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Language: English (EN)

Asset Type: Operational Forms

Insurer: Utmost Wealth Solutions

Documents

Title	Description	Market	Product	Regime	Process	Excerpt
Transferring Assets to Your Bond/Account	Please use this form when transferring assets to your Plan/Bond/Policy. For use withformer Quilter International Products, not for use in Hong Kong.	Europe Expat, Rest of the World, Singapore (SG), Spain (ES), Sweden (SE), United Kingdom (UK)	European Executive Investment Bond – PRIIPs, Executive Investment Account, Executive Investment Bond, Executive Life Portfolio, Executive Redemption Bond, Executive Redemption Bond – QIME, International Portfolio Bond (Closed), Non Product Specific, Silk Life Plan (Life Cover only), Silk Life Plan (Life Cover Plus), Swedish Executive Portfolio – PRIIPs, Tailored Life Plan (TLP)	FOS	Making a change to your policy, New Policy	Please use this form when transferring assets to your Plan/Bond/Policy. For use withformer Quilter International Products, not for use in Hong Kong. Operational Forms Transferring Assets to Your Bond/Account UWSQ PR 25131
Request Remuneration to Your Financial Adviser	Please use this form to pay an ongoing service fee or ongoing service charge to your financial adviser. For use withformer Quilter International Products only.	Rest of the World, Singapore (SG), United Kingdom (UK)	Non Product Specific	FOS	Making a change to your policy, New Policy	Please use this form to pay an ongoing service fee or ongoing service charge to your financial adviser. For use withformer Quilter International Products only. Operational Forms Request Remuneration to Your Financial Adviser UWSQ PR 25129
Doing business with Utmost International – Electronic Submissions in UK	The processes highlighted in this document apply to Utmost International Isle of Man Limited and Utmost PanEurope dac.	United Kingdom (UK)	Non Product Specific	FOS	New Policy	The processes highlighted in this document apply to Utmost International Isle of Man Limited and Utmost PanEurope dac. Operational Forms Doing business with Utmost International – Electronic Submissions in UK UWSQ PR 25126
Deferring a Policy Fund Entitlement	This form needs to be completed when a client requests to change their Policy Fund entitlements.	Middle East, Rest of the World, United Kingdom (UK)	Non Product Specific	FOS	Making a change to your policy	This form needs to be completed when a client requests to change their Policy Fund entitlements. Operational Forms Deferring a Policy Fund Entitlement UWSQ PR \| 25162
Additional Loan Agreement and Acknowledgement of Receipt of Loan by Trustees	This agreement is for use with the existing Loan Trusts offered by Utmost International.	United Kingdom (UK)	Non Product Specific		New Policy	This agreement is for use with the existing Loan Trusts offered by Utmost International. Operational Forms Additional Loan Agreement and Acknowledgement of Receipt of Loan by Trustees UWSQ PR \| 25103
Portfolio Bond Minimum Residual Value	Published minimum residual values as at February 2021	Europe Expat, Hong Kong (HK), Middle East, Singapore (SG), Sweden (SE), United Kingdom (UK)	Non Product Specific	FOS	New Policy	Published minimum residual values as at February 2021 Operational Forms Portfolio Bond Minimum Residual Value UWSQ PR \| 21018
Appointing a Fund Adviser	This form can be used with Utmost International Isle of Man Limited orUtmost PanEurope dac a range of portfolio bonds available in all regions (except Hong Kong).	Middle East, Singapore (SG)	European Executive Investment Bond – PRIIPs, Executive Investment Account, Executive Investment Bond, Executive Investment Plan, Executive Investment Portfolio, Executive Life Portfolio, Life Insurance Portfolio, Life Insurance Portfolio Plus, Non Product Specific	FOS	Making a change to your policy	This form can be used with Utmost International Isle of Man Limited orUtmost PanEurope dac a range of portfolio bonds available in all regions (except Hong Kong). Operational Forms Appointing a Fund Adviser UWSQ PR \| 20985
Appointing an Authorised Custodian – Wealth bond	Please use this form to request Utmost International Isle of Man Limited or Utmost PanEurope dac to appoint an authorised custodian. This form is only for use with the International Wealth Bond or European Wealth Bond.	United Kingdom (UK)	Non Product Specific		Making a change to your policy	Please use this form to request Utmost International Isle of Man Limited or Utmost PanEurope dac to appoint an authorised custodian. This form is only for use with the International Wealth Bond or European Wealth Bond. Operational Forms Appointing an Authorised Custodian – Wealth bond UWSQ PR \| 20951
Request to Restrict Assets – Wealth Bond	Please use this form if you wish to request Utmost International Isle of Man Limited or Utmost PanEurope dac to restrict the assets to a International Wealth Bond or European Wealth Bond.	United Kingdom (UK)	Non Product Specific	FOS	New Policy	Please use this form if you wish to request Utmost International Isle of Man Limited or Utmost PanEurope dac to restrict the assets to a International Wealth Bond or European Wealth Bond. Operational Forms Request to Restrict Assets – Wealth Bond UWSQ PR \| 20912
Source of Wealth Questionnaire	This questionnaire seeks to obtain information and documentation from the adviser to establish the source of wealth of high-risk clients of Utmost International Isle of Man Limited and Utmost PanEurope dac	Not country specific	Non Product Specific	FOS	Addition to your Policy, New Policy	This questionnaire seeks to obtain information and documentation from the adviser to establish the source of wealth of high-risk clients of Utmost International Isle of Man Limited and Utmost PanEurope dac Operational Forms Source of Wealth Questionnaire UWSQ PR \| 20888
Digital Signature Application Form – Non UK	Digital signature application form – not for use in the UK	Europe Expat, Middle East, Rest of the World, Singapore (SG)	Non Product Specific	FOS	New Policy	Digital signature application form – not for use in the UK Operational Forms Digital Signature Application Form – Non UK UWSQ PR \| 20815
Request to Add or Remove a Life Assured Form	This form can be used to add or remove a life assured on your Utmost International Portfolio Bond.	Europe Expat	Non Product Specific	FOS	Making a change to your policy	This form can be used to add or remove a life assured on your Utmost International Portfolio Bond. Operational Forms Request to Add or Remove a Life Assured Form UWSQ PR \| 20814
Appointment of an Authorised Custodian(s) Form	This form can be used if you wish to request Utmost International Isle of Man Limited or Utmost PanEurope dac. to appoint an authorised custodian in respect of your bond/ account/plan/ policy. For use with the following products – European Portfolio Bond, European Wealth Bond, Executive Investment Plan, International Portfolio Bond, International Wealth Bond, Swedish Executive Portfolio, Silk Life Plan, and Tailored Life Plan.	Europe Expat, Middle East, Rest of the World, Singapore (SG), Sweden (SE), United Kingdom (UK)	European Executive Investment Bond – PRIIPs, Executive Investment Plan, International Portfolio Bond (Closed), Silk Life Plan (Life Cover only), Silk Life Plan (Life Cover Plus), Swedish Executive Portfolio – PRIIPs, Tailored Life Plan (TLP)		Making a change to your policy	This form can be used if you wish to request Utmost International Isle of Man Limited or Utmost PanEurope dac. to appoint an authorised custodian in respect of your bond/ account/plan/ policy. For use with the following products – European Portfolio Bond, European Wealth Bond, Executive Investment Plan, International Portfolio Bond, International Wealth Bond, Swedish Executive Portfolio, Silk Life Plan, and Tailored Life Plan. Operational Forms Appointment of an Authorised Custodian(s) Form UWSQ PR \| 20669
Request for Utmost International to Appoint an Authorised Custodian	This form can be used if you wish to request Utmost International Isle of Man Limited or Utmost PanEurope dac. to appoint an authorised custodian in respect of your bond/ account/plan/ policy. For use with the following products – Collective Investment Plan, Executive Life Portfolio, Spanish Collective Investment Bond, Life Investment Portfolio, Life Investment Portfolio Plus, and Wealth Management Plan.	Europe Expat, Middle East, Rest of the World, Sweden (SE)	Executive Life Portfolio, Life Insurance Portfolio, Life Insurance Portfolio Plus, Spanish Collective Investment Bond		Making a change to your policy	This form can be used if you wish to request Utmost International Isle of Man Limited or Utmost PanEurope dac. to appoint an authorised custodian in respect of your bond/ account/plan/ policy. For use with the following products – Collective Investment Plan, Executive Life Portfolio, Spanish Collective Investment Bond, Life Investment Portfolio, Life Investment Portfolio Plus, and Wealth Management Plan. Operational Forms Request for Utmost International to Appoint an Authorised Custodian UWSQ PR \| 20668
Letter of authorisation for Authorised Custodian Account Form	This letter of authorisation permits an authorised third-party individual to make investment decisions in respect of the accounts opened by Utmost International Isle of Man Limited or Utmost PanEurope dac. with the authorised custodian.	Europe Expat, Middle East, Singapore (SG), United Kingdom (UK)	Non Product Specific	FOS	Making a change to your policy	This letter of authorisation permits an authorised third-party individual to make investment decisions in respect of the accounts opened by Utmost International Isle of Man Limited or Utmost PanEurope dac. with the authorised custodian. Operational Forms Letter of authorisation for Authorised Custodian Account Form UWSQ PR \| 20660
Deed of Assignment Form	This deed can be used to assign a policy in several scenarios, such as gifting or transfers.For use with a policy issued under Isle of Man or English law. This deed should be used with ex-Quilter products or the following range of product types only: Swedish Executive Portfolio, Executive Investment Bonds/Portfolios (including European and Spanish Collective Investment Bond), Wealth Portfolio Bonds, Managed Capital Accounts, or Life Insurance Portfolios (including those written on life cover or life cover plus)	Europe Expat, Middle East, Rest of the World, Singapore (SG), United Kingdom (UK)	Executive Investment Bond, Life Insurance Portfolio, Life Insurance Portfolio Plus, Managed Capital Account, Spanish Collective Investment Bond, Swedish Executive Portfolio – PRIIPs	FOS	Making a change to your policy	This deed can be used to assign a policy in several scenarios, such as gifting or transfers.For use with a policy issued under Isle of Man or English law. This deed should be used with ex-Quilter products or the following range of product types only: Swedish Executive Portfolio, Executive Investment Bonds/Portfolios (including European and Spanish Collective Investment Bond), Wealth Portfolio Bonds, Managed Capital Accounts, or Life Insurance Portfolios (including those written on life cover or life cover plus) Operational Forms Deed of Assignment Form UWSQ PR \| 18419
Data Subject Access Request Form	This form is for you, or someone you have authorised to represent you, to request a copy of the personal information we hold for you.	United Kingdom (UK)	Non Product Specific		Making a change to your policy	This form is for you, or someone you have authorised to represent you, to request a copy of the personal information we hold for you. Operational Forms Data Subject Access Request Form UWSQ PR \| 18031
Authorised Custodian Internet Service Request Form	This form can be used to request access to the view only internet service provided by the authorised custodian.	Europe Expat, Middle East	Non Product Specific	FOS	Making a change to your policy	This form can be used to request access to the view only internet service provided by the authorised custodian. Operational Forms Authorised Custodian Internet Service Request Form UWSQ PR \| 17990
Portfolio Bond Transaction Account Overdraft Limit	The published overdraft limit of transaction accounts for applicable portfolio bonds.	Europe Expat, Hong Kong (HK), Middle East, Rest of the World, Singapore (SG), Sweden (SE), United Kingdom (UK)	Non Product Specific	FOS	New Policy	The published overdraft limit of transaction accounts for applicable portfolio bonds. Operational Forms Portfolio Bond Transaction Account Overdraft Limit UWSQ PR \| 14355
Portfolio Bond Withdrawal / Surrender Form	Surrender and Withdrawal Request Form for Portfolio Bond	Europe Expat, Hong Kong (HK), Middle East, Rest of the World, Singapore (SG), Sweden (SE), United Kingdom (UK)	Non Product Specific	FOS	Surrender or Claim	Surrender and Withdrawal Request Form for Portfolio Bond Operational Forms Portfolio Bond Withdrawal / Surrender Form UWSQ PR \| 13485
Failed Regular Withdrawal Form	This form is to be completed where a regular withdrawal has not been paid due to insufficient value in the nominated asset.	Singapore (SG)	Non Product Specific		New Policy	This form is to be completed where a regular withdrawal has not been paid due to insufficient value in the nominated asset. Operational Forms Failed Regular Withdrawal Form UWSQ PR \| 12576
Tax Declaration and Self Certification for Entity Investors	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for Entity investors such as, companies, corporate trusts or foundations.	Finland (FI), France (FR), Hong Kong (HK), Italy (IT), Mexico (MX), Middle East, Portugal (PT), Singapore (SG), Spain (ES), Sweden (SE), Switzerland (CH), United Kingdom (UK)	Non Product Specific	FOS	Making a change to your policy, New Policy	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for Entity investors such as, companies, corporate trusts or foundations. Operational Forms Tax Declaration and Self Certification for Entity Investors UWSQ PR \| 12415
Tax Declaration and Self Certification for Individual Investors	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders, persons authorised to sign on behalf of the policyholder, for example their Power of Attorney or court appointed Deputy, and individuals linked to the trust where Utmost International Trustee Solutions Limited are the appointed trustee.	ASIA, Europe Expat, Finland (FI), France (FR), Germany (DE), Hong Kong (HK), Italy (IT), Mexico (MX), Middle East, Peru (PE), Portugal (PT), Singapore (SG), Spain (ES), Sweden (SE), Switzerland (CH), United Kingdom (UK)	Non Product Specific	FOS	Addition to your Policy, Making a change to your policy, New Policy, Surrender or Claim	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders, persons authorised to sign on behalf of the policyholder, for example their Power of Attorney or court appointed Deputy, and individuals linked to the trust where Utmost International Trustee Solutions Limited are the appointed trustee. Operational Forms Tax Declaration and Self Certification for Individual Investors UWSQ PR \| 12373
Request for Utmost to Appoint a new/additional Discretionary Asset Manager	This form should be used for International Wealth Bond or European Wealth Bond policyholders only, who would like to change their discretionary asset manager. This form should be used where you have not requested Quilter International to restrict the asset range.	United Kingdom (UK)	Non Product Specific	FOS	Making a change to your policy	This form should be used for International Wealth Bond or European Wealth Bond policyholders only, who would like to change their discretionary asset manager. This form should be used where you have not requested Quilter International to restrict the asset range. Operational Forms Request for Utmost to Appoint a new/additional Discretionary Asset Manager UWSQ PR \| 12370
Amendment to Wealth Interactive, Policyholder Online Service Terms	This form allows Trustee Policyholders to request online access for their Clients/Members.	Singapore (SG)	Non Product Specific	FOS	Making a change to your policy	This form allows Trustee Policyholders to request online access for their Clients/Members. Operational Forms Amendment to Wealth Interactive, Policyholder Online Service Terms UWSQ PR \| 11729
Amendment to Wealth Interactive, Policyholder Online Service Terms (Providing Limited Access)	This form allows Trustee Policyholders to request online access for their Clients/Members.	Singapore (SG)	Non Product Specific	FOS	Making a change to your policy	This form allows Trustee Policyholders to request online access for their Clients/Members. Operational Forms Amendment to Wealth Interactive, Policyholder Online Service Terms (Providing Limited Access) UWSQ PR \| 11544
Nominated asset for regular withdrawals	To ensure regular withdrawals are paid, you must select one or more asset from which the payment will be made. Alternatively, the Transaction Account can be selected to fund withdrawals. Please tick the appropriate box below	Europe Expat, Middle East, Singapore (SG), United Kingdom (UK)	Non Product Specific	FOS	New Policy	To ensure regular withdrawals are paid, you must select one or more asset from which the payment will be made. Alternatively, the Transaction Account can be selected to fund withdrawals. Please tick the appropriate box below Operational Forms Nominated asset for regular withdrawals UWSQ PR \| 10347
Deed of Absolute Appointment in Favour of one or more Discretionary Beneficiaries (Manx Law)	This deed is for guidance only and may be considered suitable where an Utmost International Isle of Man Limited orUtmost PanEurope dac discretionary trust subject to Manx Law has been used.	United Kingdom (UK)	Non Product Specific	FOS	New Policy	This deed is for guidance only and may be considered suitable where an Utmost International Isle of Man Limited orUtmost PanEurope dac discretionary trust subject to Manx Law has been used. Operational Forms Deed of Absolute Appointment in Favour of one or more Discretionary Beneficiaries (Manx Law) UWSQ PR \| 09637
Cheque Processing Form	This form is to be used when Wealth Interactive status is awaiting payment.	United Kingdom (UK)	Non Product Specific		New Policy	This form is to be used when Wealth Interactive status is awaiting payment. Operational Forms Cheque Processing Form UWSQ PR \| 09466
Request to Appoint a Discretionary Asset Manager (on an Advisory or Discretionary Authority)	Please use this form to appoint a discretionary asset manager on an advisory or discretionary authority.	Europe Expat, Middle East, United Kingdom (UK)	Non Product Specific		New Policy	Please use this form to appoint a discretionary asset manager on an advisory or discretionary authority. Operational Forms Request to Appoint a Discretionary Asset Manager (on an Advisory or Discretionary Authority) UWSQ PR \| 08887
Change of Financial Adviser	Please use this form if you wish to appoint a new or remove a financial adviser. If you remove a financial adviser this will stop all correspondence or information in respect of your policy going through that financial adviser.	Europe Expat, Hong Kong (HK), Middle East, Rest of the World, Singapore (SG), United Kingdom (UK)	Non Product Specific	FOS	Making a change to your policy	Please use this form if you wish to appoint a new or remove a financial adviser. If you remove a financial adviser this will stop all correspondence or information in respect of your policy going through that financial adviser. Operational Forms Change of Financial Adviser UWSQ PR \| 05271
Discounted Gift Trust Declaration of Continuing Good Health Form	This declaration should be completed by the settlor to confirm that their health has not changed since the date of the original application toUtmost Innternational Isle of Man Limited, Utmost International Trustee Solutions Limited orUtmost PanEurope dac.	United Kingdom (UK)	Non Product Specific	FOS	Making a change to your policy	This declaration should be completed by the settlor to confirm that their health has not changed since the date of the original application toUtmost Innternational Isle of Man Limited, Utmost International Trustee Solutions Limited orUtmost PanEurope dac. Operational Forms Discounted Gift Trust Declaration of Continuing Good Health Form UWSQ PR \| 04612
Intermediary Registration Application QINTL IOM and QII	Intermediary Registration Application IOM and QII – for non UK intermediaries only	United Kingdom (UK)	Non Product Specific	FOS	New Policy	Intermediary Registration Application IOM and QII – for non UK intermediaries only Operational Forms Intermediary Registration Application QINTL IOM and QII UWSQ PR \| 02230
Portfolio Bond Endorsement Request Form	This form can be used to endorse highly personalised bonds and bring into the UK regulations as well as reduce tax implications.	Europe Expat, Hong Kong (HK), Singapore (SG), Sweden (SE)	Non Product Specific	FOS	Making a change to your policy	This form can be used to endorse highly personalised bonds and bring into the UK regulations as well as reduce tax implications. Operational Forms Portfolio Bond Endorsement Request Form UWSQ PR \| 02013
Bereavement Claim Form	Bereavement Claim Form for Life Assurance Bonds	United Kingdom (UK)	Evolution, Selection	FOS	Surrender or Claim	Bereavement Claim Form for Life Assurance Bonds Operational Forms Bereavement Claim Form UWS PR 0182
Request for Withdrawal or Surrender – Life Insurance Portfolio, Tailored Life Plan and Silk Life Plan	This form should be used to request a partial or full surrender from a Life Insurance Portfolio, SILK Life Plan or Tailored Life Plan only.	Middle East, Singapore (SG)	Executive Life Portfolio, Life Insurance Portfolio, Life Insurance Portfolio Plus, Silk Life Plan (Life Cover only), Silk Life Plan (Life Cover Plus), Tailored Life Plan (TLP)	FOS	Surrender or Claim	This form should be used to request a partial or full surrender from a Life Insurance Portfolio, SILK Life Plan or Tailored Life Plan only. Operational Forms Request for Withdrawal or Surrender – Life Insurance Portfolio, Tailored Life Plan and Silk Life Plan UL PR 00420
Change of Bank Details	This form can be used to request and change bank details from clients for Utmost International Isle of Man and Utmost PanEurope polices.	United Kingdom (UK)	Non Product Specific	FOS	New Policy	This form can be used to request and change bank details from clients for Utmost International Isle of Man and Utmost PanEurope polices. Operational Forms Change of Bank Details UL PR 00303
Multi-Product Open Architecture Dealing Instruction Form (UWS)	This form can be used for Utmost International Isle of Man Limited Evolution and Estate Planning Bond policies and Utmost PanEurope dac Selection and Generation Planning Bond policies.This form can also be used for Utmost PanEurope dac’s ex-Athora Open Architecture and ex-Aviva International Premier Portfolio policies.	United Kingdom (UK)	Estate Planning Bond, Evolution, Generation Planning Bond		Making a change to your policy	This form can be used for Utmost International Isle of Man Limited Evolution and Estate Planning Bond policies and Utmost PanEurope dac Selection and Generation Planning Bond policies.This form can also be used for Utmost PanEurope dac’s ex-Athora Open Architecture and ex-Aviva International Premier Portfolio policies. Operational Forms Multi-Product Open Architecture Dealing Instruction Form (UWS) IOM PR 0042
UWS Multi-Product Withdrawal and Surrender Form	This form should only be used for surrender or withdrawal requests from products designed forUtmost International Isle of Man Limited within the UK market or for any product where the policyholder is now UK resident.	United Kingdom (UK)	Non Product Specific	FOS	Surrender or Claim	This form should only be used for surrender or withdrawal requests from products designed forUtmost International Isle of Man Limited within the UK market or for any product where the policyholder is now UK resident. Operational Forms UWS Multi-Product Withdrawal and Surrender Form IOM PR 0027
Assignment of Policies Form	This form should be used for assigning ownership of segments to an individual including slitting out segments to from a new bond.This is not for use with exQuilter policies.	United Kingdom (UK)	Non Product Specific	FOS	Making a change to your policy	This form should be used for assigning ownership of segments to an individual including slitting out segments to from a new bond.This is not for use with exQuilter policies. Operational Forms Assignment of Policies Form IOM PR 0015
Dealing Account – Overdraft Clearance Instruction Form	Please use this form to inform Utmost on what actions you would like to take in order to clear your overdraft.	United Kingdom (UK)	Estate Planning Bond, Evolution, Family Legacy Bond, Selection	FOS	Making a change to your policy	Please use this form to inform Utmost on what actions you would like to take in order to clear your overdraft. Operational Forms Dealing Account – Overdraft Clearance Instruction Form ALE PR 0018

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