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Process: Surrender or Claim

Documents

Title	Description	Insurer	Market	Asset Type	Language	Regime	Excerpt
Request a Withdrawal on Wealth Interactive Guide	This guide demonstrates how you can request a one-off withdrawal in three easy steps through Wealth Interactive.	Europe Expat, Hong Kong (HK), Rest of the World, United Kingdom (UK)	Utmost Wealth Solutions	Tax and regulatory Literature/technical sales aids and literature	English (EN)	FOS	This guide demonstrates how you can request a one-off withdrawal in three easy steps through Wealth Interactive. Tax and regulatory Literature/technical sales aids and literature Request a Withdrawal on Wealth Interactive Guide UWSQ PR \| 19515
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)	Utmost Wealth Solutions	Operational Forms	English (EN)	FOS	Surrender and Withdrawal Request Form for Portfolio Bond Operational Forms Portfolio Bond Withdrawal / Surrender Form UWSQ PR \| 13485
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)	Utmost Wealth Solutions	Operational Forms	English (EN)	FOS	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
Before Surrendering	Guides and Supporting Documents Before Surrendering UWS PR 00431	Europe Expat, Hong Kong (HK), Middle East, Rest of the World, United Kingdom (UK)	Utmost Wealth Solutions	Guides and Supporting Documents	English (EN)	FOS	Guides and Supporting Documents Before Surrendering UWS PR 00431
UPE Declaration of Residence Outside of Ireland	Utmost PanEurope Policyholders resident outside of Ireland must make the declarations contained in this form in order to receive payments without the deduction of Irish tax if they hold a policy issued by an Irish insurer.	Europe Expat, Rest of the World, United Kingdom (UK)	Utmost PanEurope	Operational Forms	English (EN)	FOS	Utmost PanEurope Policyholders resident outside of Ireland must make the declarations contained in this form in order to receive payments without the deduction of Irish tax if they hold a policy issued by an Irish insurer. Operational Forms UPE Declaration of Residence Outside of Ireland UPEQ PR \| 20900
French Executive Portfolio Withdrawal/Closure Form	This form can be used to request a withdrawal or closure of policy from the French Executive Portfolio.	Europe Expat	Utmost PanEurope	Operational Forms	English (EN)	FOS	This form can be used to request a withdrawal or closure of policy from the French Executive Portfolio. Operational Forms French Executive Portfolio Withdrawal/Closure Form UPEQ PR \| 20786
Declaração Fiscal e Auto Certificação para Investidores Individuais	Este formulário deve ser preenchido para informar com precisão a sua apólice nos termos dos acordos de troca de informações fiscais relevantes, incluindo a Lei de Conformidade Fiscal de Contas Estrangeiras (FATCA) e os regulamentos da Norma Comum de Comunicação (CRS). Este formulário deve ser utilizado por segurados individuais, pessoas autorizadas a assinar em nome do segurado, por exemplo, o seu procurador ou representante nomeado pelo tribunal, e indivíduos ligados ao fundo fiduciário em que a Utmost International Trustee Solutions Limited é o administrador fiduciário nomeado.	Europe Expat, Portugal (PT), United Kingdom (UK)	Utmost Wealth Solutions	Operational Forms	Portuguese (PT)	FOS	Este formulário deve ser preenchido para informar com precisão a sua apólice nos termos dos acordos de troca de informações fiscais relevantes, incluindo a Lei de Conformidade Fiscal de Contas Estrangeiras (FATCA) e os regulamentos da Norma Comum de Comunicação (CRS). Este formulário deve ser utilizado por segurados individuais, pessoas autorizadas a assinar em nome do segurado, por exemplo, o seu procurador ou representante nomeado pelo tribunal, e indivíduos ligados ao fundo fiduciário em que a Utmost International Trustee Solutions Limited é o administrador fiduciário nomeado. Operational Forms Declaração Fiscal e Auto Certificação para Investidores Individuais UPE_WS \| 04029
Déclaration Fiscale et Auto certification pour les Investisseurs Personnes Morales	Il vous a été demandé de remplir ce formulaire afin que la compagnie concernée puisse déclarer correctement votre contrat dans le cadre des accords d’échange d’informations fiscales, y compris FATCA et CRS.Ce formulaire doit être signé par la personne appropriée comme indiqué ci-dessous :› Pour une entreprise – Une personne qui a le pouvoir de signer, par exemple un dirigeant ou un administrateur d’une entreprise.	France (FR)	Utmost PanEurope	Operational Forms	French (FR)	FOS	Il vous a été demandé de remplir ce formulaire afin que la compagnie concernée puisse déclarer correctement votre contrat dans le cadre des accords d’échange d’informations fiscales, y compris FATCA et CRS.Ce formulaire doit être signé par la personne appropriée comme indiqué ci-dessous :› Pour une entreprise – Une personne qui a le pouvoir de signer, par exemple un dirigeant ou un administrateur d’une entreprise. Operational Forms Déclaration Fiscale et Auto certification pour les Investisseurs Personnes Morales UPE PR 12861
Never Received or Lost Policy Schedule Declaration (EN)	Utmost Pan Europe dac Never Received or Lost Policy Schedule Declaration	Chile (CL), Finland (FI), France (FR), Italy (IT), Mexico (MX), Portugal (PT), Spain (ES), United Kingdom (UK)	Utmost PanEurope	Operational Forms	English (EN)	FOS	Utmost Pan Europe dac Never Received or Lost Policy Schedule Declaration Operational Forms Never Received or Lost Policy Schedule Declaration (EN) UPE PR 12847
Déclaration Fiscale et Auto-certification pour les Investisseurs Individuels	Il vous a été demandé de remplir ce formulaire afin que la compagnie concernée puisse déclarer correctement votre contrat dans le cadre des accords d’échange d’informations fiscales, y compris FATCA et CRS. Ce formulaire doit être complété par:• Le titulaire de la police (parfois appelé titulaire du régime ou titulaire du compte)• Les personnes autorisées à signer au nom de l’Assuré, par exemple leur mandataire ou leur adjoint désigné par le tribunal, lorsque nous détenons les documents appropriés qui peuvent justifier l’intervention d’une personne autorisée.	France (FR)	Utmost PanEurope	Operational Forms	French (FR)	FOS	Il vous a été demandé de remplir ce formulaire afin que la compagnie concernée puisse déclarer correctement votre contrat dans le cadre des accords d’échange d’informations fiscales, y compris FATCA et CRS. Ce formulaire doit être complété par:• Le titulaire de la police (parfois appelé titulaire du régime ou titulaire du compte)• Les personnes autorisées à signer au nom de l’Assuré, par exemple leur mandataire ou leur adjoint désigné par le tribunal, lorsque nous détenons les documents appropriés qui peuvent justifier l’intervention d’une personne autorisée. Operational Forms Déclaration Fiscale et Auto-certification pour les Investisseurs Individuels UPE PR 00232
Death Claim	Use this form to initiate a death claim – Asia	ASIA	Utmost PCC Limited	Surrender/Claim/Withdrawal/Switch	English (EN)	FOS	Use this form to initiate a death claim – Asia Surrender/Claim/Withdrawal/Switch Death Claim UPCC PCON1168
Kuolintapaus / Death Claim	Use this form to initiate a death claim – Finland	Finland (FI)	Utmost Luxembourg S.A	Operational Forms	English (EN), Finnish (FI)	FOS	Use this form to initiate a death claim – Finland Operational Forms Kuolintapaus / Death Claim ULU PCON1006
Declaration of Loss or Non-Receipt of Policy Form	This declaration form is for use in Hong Kong only and can be used if your policy documents were lost, destroyed or never received.	Hong Kong (HK)	Utmost International - IoM	Operational Forms	English (EN)	FOS	This declaration form is for use in Hong Kong only and can be used if your policy documents were lost, destroyed or never received. Operational Forms Declaration of Loss or Non-Receipt of Policy Form ULQ PR \| 6019
The Power of Tax Deferral	This document highlights the benefits of tax deferral once a clients investment is held in a tax-efficient structure, such as an investment-linked life insurance policy.	Singapore (SG)	Utmost International - IoM	Tax and regulatory Literature/technical sales aids and literature	English (EN)		This document highlights the benefits of tax deferral once a clients investment is held in a tax-efficient structure, such as an investment-linked life insurance policy. Tax and regulatory Literature/technical sales aids and literature The Power of Tax Deferral ULQ PR \| 19303
Investment Withdrawal Options for your Clients Guide	This document shows you the different portfolio bond withdrawal options available for you current and future UK clients.	Middle East, Rest of the World	Utmost International - IoM	Tax and regulatory Literature/technical sales aids and literature	English (EN)	FOS	This document shows you the different portfolio bond withdrawal options available for you current and future UK clients. Tax and regulatory Literature/technical sales aids and literature Investment Withdrawal Options for your Clients Guide ULQ PR \| 18690
Death Claim Form – Upon Death of the Relevant Life Assured	This form should be completed by a Claimant to request payment upon death of the relevant life assured. For use with Ex Quilter Isle of Man and Ireland policies except SILK, Life Insurance Plan and Tailored Life Plan.	Europe Expat, Rest of the World, United Kingdom (UK)	Utmost International - IoM	Surrender/Claim/Withdrawal/Switch	English (EN)	FOS	This form should be completed by a Claimant to request payment upon death of the relevant life assured. For use with Ex Quilter Isle of Man and Ireland policies except SILK, Life Insurance Plan and Tailored Life Plan. Surrender/Claim/Withdrawal/Switch Death Claim Form – Upon Death of the Relevant Life Assured ULQ PR \| 07806
Request for Fixed Account Loan Withdrawal Form	This form can be used to request Utmost International Isle of Man or Utmost PanEurope to transfer monies to the fixed account and issue a loan withdrawal for the same amount.	Europe Expat, Middle East, Rest of the World	Utmost International - IoM	Operational Forms	English (EN)	FOS	This form can be used to request Utmost International Isle of Man or Utmost PanEurope to transfer monies to the fixed account and issue a loan withdrawal for the same amount. Operational Forms Request for Fixed Account Loan Withdrawal Form ULQ PR \| 04839
Assignment of Policy for Surrender Form	This Assignment and Surrender Form can be used for assigning of policies for immediate surrender.	United Kingdom (UK)	Utmost International - IoM	Operational Forms	English (EN)	FOS	This Assignment and Surrender Form can be used for assigning of policies for immediate surrender. Operational Forms Assignment of Policy for Surrender Form UL PR 00334
Retirement Benefits Plan – Withdrawal Form	This is a list of several options in relation to the accrued pension benefits.This form is used with a small number of older products.		Utmost PanEurope	Operational Forms	English (EN)		This is a list of several options in relation to the accrued pension benefits.This form is used with a small number of older products. Operational Forms Retirement Benefits Plan – Withdrawal Form UIC PR 00187
Retirement Benefits Plan – Retirement Advice Form	This form is intended to allow the Trustees to indicate the required benefits for the retiring employee, provide details and authorise the payment of benefits.This form is used with a small number of older products.		Utmost PanEurope	Operational Forms	English (EN)		This form is intended to allow the Trustees to indicate the required benefits for the retiring employee, provide details and authorise the payment of benefits.This form is used with a small number of older products. Operational Forms Retirement Benefits Plan – Retirement Advice Form UIC PR 00186
Permanent Health Insurance Claim Form	Permanent health insurance claim form to request the health details of the life assured and consent to Utmost PanEurope dac seeking and processing information in order to be able to process this claim.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	Operational Forms	English (EN)	FOS	Permanent health insurance claim form to request the health details of the life assured and consent to Utmost PanEurope dac seeking and processing information in order to be able to process this claim. Operational Forms Permanent Health Insurance Claim Form UIC PR 00184
Lapse Value Claim Form	Lapse Value Claim Form to claim the cash in value of the policy at the date of lapse together with late payment interest in full and final settlement of the policy.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	Operational Forms	English (EN)	FOS	Lapse Value Claim Form to claim the cash in value of the policy at the date of lapse together with late payment interest in full and final settlement of the policy. Operational Forms Lapse Value Claim Form UIC PR 00180
Full Encashment Request Form	This form is used to request full encashment. Please note the encashment value will be based on the date of receipt of all requirements and payable to the individual who according to Utmost PanEurope dac’s records is entitled to receive it.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	Operational Forms	English (EN)	FOS	This form is used to request full encashment. Please note the encashment value will be based on the date of receipt of all requirements and payable to the individual who according to Utmost PanEurope dac’s records is entitled to receive it. Operational Forms Full Encashment Request Form UIC PR 00179
Surrender Request Form	Surrender Request Form outlining the bond surrender details along with the bond owners, both personal and corporate investors. Also, any other surrender instructions, such as payment details.For products formerly Scottish Mutual International.		Utmost PanEurope	Operational Forms	English (EN)	FOS	Surrender Request Form outlining the bond surrender details along with the bond owners, both personal and corporate investors. Also, any other surrender instructions, such as payment details.For products formerly Scottish Mutual International. Operational Forms Surrender Request Form UIC PR 00169
Rückkaufsantrag	This surrender Request Form outlines the bond surrender details along with the bond owners, both personal and corporate investors. Also, any other surrender instructions, such as payment details. Fund Adviser Form used to request the appointment of a Fund Adviser to the contract. For products formerly Scottish Mutual International.		Utmost PanEurope	Operational Forms	German (DE)	FOS	This surrender Request Form outlines the bond surrender details along with the bond owners, both personal and corporate investors. Also, any other surrender instructions, such as payment details. Fund Adviser Form used to request the appointment of a Fund Adviser to the contract. For products formerly Scottish Mutual International. Operational Forms Rückkaufsantrag UIC PR 00168
Antragsformular für Regelmäßige Entnahmen	The Regular Withdrawal Request Form outlines the bond withdrawal details along with the bond owners, both personal and corporate investors.	Europe Expat	Utmost PanEurope	Operational Forms	German (DE)	FOS	The Regular Withdrawal Request Form outlines the bond withdrawal details along with the bond owners, both personal and corporate investors. Operational Forms Antragsformular für Regelmäßige Entnahmen UIC PR 00165
Regular Withdrawal Request Form	The Regular Withdrawal Request Form outlines the bond withdrawal details along with the bond owners, both personal and corporate investors.For products formerly Scottish Mutual International.		Utmost PanEurope	Operational Forms	English (EN)	FOS	The Regular Withdrawal Request Form outlines the bond withdrawal details along with the bond owners, both personal and corporate investors.For products formerly Scottish Mutual International. Operational Forms Regular Withdrawal Request Form UIC PR 00164
Declaration of Loss of Plan Schedule	For Products formerly Scottish Mutual International this form is used to declare the loss of Plan Schedule and any owners of the bond, both personal and corporate investors.	Germany (DE)	Utmost PanEurope	Operational Forms	English (EN)	FOS	For Products formerly Scottish Mutual International this form is used to declare the loss of Plan Schedule and any owners of the bond, both personal and corporate investors. Operational Forms Declaration of Loss of Plan Schedule UIC PR 00158
Meldung Über den Verlust der Versicherungsurkunde	This form is used to declare the loss of Plan Schedule and any owners of the bond, both personal and corporate investors.	Germany (DE)	Utmost PanEurope	Operational Forms	German (DE)	FOS	This form is used to declare the loss of Plan Schedule and any owners of the bond, both personal and corporate investors. Operational Forms Meldung Über den Verlust der Versicherungsurkunde UIC PR 00157
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)	Utmost Wealth Solutions	Operational Forms	English (EN)	FOS	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

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