aegon buyout plan with protected tax-free cash drawdown pension option Page 5 of 10
5. How we confirm your identity continued Option 2 Send us a postal bank statement which is less than 12 months old for the account where you want your money paid to (we don t accept internet bank statements) *. This statement must have been sent to, and also show your home address. We also need a certified copy of one document from list A and one from list B *. List A Current (old pre-photo card style) full UK driving licence Birth certificate Proof of benefit entitlement in the last 12 months Inland revenue tax notification quoting National Insurance number sent to your home address List B Current council tax demand letter or statement received in the last 12 months Credit card statement received in the last 12 months Mortgage statement received in the last 12 months Local authority rent card or tenancy agreement 5.2 Who can certify a document and how do they do it Copies of documents can be certified by one of the following people: n Doctors/dentists n Ministers of religion n Teachers n Social workers n Credit union employees n Post Office officials (through the Post Office s certification service) n Accountants n Bank/building society employees n Barristers/solicitors/paralegals n Councillors n Financial advisers n Justice of the Peace n Members of Parliament The person certifying your document should provide the following on the copy: n Their name in block capitals n The name of the company they work for and their occupation n The statement I certify this to be a true likeness of the original, and n Their signature and date Aegon buyout plan with protected tax-free cash drawdown pension option Page 6 of 10
6. Declaration In this declaration I means the person named in section 1 making the claim and asking for the drawdown to drawdown transfer and you means Aegon. 6.1 I request that you pay to me the pensions and/or tax-free cash set out in this form, provide drawdown pension from the balance of the funds under my existing Aegon buyout plan and effect an immediate drawdown to drawdown transfer to the Aegon Self Invested Personal Pension Scheme (the scheme ). 6.2 I consent to the transfer payment from the Aegon buyout plan being paid to the scheme to provide benefits for me. 6.3 I declare that, to the best of my knowledge and belief, the details I ve given above and the information given in this form and any supplementary forms, whether in handwriting or not, are correct and complete. 6.4 I agree that if there s any failure to provide any information that the scheme administrator needs to administer my benefits accurately, the scheme administrator has the right to make further administration charges. 6.5 I agree that no benefits can be commuted, surrendered or assigned except in line with the Finance Act 2004. 6.6 I agree that you or your representatives may approach the scheme administrators or the providers of any other registered pension schemes that I m contributing to or have contributed to in the past, to obtain any information you feel is necessary to administer my arrangements under the scheme. 6.7 I agree that deliberate or careless failure to answer any questions correctly and completely, to the best of my knowledge and belief, may result in benefits not being payable. 6.8 Lifetime allowance declaration This declaration applies to me if I answered yes to both 3.2 and 3.3 in section 3 to confirm that I won t be subject to a lifetime allowance charge. a I declare that the total value of all benefits being vested, when added to the total value of all my pension benefits that have crystallised or will crystallise under any and all registered pension schemes before payment of the tax-free cash sum under section 2, when taken with any pension or income withdrawal in payment on 5 April 2006 isn t more than my lifetime allowance. If that isn t the case, I ll inform the scheme administrator immediately, in writing. b I agree that you ll rely on the declaration I ve given in a above. c I agree that if, for any reason, all or part of the benefits being crystallised under the policy detailed in Section 2 are more than the standard lifetime allowance or my personal lifetime allowance and this results in the scheme administrator being liable for a lifetime allowance charge (or an increase in the lifetime allowance charge), penalties and/or interest to HMRC, that I ll be responsible for and liable to pay to the scheme administrator, a sum equal to the amount of that lifetime allowance charge (or any increase in the lifetime allowance charge), any penalties and interest charged by HMRC and any interest charged by the scheme administrator. 6.9 I declare that I or any person acting on my behalf won t use any of the tax-free cash sum that I receive from the Aegon buyout plan in a way that would breach the recycling rule. However, I agree that, in the event of any arrangement or action by me, or any other person, which constitutes or results in such a breach and consequently the scheme administrator becoming liable for a scheme sanction charge and penalties and/or interest to HMRC, that I ll be liable to pay to the scheme administrator a sum equal to the amount of that scheme sanction charge, any penalties and Aegon buyout plan with protected tax-free cash drawdown pension option Page 7 of 10
6. Declaration continued interest charged by HMRC, and any interest charged by the scheme administrator. 6.10 I agree that any sum due may be deducted from any arrangements for or in respect of me under the scheme. The information given in this application is needed for income tax purposes and may be inspected by UK tax authorities. If I give false information, the tax authorities may prosecute me, which could lead to severe penalties. Date (dd/mm/yyyy) Signature of applicant 7 7 7. For financial advisers only 7.1 Financial adviser case number Did you give this applicant advice when choosing to set up this pension? This is for the purposes of Financial Conduct Authority reporting. Yes No 7.2 Illustration number Definitions Aegon buyout plan this is an: n Aegon Section 32 Buyout policy,or n Aegon Trustee Proposed Section 32 Buyout policy Certified copy this is a copy of a document which has been certified by a certain person. These are required by law so that we can progress your instruction to us. Please make sure that you attach the correct certified documents to avoid delays in processing your instruction. For a full list of people who can certify your documents, and the information required, go to section 5. Drawdown pension a flexi access drawdown arrangement which lets you take as much or as little income (which may be subject to tax) from the arrangement as you wish. Enhanced protection provides full protection from the lifetime allowance charge for the value of the whole of your pension rights built up as at 5 April 2006, regardless of subsequent growth. No further contributions can be paid. Fixed protection 2012 at 6 April 2012 the standard lifetime allowance reduced from 1.8 million to 1.5 million. Fixed protection 2012 maintains the standard lifetime allowance at 1.8 million and provides protection against the lifetime allowance charge for benefits up to this level. If the standard lifetime allowance rises above Aegon buyout plan with protected tax-free cash drawdown pension option Page 8 of 10
Definitions continued 1.8 million in the future the higher standard lifetime allowance will apply. Fixed protection 2014 at 6 April 2014 the standard lifetime allowance reduced from 1.5 million to 1.25 million. Fixed protection 2014 maintains the standard lifetime allowance at 1.5 million and provides protection against the lifetime allowance charge for benefits up to this level. If the standard lifetime allowance rises above 1.5 million in the future the higher standard lifetime allowance will apply. Individual protection 2014 at 6 April 2014 the standard lifetime allowance reduced from 1.5 million to 1.25 million. Individual protection 2014 maintains the standard lifetime allowance at whichever is the lower of the value of the individual s pensions savings as at 5 April 2014 and 1.5 million, and provides protection against the lifetime allowance charge for benefits up to this level. If the standard lifetime allowance rises above the individual protection 2014 level in the future, the higher standard lifetime allowance will apply. Interest will be added on a daily basis to any amount due to the scheme administrator for any lifetime allowance charge and/or scheme sanction charge. It will be calculated on a daily basis from the date the first payment was due at the Royal Bank of Scotland s base rate plus 5%. Lifetime allowance is the limit that applies to the total value of tax-privileged pensions savings you can have across all approved or registered pension schemes. Unless you have enhanced protection, when benefits are taken, savings above that level may attract a lifetime allowance charge. If you don t have enhanced protection, you ll have either a personal lifetime allowance or a standard lifetime allowance. Lifetime allowance charge unless you have enhanced protection when you take benefits, if your pensions savings are more than your lifetime allowance, the excess is subject to this charge. This tax is 55% on lump sums and 25% on funds used to buy a pension. The pension income is taxed under the Pay As You Earn (PAYE) system. Money purchase annual allowance this is the amount that can be paid in one year to your money purchase arrangements without a tax charge applying, for the 2015/2016 tax year this is 10,000. If the money purchase annual allowance provisions apply to you, and during the year more than 10,000 has been paid to your money purchase arrangements under all of your registered pension schemes, a tax charge: n will apply on the money purchase contributions above 10,000, and n may apply on the value of any savings made to defined benefit arrangements that are higher than 30,000 plus any carry forward you have available Special rules apply in the year that your first trigger your money purchase annual allowance. Please speak to a financial adviser for more information. Personal lifetime allowance where you ve registered with HMRC for certain types of protection you ll have an enhancement to the standard lifetime allowance. This increased amount is your personal lifetime allowance. Primary protection if you d built up pension rights of more than 1.5 million at 5 April 2006, primary protection is available to provide a measure of protection from the lifetime allowance. Your personal lifetime allowance will be calculated based on 1.8 million (or the standard lifetime allowance, if this increases above 1.8 million) and the value at 5 April 2006, you registered with HMRC. The calculation of enhanced lifetime allowance for primary protection isn t affected by the reductions of the standard lifetime allowance that took place from 6 April 2012 and 6 April 2014. Recycling rule is a rule in the Finance Act 2004 designed to stop people using all or Aegon buyout plan with protected tax-free cash drawdown pension option Page 9 of 10
Definitions continued part of a lump sum as a direct or indirect way of paying significantly greater pension contributions. Registered pension scheme is a pension scheme that s registered with HMRC under Chapter 2 Part 4 of the Finance Act 2004. Standard lifetime allowance This is the value of pension benefits an individual can build up before a lifetime allowance charge is applied. The current standard lifetime allowance is: n 1.5 million if you have fixed protection 2014 n the protected amount (being more than 1.25 million and not more than 1.5 million) if you have individual protection 2014 n 1.25 million if you don t have fixed protection 2012, fixed protection 2014 or individual protection 2014 n 1.8 million if you have fixed protection 2012 Aegon is a brand name of Scottish Equitable plc (No. SC144517) and Aegon Investment Solutions Ltd (No. SC394519) registered in Scotland, registered office: Edinburgh Park, Edinburgh EH12 9SE. Both are Aegon companies. Scottish Equitable plc is authorised by the Prudential Regulation Authority and regulated by the Financial Conduct Authority and the Prudential Regulation Authority. Aegon Investment Solutions Ltd is authorised and regulated by the Financial Conduct Authority. Their Financial Services Register numbers are 165548 and 543123 respectively. 2015 Aegon UK plc C 289360 ARC 00270357 04/15 We re proud to be the Lead Partner of British Tennis.