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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
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Utmost Wealth Solutions |
Operational Forms |
English (EN) |
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
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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 trusts where all the trustees are all individuals. It should be completed by one trustee on behalf of the trust.
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Utmost Wealth Solutions |
Tax and regulatory Literature/technical sales aids and literature |
English (EN) |
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 trusts where all the trustees are all individuals. It should be completed by one trustee on behalf of the trust.
Tax and regulatory Literature/technical sales aids and literature
Tax Declaration and Self-Certification for Trusts
UTSQ PR | 20885
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
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Utmost Luxembourg S.A |
Key Information Document |
French (FR) |
Private Client Portfolio |
FOS |
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
Key Information Document
Document d’informations clés (“DIC”)
ULU_KID_LU_LU_EUR_PCP_FR PR
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
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Utmost Luxembourg S.A |
Key Information Document |
English (EN) |
Private Client Portfolio |
FOS |
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
Key Information Document
Key Information Document (‘KID’)
ULU_KID_LU_LU_EUR_PCP_EN PR
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
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Utmost Luxembourg S.A |
Key Information Document |
French (FR) |
Luxembourg Capitalisation Bond |
FOS |
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
Key Information Document
Document d’informations clés (“DIC”)
ULU_KID_LU_LU_EUR_LCB_FR PR
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
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Utmost Luxembourg S.A |
Key Information Document |
French (FR) |
Luxembourg Capitalisation Bond |
FOS |
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
Key Information Document
Document d’informations clés (“DIC”)
ULU_KID_LU_LU_EUR_LC_FR PR
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
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Utmost Luxembourg S.A |
Key Information Document |
English (EN) |
Luxembourg Capitalisation Bond |
FOS |
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
Key Information Document
Key Information Document (‘KID’)
ULU_KID_LU_LU_EUR_LCB_EN PR
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
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Utmost Luxembourg S.A |
Key Information Document |
English (EN) |
Luxembourg Capitalisation Bond |
FOS |
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This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.
Key Information Document
Key Information Document (‘KID’)
ULU_KID_LU_LU_EUR_LC_EN PR
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Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures
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Utmost Luxembourg S.A |
Operational Forms |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures
Operational Forms
Change of Communication Means and Use of Electronic Signatures Form / Formulaire de changement de moyen de communication et utilisation des signatures électroniques
ULU PCON1514
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Use this form to request a switch of investments on your policy/contract – Luxembourg
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Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Use this form to request a switch of investments on your policy/contract – Luxembourg
Surrender/Claim/Withdrawal/Switch
Switch form / Formulaire d’arbitrage
ULU PCON1391
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Use this form to request a withdrawal from your policy/contract – Luxembourg
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Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Use this form to request a withdrawal from your policy/contract – Luxembourg
Surrender/Claim/Withdrawal/Switch
Partial surrender request / Demande de rachat partiel
ULU PCON1387
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Use this form for an addition to your policy/contract – Luxembourg
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Utmost Luxembourg S.A |
Top Up/Additional Investment |
English (EN), French (FR) |
Luxembourg Capitalisation Bond, Private Client Portfolio |
FOS |
Addition to your Policy |
Use this form for an addition to your policy/contract – Luxembourg
Top Up/Additional Investment
Additional Premium Form / Formulaire de versement de Prime complémentaire
ULU PCON1385
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Use this form to request the surrender of your policy/contract – Luxembourg
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Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Use this form to request the surrender of your policy/contract – Luxembourg
Surrender/Claim/Withdrawal/Switch
Surrender request / Demande de rachat total
ULU PCON1386
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Power of Attorney for the Investment Advisor – Luxembourg – Capitalisation Bond
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Utmost Luxembourg S.A |
Operational Forms |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Power of Attorney for the Investment Advisor – Luxembourg – Capitalisation Bond
Operational Forms
Power of Attorney / Procuration – Luxembourg Capitalisation Bond
ULU CONT4549
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Please 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 controlling persons.
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Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
Non Product Specific |
FOS |
New Policy |
Please 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 controlling persons.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes détenant le contrôle
ULU CONT4262
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Please 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 corporate applications.
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Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
Non Product Specific |
FOS |
New Policy |
Please 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 corporate applications.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les entités
ULU CONT4250
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Please 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.
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Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
Non Product Specific |
FOS |
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Please 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.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes physiques
ULU CONT4241
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Fact Find for INTERMEDIARIES for the Luxembourg market; dedicated to CORPORATE ENTITIES subscribing. To be used in combination with the new business application forms for this market
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Utmost Luxembourg S.A |
Fact Find |
English (EN), French (FR) |
Capitalisation Bond, Private Client Portfolio |
FOS |
New Business Pack |
Fact Find for INTERMEDIARIES for the Luxembourg market; dedicated to CORPORATE ENTITIES subscribing. To be used in combination with the new business application forms for this market
Fact Find
FOR INTERMEDIARIES – Fact find (Company)/ Document d’entrée en relation (Société)- Intermediary version / Version pour l’Intermédiaire
ULU CONT3975
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Fact Find for INTERMEDIARIES for the Luxembourg market; dedicated to PHYSICAL PERSONS subscribing. To be used in combination with the new business application forms for this market.
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Utmost Luxembourg S.A |
Fact Find |
English (EN), French (FR) |
Capitalisation Bond, Private Client Portfolio |
FOS |
New Business Pack |
Fact Find for INTERMEDIARIES for the Luxembourg market; dedicated to PHYSICAL PERSONS subscribing. To be used in combination with the new business application forms for this market.
Fact Find
FOR INTERMEDIARIES – Fact find (Individual)/ Document d’entrée en relation (Individu)- Intermediary version / Version pour l’Intermédiaire
ULU CONT3937
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Table of Luxembourg Investment Rules
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Utmost Luxembourg S.A |
Investment literature/Strategies |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Table of Luxembourg Investment Rules
Investment literature/Strategies
Règles d’investissement pour les Fonds Internes et Externes
ULU CONT3807
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Table of Luxembourg Investment Rules – Capitalisation Bond – Luxembourg
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Utmost Luxembourg S.A |
Investment literature/Strategies |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Table of Luxembourg Investment Rules – Capitalisation Bond – Luxembourg
Investment literature/Strategies
Appendix: Investment Rules for Internal Funds and External Funds / Annexe : Règles d’Investissement pour Fonds Internes et Fonds Externes
ULU CONT3808
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Privacy Notice – English/French version
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Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Privacy Notice – English/French version
Client Letters/Indemnity/Data Protection
Avis de confidentialité / Privacy Notice
ULU CONT3350-WEB
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Privacy Notice – English/French version – Luxembourg
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Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Privacy Notice – English/French version – Luxembourg
Client Letters/Indemnity/Data Protection
Déclaration concernant la Protection des Données à Caractère Personnel / Declaration with regard to Personal Data Protection
ULU CONT3350
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Privacy Notice – English version
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Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
English (EN) |
Non Product Specific |
FOS |
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Privacy Notice – English version
Client Letters/Indemnity/Data Protection
Privacy Notice
ULU CONT3337-WEB
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Annex to add additional Specialised Assurance Funds to the contract/policy
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Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
Private Client Portfolio |
FOS |
New Policy |
Annex to add additional Specialised Assurance Funds to the contract/policy
Operational Forms
Private Client Portfolio – Additional SAF / FAS supplémentaire
ULU CONT3186
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Power of Attorney for the Investment Advisor – Luxembourg
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Utmost Luxembourg S.A |
Operational Forms |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Power of Attorney for the Investment Advisor – Luxembourg
Operational Forms
Power of Attorney / Procuration (Adviser)
ULU CONT3198
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Use this form to request a upgrade of your investment category
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Utmost Luxembourg S.A |
Investment literature/Strategies |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Use this form to request a upgrade of your investment category
Investment literature/Strategies
Request for Investment Category Upgrade / Demande de classement dans une catégorie d’investissement supérieure
ULU CONT3194
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Annex to add additional Internal Dedicated Funds to the contract/policy
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Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
Private Client Portfolio |
FOS |
New Policy |
Annex to add additional Internal Dedicated Funds to the contract/policy
Operational Forms
Private Client Portfolio – Additional IDF / FID supplémentaire
ULU CONT3185
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Annex showing the activity-based charging grid
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Utmost Luxembourg S.A |
Operational Forms |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Annex showing the activity-based charging grid
Operational Forms
Schedule of Additional Administrative Charges / Aperçu des frais administratifs additionnels
ULU CONT3179
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Use this form to request a deviation from your investment profile
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Utmost Luxembourg S.A |
Investment literature/Strategies |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Use this form to request a deviation from your investment profile
Investment literature/Strategies
Investment Profile (Deviation) / Profil d’Investissement (Déviation)
ULU CONT2993
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Use this form to complete an investment profile questionnaire and request a deviation from your investment profile
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Utmost Luxembourg S.A |
Investment literature/Strategies |
English (EN), French (FR) |
Luxembourg Capitalisation Bond, Private Client Portfolio |
FOS |
Addition to your Policy |
Use this form to complete an investment profile questionnaire and request a deviation from your investment profile
Investment literature/Strategies
Investment Profile and Suitability Assessment / Profil d’investissement et évaluation de l’adéquation
ULU CONT2992
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Information Disclosure Agreement
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Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Information Disclosure Agreement
Client Letters/Indemnity/Data Protection
INFORMATION DISCLOSURE AGREEMENT / ACCORD DE COMMUNICATION D’INFORMATION
ULU CONT2868
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Information Disclosure Agreement
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Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
French (FR) |
Non Product Specific |
FOS |
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Information Disclosure Agreement
Client Letters/Indemnity/Data Protection
INFORMATION DISCLOSURE AGREEMENT / ACCORD DE COMMUNICATION D’INFORMATION
ULU CONT2867
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Addendum to the Personalised Portfolio Bond – Luxembourg
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Utmost Luxembourg S.A |
Operational Forms |
English (EN) |
Non Product Specific |
FOS |
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Addendum to the Personalised Portfolio Bond – Luxembourg
Operational Forms
Addendum to Life Assurance Policy (PPB Addendum) – Discretionary Mandates
ULU CONT2688
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Please 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.
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Utmost Luxembourg S.A |
Operational Forms |
English (EN) |
Non Product Specific |
FOS |
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Please 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.
Operational Forms
Automatic Exchange of Information – Self-Certification for Individuals
ULU CONT2593
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Please 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 corporate applications.
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Utmost Luxembourg S.A |
Operational Forms |
English (EN) |
Non Product Specific |
FOS |
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Please 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 corporate applications.
Operational Forms
Automatic Exchange of Information – Self-Certification for Entities
ULU CONT2596
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Please 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 controlling persons.
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Utmost Luxembourg S.A |
Operational Forms |
English (EN) |
Non Product Specific |
FOS |
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Please 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 controlling persons.
Operational Forms
Automatic Exchange of Information – Self-Certification for Controlling Persons
ULU CONT2599
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Use this form to request a downgrade of your investment category
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Utmost Luxembourg S.A |
Investment literature/Strategies |
English (EN) |
Non Product Specific |
FOS |
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Use this form to request a downgrade of your investment category
Investment literature/Strategies
Demand for Investment Category Downgrade
ULU CONT2506
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Please 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 controlling persons.
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Utmost Luxembourg S.A |
Operational Forms |
English (EN) |
Non Product Specific |
FOS |
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Please 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 controlling persons.
Operational Forms
FATCA Self-Certification
ULU CONT2170-5
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Use this form to declare a status of “Non-U.S. Person”
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Utmost Luxembourg S.A |
Operational Forms |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Use this form to declare a status of “Non-U.S. Person”
Operational Forms
Declaration of “Non-U.S. Person” Status / Declaration de statut de « Non-U.S. Person »
ULU CONT2042
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Use this form to declare a status of “Non-U.S. Person” for the Capitalisation Bond product – Luxembourg
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Utmost Luxembourg S.A |
Operational Forms |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Use this form to declare a status of “Non-U.S. Person” for the Capitalisation Bond product – Luxembourg
Operational Forms
Declaration of “Non-U.S. Person” Status / Declaration de statut de « Non-U.S. Person »
ULU CONT2043
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Declaration for the Use of a Custodian Bank located outside of the EEA – Luxembourg Capitalisation product
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Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Declaration for the Use of a Custodian Bank located outside of the EEA – Luxembourg Capitalisation product
Client Letters/Indemnity/Data Protection
Custodian Bank located outside the EEA / Banque Depositaire hors de l’EEE
ULU CONT2037
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Declaration for the Use of a Custodian Bank located outside of the EEA – Luxembourg
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Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Declaration for the Use of a Custodian Bank located outside of the EEA – Luxembourg
Client Letters/Indemnity/Data Protection
Custodian Bank located outside the EEA / Banque Depositaire hors de l’EEE
ULU CONT2036
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Stand-alone Tax Compliance Certification form – Luxembourg Capitalisation Bond
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Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Stand-alone Tax Compliance Certification form – Luxembourg Capitalisation Bond
Client Letters/Indemnity/Data Protection
Tax Compliance Certification – Capitalisation Bond (PH) / Déclaration relative aux Obligations fiscales
ULU CONT2026
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Stand-alone Tax Compliance Certification form – Luxembourg
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Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Stand-alone Tax Compliance Certification form – Luxembourg
Client Letters/Indemnity/Data Protection
Tax Compliance Certification (PH) / Déclaration relative aux Obligations fiscales
ULU CONT2025
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Stand-alone version of General Conditions for the Luxembourg Capitalisation Bond product – Luxembourg
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Utmost Luxembourg S.A |
Policy Conditions |
English (EN), French (FR) |
Capitalisation Bond |
FOS |
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Stand-alone version of General Conditions for the Luxembourg Capitalisation Bond product – Luxembourg
Policy Conditions
Luxembourg Capitalisation Bond – General Conditions/Conditions Générales
ULU CONT1983
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Stand-alone version of General Conditions for the Private Client Portfolio product – Luxembourg
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Utmost Luxembourg S.A |
Policy Conditions |
English (EN), French (FR) |
Private Client Portfolio |
FOS |
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Stand-alone version of General Conditions for the Private Client Portfolio product – Luxembourg
Policy Conditions
Private Client Portfolio – General Conditions/Conditions Générales
ULU CONT1952
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New business application form for the Luxembourg Capitalisation Bond product – Luxembourg
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Utmost Luxembourg S.A |
Application Form |
English (EN), French (FR) |
Luxembourg Capitalisation Bond |
FOS |
New Business Pack |
New business application form for the Luxembourg Capitalisation Bond product – Luxembourg
Application Form
Luxembourg Capitalisation Bond
ULU CONT1862
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New business application form for the Private Client Portfolio product – Luxembourg
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Utmost Luxembourg S.A |
Application Form |
English (EN), French (FR) |
Private Client Portfolio |
FOS |
New Business Pack |
New business application form for the Private Client Portfolio product – Luxembourg
Application Form
Private Client Portfolio
ULU CONT1784
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Confirmation of Client contact details used for the Electronic Signing of documents
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Utmost Luxembourg S.A |
Operational Forms |
English (EN), French (FR) |
Non Product Specific |
FOS |
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Confirmation of Client contact details used for the Electronic Signing of documents
Operational Forms
Confirmation of Client contact details used for the Electronic Signing of documents / Confirmation des coordonnées du Client utilisées pour la signature électronique des documents
ULU CONNECT1056
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