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Documents

Title	Description	Insurer	Market	Language	Product	Regime	Process	Excerpt
Apex Portugal Notification of intention to return to the UK	Before completing this form you should discuss your personal circumstances with your Insurance Intermediary to ensure that the Life Insurance Policy will continue to meet your needs on your return to the UK.	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	Making a change to your policy	Before completing this form you should discuss your personal circumstances with your Insurance Intermediary to ensure that the Life Insurance Policy will continue to meet your needs on your return to the UK. Operational Forms Apex Portugal Notification of intention to return to the UK UPE_WS PR 00046
Residenza e Comunicazioni	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	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOE FOS		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 Residenza e Comunicazioni ULU PCON1527
Formulario de cambio de medio de comunicación y uso de firmas electrónicas / Change of Communication Means and Use of Electronic Signatures Form	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	Spain (ES)	Utmost Luxembourg S.A	English (EN), Spanish (ES)	Non Product Specific	FOS		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 Formulario de cambio de medio de comunicación y uso de firmas electrónicas / Change of Communication Means and Use of Electronic Signatures Form ULU PCON1518
Formulário de Alteração dos Meios de Comunicação e Utilização de Assinaturas Electrónicas / Change of Communication Means and Use of Electronic Signatures Form	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	Portugal (PT)	Utmost Luxembourg S.A	English (EN), Portuguese (PT)	Non Product Specific	FOS		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 Formulário de Alteração dos Meios de Comunicação e Utilização de Assinaturas Electrónicas / Change of Communication Means and Use of Electronic Signatures Form ULU PCON1523
Information Disclosure Agreement	Information Disclosure Agreement	ASIA	Utmost PCC Limited	English (EN)	Non Product Specific	FOS		Information Disclosure Agreement Operational Forms Information Disclosure Agreement UPCC CONT2859
Automatic Exchange of Information – Self-Certification Form for Trust	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 Trusts.	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		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 Trusts. Operational Forms Automatic Exchange of Information – Self-Certification Form for Trust ULU CONT2655
Modification des caractéristiques principales d’une Unité de Compte constituée par un Fonds d’Assurance Spécialisé existant	Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank Operational Forms Modification des caractéristiques principales d’une Unité de Compte constituée par un Fonds d’Assurance Spécialisé existant ULU PCON1566
Varallisuuden Lähde	Varallisuuden Lähde asiakkaan varallisuustietojen toimittamisesta	Finland (FI)	Utmost Wealth Solutions	Finnish (FI)	Non Product Specific	FOS	Making a change to your policy, New Policy	Varallisuuden Lähde asiakkaan varallisuustietojen toimittamisesta Operational Forms Varallisuuden Lähde UWS PR 00433
Formulär för förordnande av förmånstagare för Swedish Executive Portfolio med flera försäkringstagare (Nomination Form – to Nominate Beneficiaries Under the Swedish Executive Portfolio with multiple Policyholders)	Fyll i det här formuläret om försäkringstagarna vill förordna att äganderätten till Swedish Executive Portfolio vid en eller flera försäkringstagares död ska övergå till de kvarvarande försäkringstagarna, och vid den sista försäkringstagarens död till de förmånstagare. (This form is to be used when the Policyholder wishes to nominate that the ownership of the Swedish Executive Portfolio is transferred upon death of the Policyholders to the surviving policyholders and upon death of the last policyholder to the beneficiaries nominated in this form. This form is to be used when there are multiple policyholders.)	Sweden (SE)	Utmost PanEurope	English (EN), Swedish (SV)	Swedish Executive Portfolio – PRIIPs	FOS	New Policy	Fyll i det här formuläret om försäkringstagarna vill förordna att äganderätten till Swedish Executive Portfolio vid en eller flera försäkringstagares död ska övergå till de kvarvarande försäkringstagarna, och vid den sista försäkringstagarens död till de förmånstagare. (This form is to be used when the Policyholder wishes to nominate that the ownership of the Swedish Executive Portfolio is transferred upon death of the Policyholders to the surviving policyholders and upon death of the last policyholder to the beneficiaries nominated in this form. This form is to be used when there are multiple policyholders.) Operational Forms Formulär för förordnande av förmånstagare för Swedish Executive Portfolio med flera försäkringstagare (Nomination Form – to Nominate Beneficiaries Under the Swedish Executive Portfolio with multiple Policyholders) UPEQ PR \| 12207
Future Vakuutuksenottajan ja Vakuutetun välinen sopimus	Future vakuutuksenottajan ja vakuutetun välinen sopimus, jolla voidaan sopiva vakuutetun työntekijän oikeuksista vakuutukseen.	Finland (FI)	Utmost PanEurope	Finnish (FI)	Future	FOS	Making a change to your policy, New Policy	Future vakuutuksenottajan ja vakuutetun välinen sopimus, jolla voidaan sopiva vakuutetun työntekijän oikeuksista vakuutukseen. Operational Forms Future Vakuutuksenottajan ja Vakuutetun välinen sopimus UPE_WS PR 00096
Target ja Future Vakuutusedustajan palvelupalkkio-lomake	Tällä lomakkeella voit pyytää vakuutusneuvojan palkkiota Target ja Future vakuutuksille.	Finland (FI)	Utmost PanEurope	Finnish (FI)	Future, Target	FOS	Making a change to your policy	Tällä lomakkeella voit pyytää vakuutusneuvojan palkkiota Target ja Future vakuutuksille. Operational Forms Target ja Future Vakuutusedustajan palvelupalkkio-lomake UPE_WS \| 05327
Valtakirja	Valtakirja.	Finland (FI)	Utmost PanEurope	Finnish (FI)	Advantage Corporate (Closed), Future, Professional Portfolio, Target, Vision (Closed), Wealth Portfolio Finland	FOS	Making a change to your policy	Valtakirja. Operational Forms Valtakirja UPE_WS \| 4433
Luovutusilmoituslomake	Tätä asiakirjaa voidaan käyttää vakuutuksen luovuttamiseen kolmannelle osapuolelle.	Finland (FI)	Utmost PanEurope	Finnish (FI)	Advantage Corporate (Closed), Future, Professional Portfolio, Target, Vision (Closed), Wealth Portfolio Finland		Making a change to your policy	Tätä asiakirjaa voidaan käyttää vakuutuksen luovuttamiseen kolmannelle osapuolelle. Operational Forms Luovutusilmoituslomake UPE_WS \| 05078
Palvelupalkkio-lomake	Tällä lomakkeella voidaan pyytää palvelumaksun palkkion käyttöönottoa Wealth Portfolio Finland ja Professional Portfolio vakuutuksille.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Professional Portfolio, Wealth Portfolio Finland	FOS	Making a change to your policy	Tällä lomakkeella voidaan pyytää palvelumaksun palkkion käyttöönottoa Wealth Portfolio Finland ja Professional Portfolio vakuutuksille. Operational Forms Palvelupalkkio-lomake UPE_WS \| 05008
Maksulomake	Tällä lomakkeella voit ilmoittaa takaisinoston maksutiedot.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Future, Professional Portfolio, Target, Vision (Closed), Wealth Portfolio Finland	FOS	Surrender or Claim	Tällä lomakkeella voit ilmoittaa takaisinoston maksutiedot. Operational Forms Maksulomake UPE_WS \| 05013
Ilmoitus vakuutuksen panttaamisesta	Lomake jolla vakuutus voidaan pantata.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Professional Portfolio, Vision (Closed), Wealth Portfolio Finland	FOS	Making a change to your policy	Lomake jolla vakuutus voidaan pantata. Operational Forms Ilmoitus vakuutuksen panttaamisesta UPE_WS \| 04429
Vision ja Advantage Vakuutusmaksuvapaa ja säännöllisten vakuutusmaksujen uudelleenaktivointi	Tätä lomaketta voidaan käyttää, jos vakuutuksenottaja haluaa ottaa vakuutusmaksuvapaan tai palauttaa säännöllisen vakuutusmaksunsa Vision tai Advantage vakuutuksille.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Future, Target, Vision (Closed)	FOS	Making a change to your policy	Tätä lomaketta voidaan käyttää, jos vakuutuksenottaja haluaa ottaa vakuutusmaksuvapaan tai palauttaa säännöllisen vakuutusmaksunsa Vision tai Advantage vakuutuksille. Operational Forms Vision ja Advantage Vakuutusmaksuvapaa ja säännöllisten vakuutusmaksujen uudelleenaktivointi UPE_WS \| 04430
Rekisteröityminen Service Centre verkkopalveluun vakuutusedustajana	Tällä lomakkeella vakuutusedustaja voi rekisteröityä verkkopalveluumme.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Future, Professional Portfolio, Target, Vision (Closed), Wealth Portfolio Finland	FOS	Making a change to your policy	Tällä lomakkeella vakuutusedustaja voi rekisteröityä verkkopalveluumme. Operational Forms Rekisteröityminen Service Centre verkkopalveluun vakuutusedustajana UPE_WS \| 04431
Rekisteröityminen Service Centre verkkopalveluun	Tällä lomakkeella vakuutuksenottajat voivat rekisteröityä verkkopalveluumme.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Future, Professional Portfolio, Target, Vision (Closed), Wealth Portfolio Finland	FOS	Making a change to your policy	Tällä lomakkeella vakuutuksenottajat voivat rekisteröityä verkkopalveluumme. Operational Forms Rekisteröityminen Service Centre verkkopalveluun UPE_WS \| 04432
Arvopaperisiirto	Tätä lomaketta käytetään arvopaperisiirtojen yhteydessä tarvittaessa.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Professional Portfolio, Wealth Portfolio Finland	FOS	Making a change to your policy, New Policy	Tätä lomaketta käytetään arvopaperisiirtojen yhteydessä tarvittaessa. Operational Forms Arvopaperisiirto UPE_WS \| 04434
Nimikirjoituksen Vahvistaminen Käsialanäyte	Lomake, jolla muuttunut nimikirjoitus voidaan vahvistaa.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Future, Professional Portfolio, Target, Vision (Closed), Wealth Portfolio Finland	FOS	Making a change to your policy	Lomake, jolla muuttunut nimikirjoitus voidaan vahvistaa. Operational Forms Nimikirjoituksen Vahvistaminen Käsialanäyte UPE_WS \| 04324
Osoitteenmuutos	Lomake osoitteenmuutoksesta ilmoittamiseksi.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Professional Portfolio, Vision (Closed), Wealth Portfolio Finland	FOS	Making a change to your policy	Lomake osoitteenmuutoksesta ilmoittamiseksi. Operational Forms Osoitteenmuutos UPE_WS \| 04408
Ilmoitus Verosääntöjen Noudattamisesta Yksityisasiakkaille (Tax Declaration and Self-Certification for Individuals) – Bilingual FI/EN	The Tax Declaration and Self-Certification form should be completed in order to 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 investors only.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Professional Portfolio, Vision (Closed), Wealth Portfolio Finland	FOS	Making a change to your policy, New Policy	The Tax Declaration and Self-Certification form should be completed in order to 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 investors only. Operational Forms Ilmoitus Verosääntöjen Noudattamisesta Yksityisasiakkaille (Tax Declaration and Self-Certification for Individuals) – Bilingual FI/EN UPE_WS \| 04409
Ilmoitus kadonneesta/vastaanottamattomasta vakuutuskirjasta	Lomake, jota voidaan käyttää, jos vakuutuskirja on kadonnut, tuhoutunut tai sitä ei ole koskaan vastaanotettu.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Professional Portfolio, Vision (Closed), Wealth Portfolio Finland	FOS	Surrender or Claim	Lomake, jota voidaan käyttää, jos vakuutuskirja on kadonnut, tuhoutunut tai sitä ei ole koskaan vastaanotettu. Operational Forms Ilmoitus kadonneesta/vastaanottamattomasta vakuutuskirjasta UPE_WS \| 04410
Edunsaajamääräys	Lomake, jolla edunsaajia voidaan muuttaa/nimittää.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Professional Portfolio, Vision (Closed), Wealth Portfolio Finland	FOS	Making a change to your policy	Lomake, jolla edunsaajia voidaan muuttaa/nimittää. Operational Forms Edunsaajamääräys UPE_WS \| 04411
Sijoituspäätösvallan siirtolomake	Tällä lomakkeella voidaan antaa kolmannelle osapuolelle oikeus valita sijoituskohteita Vision, Advantage, Target ja Future vakuutuksille.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Future, Target, Vision (Closed)	FOS	Making a change to your policy	Tällä lomakkeella voidaan antaa kolmannelle osapuolelle oikeus valita sijoituskohteita Vision, Advantage, Target ja Future vakuutuksille. Operational Forms Sijoituspäätösvallan siirtolomake UPE_WS \| 04428
Kuolemantapauskorvaushakemus	Kuolemantapauskorvaushakemus.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Professional Portfolio, Vision (Closed)	FOS	Surrender or Claim	Kuolemantapauskorvaushakemus. Operational Forms Kuolemantapauskorvaushakemus UPE_WS \| 04287
Kaupankäyntiohjeet	Lomake kaupankäyntiohjeiden antamiseen Wealth Portfolio Finland ja Professional Portfolio vakuutuksille.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Professional Portfolio, Wealth Portfolio Finland	FOS	Making a change to your policy, New Policy	Lomake kaupankäyntiohjeiden antamiseen Wealth Portfolio Finland ja Professional Portfolio vakuutuksille. Operational Forms Kaupankäyntiohjeet UPE_WS \| 04288
Jatkuvan maksun muutos ja ylimääräiset kertamaksut	Lomake jatkuvien vakuutusmaksujen summan muuttamiseen ja/tai lisämaksujen tekemiseen.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Professional Portfolio, Vision (Closed)	FOS	Making a change to your policy	Lomake jatkuvien vakuutusmaksujen summan muuttamiseen ja/tai lisämaksujen tekemiseen. Operational Forms Jatkuvan maksun muutos ja ylimääräiset kertamaksut UPE_WS \| 04289
Takaisinostopyyntö	Lomake takaisinostojen tekemiseen.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Professional Portfolio, Vision (Closed), Wealth Portfolio Finland	FOS	Surrender or Claim	Lomake takaisinostojen tekemiseen. Operational Forms Takaisinostopyyntö UPE_WS \| 04290
Target ja Future Peruuttamisilmoitus	Peruuttamisilmoituksella vakuutuksenottajat voivat peruuttaa Target ja Future vakuutuksensa 30 päivän sisällä siitä, kun he ovat vastaanottaneet vakuutuskirjan.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Advantage Corporate (Closed), Future, Target, Vision (Closed), Vision Alexandria (Closed), Vision Alexandria Over 60s (Closed)	FOS	New Policy	Peruuttamisilmoituksella vakuutuksenottajat voivat peruuttaa Target ja Future vakuutuksensa 30 päivän sisällä siitä, kun he ovat vastaanottaneet vakuutuskirjan. Operational Forms Target ja Future Peruuttamisilmoitus UPE_WS \| 04252
Vision ja Advantage Finland Rahastojen vaihto tai vakuutusmaksun uudelleenohjaus	Lomake rahastojen vaihtoon tai uudelleenohjaukseen Vision ja Advantage vakuutuksille.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Vision (Closed)	FOS	Making a change to your policy	Lomake rahastojen vaihtoon tai uudelleenohjaukseen Vision ja Advantage vakuutuksille. Operational Forms Vision ja Advantage Finland Rahastojen vaihto tai vakuutusmaksun uudelleenohjaus UPE_WS \| 04285
Ilmoitus Verosa¨a¨nto¨jen Noudattamisesta Oikeushenkilo¨ille (Tax Declaration and Self-Certification for Entity Investors) Bilingual FI/EN	The Tax Declaration and Self-Certification form should be completed in order to 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)	Utmost PanEurope	English (EN), Finnish (FI)	Non Product Specific	FOS	Making a change to your policy, New Policy	The Tax Declaration and Self-Certification form should be completed in order to 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 Ilmoitus Verosa¨a¨nto¨jen Noudattamisesta Oikeushenkilo¨ille (Tax Declaration and Self-Certification for Entity Investors) Bilingual FI/EN UPE PR 12865
ELÄKE-ETUUSMAKSULOMAKE (PENSION BENEFIT PAYMENT FORM)	ELÄKE-ETUUSMAKSULOMAKE (PENSION BENEFIT PAYMENT FORM) for Future /Advantage (Corporate)	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Future		Making a change to your policy	ELÄKE-ETUUSMAKSULOMAKE (PENSION BENEFIT PAYMENT FORM) for Future /Advantage (Corporate) Operational Forms ELÄKE-ETUUSMAKSULOMAKE (PENSION BENEFIT PAYMENT FORM) UPE PR 12869
Vakuutus Kiinteistörahastojen Kaupankäyntitiheys (Declaration for Real Estate / Real Asset Funds Dealing Frequency)	Vakuutus Kiinteistörahastojen Kaupankäyntitiheys (Declaration for Real Estate / Real Asset Funds Dealing Frequency)	Finland (FI)	Utmost PanEurope	English (EN)	Wealth Portfolio Finland		New Policy	Vakuutus Kiinteistörahastojen Kaupankäyntitiheys (Declaration for Real Estate / Real Asset Funds Dealing Frequency) Operational Forms Vakuutus Kiinteistörahastojen Kaupankäyntitiheys (Declaration for Real Estate / Real Asset Funds Dealing Frequency) UPE PR 12894
Wealth Portfolio Finland Lisäsijoituslomake	Lomake lisämaksun tekemiseen Wealth Portfolio Finland vakuuutukseen.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Wealth Portfolio Finland	FOS	Making a change to your policy	Lomake lisämaksun tekemiseen Wealth Portfolio Finland vakuuutukseen. Operational Forms Wealth Portfolio Finland Lisäsijoituslomake UPE PR 12659
Wealth Portfolio Finland Varainhoitajan tai valtuutetun säilytyspankin nimittäminen	Lomake täyden valtakirjan varainhoitajan tai valtuutetun säilytyspankin nimittämiseen Wealth Portfolio Finland vakuutukseen.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Wealth Portfolio Finland		Making a change to your policy, New Policy	Lomake täyden valtakirjan varainhoitajan tai valtuutetun säilytyspankin nimittämiseen Wealth Portfolio Finland vakuutukseen. Operational Forms Wealth Portfolio Finland Varainhoitajan tai valtuutetun säilytyspankin nimittäminen UPE PR 12507
Target ja Future Maksuvapaapyyntö	Lomake vakuutusmaksukauden aikana pyydettävälle maksuvapaalle.	Finland (FI)	Utmost PanEurope	English (EN), Finnish (FI)	Future, Target		Making a change to your policy, Surrender or Claim	Lomake vakuutusmaksukauden aikana pyydettävälle maksuvapaalle. Operational Forms Target ja Future Maksuvapaapyyntö UPE PR 12434
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	English (EN)	Non Product Specific	FOS	Surrender or Claim	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
Hong Kong switch form for use with Unit-linked accounts (English)	Switch Form for use with Unit-Linked Accounts. For Hong Kong use only.	Hong Kong (HK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	Switch Form for use with Unit-Linked Accounts. For Hong Kong use only. Operational Forms Hong Kong switch form for use with Unit-linked accounts (English) ULQ PR \| 13555
Executive Investment Bond – Swedish Document	Executive Investment Bond – Swedish Document.	Sweden (SE)	Utmost International - IoM	Swedish (SV)	Executive Investment Bond	FOS	New Policy	Executive Investment Bond – Swedish Document. Operational Forms Executive Investment Bond – Swedish Document ULQ PR \| 09115
Change of Bank Details Form	Use this Utmost International Isle of Man Limited form to update bank details for incoming premiums for the Managed Capital Account, Managed Savings Account, Managed Pension Account and Executive Wealthbuilder Account.	Europe Expat, Middle East, Rest of the World, United Kingdom (UK)	Utmost International - IoM	English (EN)	Legacy Product (Closed), Managed Capital Account	FOS	Making a change to your policy	Use this Utmost International Isle of Man Limited form to update bank details for incoming premiums for the Managed Capital Account, Managed Savings Account, Managed Pension Account and Executive Wealthbuilder Account. Operational Forms Change of Bank Details Form ULQ PR \| 00654
Singapore Nomination of Beneficiary Form 4 – Revocable Nomination – UW Version	Singapore Nomination of Beneficiary Form 4 – Revocable Nomination. This form can only be used to make a revocable nomination in respect of one relevant Utmost Worldwide Limited policy.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore, Professional Portfolio - Singapore	FOS	Making a change to your policy, New Policy	Singapore Nomination of Beneficiary Form 4 – Revocable Nomination. This form can only be used to make a revocable nomination in respect of one relevant Utmost Worldwide Limited policy. Operational Forms Singapore Nomination of Beneficiary Form 4 – Revocable Nomination – UW Version UWWS PR 00122
Utmost Worldwide Source of Wealth Questionnaire	Source of Wealth Questionnaire for providing details of a client’s wealth (for high risk clients/clients subject to enhanced due diligence). This questionnaire seeks to obtain information and documentation to establish the source of wealth for Utmost Worldwide Limited clients.	Hong Kong (HK), Singapore (SG), Switzerland (CH)	Utmost Worldwide	English (EN)	Non Product Specific	FOS	Making a change to your policy, New Policy	Source of Wealth Questionnaire for providing details of a client’s wealth (for high risk clients/clients subject to enhanced due diligence). This questionnaire seeks to obtain information and documentation to establish the source of wealth for Utmost Worldwide Limited clients. Operational Forms Utmost Worldwide Source of Wealth Questionnaire UWWS PR 00123
Current Financial Information Request Form	Current Financial Information Request Form for use with a Utmost Worldwide policy, to confirm your current taxation status, residence, and financial information.	Hong Kong (HK), Rest of the World, Singapore (SG), Switzerland (CH), United Kingdom (UK)	Utmost Worldwide	English (EN)	Non Product Specific	FOS	Making a change to your policy, New Policy	Current Financial Information Request Form for use with a Utmost Worldwide policy, to confirm your current taxation status, residence, and financial information. Operational Forms Current Financial Information Request Form UWWS PR 00119
Individual International Tax Compliance From (International)	This form should be used by individuals to self-certify your Tax Compliance (International)	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS	Making a change to your policy, New Policy, Surrender or Claim	This form should be used by individuals to self-certify your Tax Compliance (International) Operational Forms Individual International Tax Compliance From (International) UWWS PR 00084
Professional Portfolio Payment Methods Information for Clients and Brokers Form International	Professional Portfolio Payment Methods Information for Clients and Brokers Form	Rest of the World	Utmost Worldwide	English (EN)	Professional Portfolio - International	FOS	Making a change to your policy	Professional Portfolio Payment Methods Information for Clients and Brokers Form Operational Forms Professional Portfolio Payment Methods Information for Clients and Brokers Form International UWWS PR 00085
US Person Declaration Form (International)	This form should be used where you are a non-US resident US Person wishing to buy or increase the investment in your Plan (International)	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS	Making a change to your policy, New Policy	This form should be used where you are a non-US resident US Person wishing to buy or increase the investment in your Plan (International) Operational Forms US Person Declaration Form (International) UWWS PR 00090
Regular Premium Increase and Single Premium Top-Up Request Form (International)	This form should be used were you want to request a regular premium increase or a single premium top-up on your unit-linked Plan (international)	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International	FOS	Making a change to your policy	This form should be used were you want to request a regular premium increase or a single premium top-up on your unit-linked Plan (international) Operational Forms Regular Premium Increase and Single Premium Top-Up Request Form (International) UWWS PR 00099
Professional Portfolio Payment Surrender Form	If you purchased your Utmost Worldwide Limited Professional Portfolio Plan in Singapore, use this from to request a full surrender, partial surrender or regular withdrawal.	Singapore (SG)	Utmost Worldwide	English (EN)	Professional Portfolio - Singapore	FOS	Surrender or Claim	If you purchased your Utmost Worldwide Limited Professional Portfolio Plan in Singapore, use this from to request a full surrender, partial surrender or regular withdrawal. Operational Forms Professional Portfolio Payment Surrender Form UWWS PR 00105
Client Information and Change of Details Form	This form is intended for Utmost Worldwide Limited customers who wish to inform us of any changes to their personal details, such as name, specimen signature, address, email address or telephone number.	Hong Kong (HK), Rest of the World, Singapore (SG), Switzerland (CH), United Kingdom (UK)	Utmost Worldwide	English (EN)	Non Product Specific	FOS	Making a change to your policy	This form is intended for Utmost Worldwide Limited customers who wish to inform us of any changes to their personal details, such as name, specimen signature, address, email address or telephone number. Operational Forms Client Information and Change of Details Form UWWS PR 00106
Cross-Border Independent Financial Advice Notice (Singapore)	This form should be used where you want to declare that you have sought unsolicited cross border financial advice – Singapore only.	Singapore (SG)	Utmost Worldwide	English (EN)	Focus - Singapore	FOS	New Policy	This form should be used where you want to declare that you have sought unsolicited cross border financial advice – Singapore only. Operational Forms Cross-Border Independent Financial Advice Notice (Singapore) UWWS PR 00110
Professional Portfolio Structured Product Confirmation (Singapore)	This form should be used where you want to include structured products as underlying investments on your Singapore issued Professional Portfolio Plan.	Singapore (SG)	Utmost Worldwide	English (EN)	Professional Portfolio - Singapore	FOS	Making a change to your policy, New Policy	This form should be used where you want to include structured products as underlying investments on your Singapore issued Professional Portfolio Plan. Operational Forms Professional Portfolio Structured Product Confirmation (Singapore) UWWS PR 00113
Entity International Tax Compliance Form (Singapore)	This form should be used were you are an entity and want to self-certify your tax compliance for an Utmost Worldwide Limited bond (Singapore)	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore, Professional Portfolio - Singapore	FOS	Making a change to your policy, New Policy	This form should be used were you are an entity and want to self-certify your tax compliance for an Utmost Worldwide Limited bond (Singapore) Operational Forms Entity International Tax Compliance Form (Singapore) UWWS PR 00072
Focus Cooling off Notice (Singapore)	This form should be used to exercise your right to cancel your Focus Plan within 30 days of the Plan commencement date. For the Singapore market only.	Singapore (SG)	Utmost Worldwide	English (EN)	Focus - Singapore	FOS	New Policy	This form should be used to exercise your right to cancel your Focus Plan within 30 days of the Plan commencement date. For the Singapore market only. Operational Forms Focus Cooling off Notice (Singapore) UWWS PR 00076
Focus Cooling off Notice (International)	Cooling Off Notice is to be completed should you wish to exercise your right to cancel your Utmost Worldwide Limited, Focus Plan within 30 days of the Plan commencement date.	Rest of the World	Utmost Worldwide	English (EN)	Focus - International	FOS	New Policy	Cooling Off Notice is to be completed should you wish to exercise your right to cancel your Utmost Worldwide Limited, Focus Plan within 30 days of the Plan commencement date. Operational Forms Focus Cooling off Notice (International) UWWS PR 00079
Unit Linked Investment Services Authority Form (Hong Kong)	This form should be used were you want to appoint an Investment Adviser to your Utmost Worldwide Limited, Unit-Linked Plan. For use in the Hong Kong market only.	Hong Kong (HK)	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International	FOS	Making a change to your policy, New Policy	This form should be used were you want to appoint an Investment Adviser to your Utmost Worldwide Limited, Unit-Linked Plan. For use in the Hong Kong market only. Operational Forms Unit Linked Investment Services Authority Form (Hong Kong) UWWS PR 00066
US Assignee Declaration Form (International)	This form should be used were a US Assignee takes an interest in a Plan (International)	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS		This form should be used were a US Assignee takes an interest in a Plan (International) Operational Forms US Assignee Declaration Form (International) UWWS PR 00054
Verification of Corporate or Trustee Identity (International)	This form is to be used to verify the identity of a Company or a Trustee.	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS	Making a change to your policy, New Policy, Surrender or Claim	This form is to be used to verify the identity of a Company or a Trustee. Operational Forms Verification of Corporate or Trustee Identity (International) UWWS PR 00055
Nomination of Beneficiaries Form (International)	This form should be used to provide details of the nominated Beneficiaries of your Utmost Worldwide Limited Plan.	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS	Making a change to your policy, New Policy	This form should be used to provide details of the nominated Beneficiaries of your Utmost Worldwide Limited Plan. Operational Forms Nomination of Beneficiaries Form (International) UWWS PR 00056
Professional Portfolio Additional Contribution Request Form (International)	Additional Contribution Request Form is be used to should you wish to apply an additional contribution to your Professional Portfolio Bond (International)	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS	Making a change to your policy	Additional Contribution Request Form is be used to should you wish to apply an additional contribution to your Professional Portfolio Bond (International) Operational Forms Professional Portfolio Additional Contribution Request Form (International) UWWS PR 00058
Professional Portfolio Premium Request Form (International)	This form should be used to instruct an additional premium payment to your Professional Portfolio Life Plan (International)	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS	Making a change to your policy, New Policy	This form should be used to instruct an additional premium payment to your Professional Portfolio Life Plan (International) Operational Forms Professional Portfolio Premium Request Form (International) UWWS PR 00059
Professional Portfolio Payment Instruction Form (International)	This form should be used were you want to advise us how you want to pay premiums on your Professional Portfolio Plan	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS		This form should be used were you want to advise us how you want to pay premiums on your Professional Portfolio Plan Operational Forms Professional Portfolio Payment Instruction Form (International) UWWS PR 00061
Professional Portfolio Preferred Trustee Partner New Business Checklist (International)	Preferred Trustee Partner New Business Checklist should be used to assist you when submitting your Professional Portfolio Bond New Business Application.	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS		Preferred Trustee Partner New Business Checklist should be used to assist you when submitting your Professional Portfolio Bond New Business Application. Operational Forms Professional Portfolio Preferred Trustee Partner New Business Checklist (International) UWWS PR 00062
Unit Linked Investment Services Authority Form Qatar (International)	This form should be used where you reside in Qatar and wish to appoint an Investment Adviser to your Utmost Worldwide Limited, Unit-Linked Plan (International)		Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International	FOS		This form should be used where you reside in Qatar and wish to appoint an Investment Adviser to your Utmost Worldwide Limited, Unit-Linked Plan (International) Operational Forms Unit Linked Investment Services Authority Form Qatar (International) UWWS PR 00063
Unit-Linked Alteration of ILP Sub Funds (Singapore)	This form should be used to instruct a change to the ILP Sub Funds underlying your Utmost Worldwide Limited, Unit-Linked Plan, for use in the Singapore market.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore	FOS	Making a change to your policy	This form should be used to instruct a change to the ILP Sub Funds underlying your Utmost Worldwide Limited, Unit-Linked Plan, for use in the Singapore market. Operational Forms Unit-Linked Alteration of ILP Sub Funds (Singapore) UWWS PR 00064
Unit-Linked Alteration of Plan Investments (International)	This form should be used to instruct a change to the Investments underlying your Utmost Worldwide Limited, Unit-Linked Plan (International)	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International	FOS		This form should be used to instruct a change to the Investments underlying your Utmost Worldwide Limited, Unit-Linked Plan (International) Operational Forms Unit-Linked Alteration of Plan Investments (International) UWWS PR 00065
Claim For Death Benefit Request Form (International)	Claim for Death Benefit Request Form, for use in the International market, to notify us of a death benefit claim under your Utmost Worldwide Limited Plan.	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International	FOS	Surrender or Claim	Claim for Death Benefit Request Form, for use in the International market, to notify us of a death benefit claim under your Utmost Worldwide Limited Plan. Operational Forms Claim For Death Benefit Request Form (International) UWWS PR 00038
Cross-Border Independent Financial Advice Notice (International)	Cross-Border Independent Financial Advice Notice, for use in the International market, to be used to declare that you have sought unsolicited cross-border financial advice for your Utmost Worldwide Limited Plan.	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS		Cross-Border Independent Financial Advice Notice, for use in the International market, to be used to declare that you have sought unsolicited cross-border financial advice for your Utmost Worldwide Limited Plan. Operational Forms Cross-Border Independent Financial Advice Notice (International) UWWS PR 00039
Middle East PO Box Disclaimer (International)	Middle East PO Box Disclaimer Form, for use in the International market (predominantly Middle East), where mail is delivered to a PO Box address for their Utmost Worldwide Limited Plan. This form requests the Intermediary to confirm they have personally met the client at their physical address.		Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS		Middle East PO Box Disclaimer Form, for use in the International market (predominantly Middle East), where mail is delivered to a PO Box address for their Utmost Worldwide Limited Plan. This form requests the Intermediary to confirm they have personally met the client at their physical address. Operational Forms Middle East PO Box Disclaimer (International) UWWS PR 00041
Never received / Lost Policy Declaration (International)	Never Received / Lost Policy Declaration, for use in the International market, to declare that you have never received/lost your original policy documentation for your Utmost Worldwide Limited Plan and provide indemnity in our favour in the event of us paying a claim without the original policy documents.	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS	Making a change to your policy, Surrender or Claim	Never Received / Lost Policy Declaration, for use in the International market, to declare that you have never received/lost your original policy documentation for your Utmost Worldwide Limited Plan and provide indemnity in our favour in the event of us paying a claim without the original policy documents. Operational Forms Never received / Lost Policy Declaration (International) UWWS PR 00042
Online Service Registration for Adviser Form	Online Service Registration Form should be used by Advisers/Managers in the global market to request access to the Utmost Worldwide Limited’s Online Service Centre.	Hong Kong (HK), Rest of the World, Singapore (SG)	Utmost Worldwide	English (EN)	Non Product Specific	FOS		Online Service Registration Form should be used by Advisers/Managers in the global market to request access to the Utmost Worldwide Limited’s Online Service Centre. Operational Forms Online Service Registration for Adviser Form UWWS PR 00043
Online Service Centre Registration as Trustee Request (International)	This form is to be used to register for Trustee access our Online Service Centre (International)	Rest of the World	Utmost Worldwide	English (EN)	Non Product Specific	FOS		This form is to be used to register for Trustee access our Online Service Centre (International) Operational Forms Online Service Centre Registration as Trustee Request (International) UWWS PR 00044
Online Service Centre Registration (as an individual) Request (International)	This form should be used were you want to register (as an Individual) for access the Utmost Worldwide Online Service Centre (International)	Rest of the World	Utmost Worldwide	English (EN)	Non Product Specific	FOS		This form should be used were you want to register (as an Individual) for access the Utmost Worldwide Online Service Centre (International) Operational Forms Online Service Centre Registration (as an individual) Request (International) UWWS PR 00045
Payment Instruction Form (International)	This form should be used were you want to give us premium payment instructions (international)	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS	Making a change to your policy	This form should be used were you want to give us premium payment instructions (international) Operational Forms Payment Instruction Form (International) UWWS PR 00046
Professional Portfolio Structured Product Confirmation (International)	This form should be used where you want to include structured products as underlying investments on your Professional Portfolio Plan	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International, Professional Portfolio - International	FOS		This form should be used where you want to include structured products as underlying investments on your Professional Portfolio Plan Operational Forms Professional Portfolio Structured Product Confirmation (International) UWWS PR 00053
Specimen Signature Form (Singapore)	Specimen Signature Form, for use in the Singapore market, where your signature differs from your current signature to our records or where proof of identity documents do not enclose your signature, for your Utmost Worldwide Limited Plan.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore, Professional Portfolio - Singapore	FOS	Making a change to your policy, New Policy	Specimen Signature Form, for use in the Singapore market, where your signature differs from your current signature to our records or where proof of identity documents do not enclose your signature, for your Utmost Worldwide Limited Plan. Operational Forms Specimen Signature Form (Singapore) UWWS PR 00024
Unit Linked Investment Services Authority Form (Singapore)	Unit Linked Investment Services Authority Form, for use in the Singapore market, to appoint an Investment Adviser to your Utmost Worldwide Limited, Unit-Linked Plan.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore	FOS	Making a change to your policy, New Policy	Unit Linked Investment Services Authority Form, for use in the Singapore market, to appoint an Investment Adviser to your Utmost Worldwide Limited, Unit-Linked Plan. Operational Forms Unit Linked Investment Services Authority Form (Singapore) UWWS PR 00025
US Person Declaration Form (Singapore)	US Person Declaration Form to be used by non-US resident US person wishing to purchase or increase the investment within their Utmost Worldwide Limited Plan. For use in the Singapore market.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore, Professional Portfolio - Singapore	FOS	Making a change to your policy, New Policy	US Person Declaration Form to be used by non-US resident US person wishing to purchase or increase the investment within their Utmost Worldwide Limited Plan. For use in the Singapore market. Operational Forms US Person Declaration Form (Singapore) UWWS PR 00026
Unit-Linked Regular Withdrawal Payment Request Form (International)	Unit-Linked Regular Withdrawal Request Form, for use in the International market, to request a regular withdrawals from your Unit-Linked, Utmost Worldwide Limited Plan.	Rest of the World	Utmost Worldwide	English (EN)	Choice and Vision - International, Focus - International	FOS	Surrender or Claim	Unit-Linked Regular Withdrawal Request Form, for use in the International market, to request a regular withdrawals from your Unit-Linked, Utmost Worldwide Limited Plan. Operational Forms Unit-Linked Regular Withdrawal Payment Request Form (International) UWWS PR 00036
Never Received/Lost Policy Declaration (Singapore)	Never Received/Lost Policy Declaration, to be used to declare you have never received or have lost your Utmost Worldwide Limited Plan policy documentation and provide an indemnity in our favour, in the event of us paying a claim without the original policy documents. For use in the Singapore market	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore, Professional Portfolio - Singapore	FOS	New Policy, Surrender or Claim	Never Received/Lost Policy Declaration, to be used to declare you have never received or have lost your Utmost Worldwide Limited Plan policy documentation and provide an indemnity in our favour, in the event of us paying a claim without the original policy documents. For use in the Singapore market Operational Forms Never Received/Lost Policy Declaration (Singapore) UWWS PR 00012
Payment Card Mandate Form (Singapore)	Payment Card Mandate Form, to be used to confirm to Utmost Worldwide Limited that your premium for your Plan will be paid by Visa/Mastercard. For use in the Singapore market.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore	FOS	Making a change to your policy	Payment Card Mandate Form, to be used to confirm to Utmost Worldwide Limited that your premium for your Plan will be paid by Visa/Mastercard. For use in the Singapore market. Operational Forms Payment Card Mandate Form (Singapore) UWWS PR 00013
Dealing Instruction Form for Professional Portfolio Bond (Singapore)	Dealing Instruction Form, to be used to instruct Utmost Worldwide Limited of your investment instructions for your Professional Portfolio Bond, for use in the Singapore market	Singapore (SG)	Utmost Worldwide	English (EN)	Professional Portfolio - Singapore	FOS	Making a change to your policy	Dealing Instruction Form, to be used to instruct Utmost Worldwide Limited of your investment instructions for your Professional Portfolio Bond, for use in the Singapore market Operational Forms Dealing Instruction Form for Professional Portfolio Bond (Singapore) UWWS PR 00016
Discharge and Request for Payment Form for Professional Portfolio Bond (Singapore)	Discharge and Request for Payment Form to be used to request final payment and discharge from all future liabilities under your Utmost Worldwide Limited Professional Portfolio Bond, for use in the Singapore market.	Singapore (SG)	Utmost Worldwide	English (EN)	Professional Portfolio - Singapore	FOS	Surrender or Claim	Discharge and Request for Payment Form to be used to request final payment and discharge from all future liabilities under your Utmost Worldwide Limited Professional Portfolio Bond, for use in the Singapore market. Operational Forms Discharge and Request for Payment Form for Professional Portfolio Bond (Singapore) UWWS PR 00017
Fixed Deposit – Placement Request Form for Professional Portfolio Bond (Singapore)	Fixed Deposit – Placement Request Form, to be used to instruct a fixed deposit included in the investments for your Utmost Worldwide Limited Professional Portfolio Bond, for use in the Singapore market.	Singapore (SG)	Utmost Worldwide	English (EN)	Professional Portfolio - Singapore	FOS	Making a change to your policy	Fixed Deposit – Placement Request Form, to be used to instruct a fixed deposit included in the investments for your Utmost Worldwide Limited Professional Portfolio Bond, for use in the Singapore market. Operational Forms Fixed Deposit – Placement Request Form for Professional Portfolio Bond (Singapore) UWWS PR 00018
Registration Request Form for the Online Service Centre (Singapore)	Registration Request Form to gain access to Utmost Worldwide Limited’s Online Service Centre, for individual applicants in the Singapore market	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore, Non Product Specific, Professional Portfolio - Singapore	FOS	Making a change to your policy, New Policy	Registration Request Form to gain access to Utmost Worldwide Limited’s Online Service Centre, for individual applicants in the Singapore market Operational Forms Registration Request Form for the Online Service Centre (Singapore) UWWS PR 00019
Regular Premium Increase and Single Premium Top-Up Request Form (Singapore)	Regular Premium Increase and Single Premium Top-Up Request Form, for use in the Singapore market only, to request a regular premium increase or single premium top-up on your Utmost Worldwide Limited Unit-linked Plan.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore	FOS	Making a change to your policy	Regular Premium Increase and Single Premium Top-Up Request Form, for use in the Singapore market only, to request a regular premium increase or single premium top-up on your Utmost Worldwide Limited Unit-linked Plan. Operational Forms Regular Premium Increase and Single Premium Top-Up Request Form (Singapore) UWWS PR 00020
Regular Premium Reduction Request (Singapore)	Regular Premium Reduction Request Form, for use in the Singapore market, to request the reduction of a regular premium on your Utmost Worldwide Limited Plan.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore	FOS	Making a change to your policy	Regular Premium Reduction Request Form, for use in the Singapore market, to request the reduction of a regular premium on your Utmost Worldwide Limited Plan. Operational Forms Regular Premium Reduction Request (Singapore) UWWS PR 00021
Vision Reinstatement Request Form (Singapore)	Reinstatement Request Form, for use in the Singapore market, to request a reinstatement of your Utmost Worldwide Limited, Vision Plan.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore	FOS	Making a change to your policy	Reinstatement Request Form, for use in the Singapore market, to request a reinstatement of your Utmost Worldwide Limited, Vision Plan. Operational Forms Vision Reinstatement Request Form (Singapore) UWWS PR 00022
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)	Utmost Wealth Solutions	English (EN)	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)	Utmost Wealth Solutions	English (EN)	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
Beneficial Owner Identification Form (Singapore)	This form should be used were you want to provide details of the Beneficial Owner Identification on your Utmost Worldwide Limited plan. For use in the Singapore market.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore, Professional Portfolio - Singapore	FOS	Making a change to your policy, New Policy	This form should be used were you want to provide details of the Beneficial Owner Identification on your Utmost Worldwide Limited plan. For use in the Singapore market. Operational Forms Beneficial Owner Identification Form (Singapore) UWWS PR 00006
VIDEO: Claim For Death Benefit Form (Singapore)	Claim for Death Benefit Form for use with an Utmost Worldwide Limited Plan, for the Singapore market.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore, Professional Portfolio - Singapore	FOS	Surrender or Claim	Claim for Death Benefit Form for use with an Utmost Worldwide Limited Plan, for the Singapore market. Operational Forms VIDEO: Claim For Death Benefit Form (Singapore) UWWS PR 00008
Declaration of an Assignment Form (Singapore)	Declaration of Assignment Form for use with an Utmost Worldwide Limited Plan, for the Singapore market.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore, Professional Portfolio - Singapore	FOS	Making a change to your policy	Declaration of Assignment Form for use with an Utmost Worldwide Limited Plan, for the Singapore market. Operational Forms Declaration of an Assignment Form (Singapore) UWWS PR 00009
Application for GIRO (Singapore)	Application for GIRO, for use with an Utmost Worldwide Limited Plan, to instruct regular payments from your bank to pay premiums by GIRO. For use in the Singapore market.	Singapore (SG)	Utmost Worldwide	English (EN)	Focus - Singapore	FOS	Making a change to your policy, New Policy	Application for GIRO, for use with an Utmost Worldwide Limited Plan, to instruct regular payments from your bank to pay premiums by GIRO. For use in the Singapore market. Operational Forms Application for GIRO (Singapore) UWWS PR 00010
Income Payment Request Form (Singapore)	Income Payment Request Form, to be used to instruct regular withdrawals from your Utmost Worldwide Limited Plan. For use in the Singapore market.	Singapore (SG)	Utmost Worldwide	English (EN)	Choice and Vision - Singapore, Focus - Singapore, Professional Portfolio - Singapore	FOS	New Policy	Income Payment Request Form, to be used to instruct regular withdrawals from your Utmost Worldwide Limited Plan. For use in the Singapore market. Operational Forms Income Payment Request Form (Singapore) UWWS PR 00011
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)	Utmost Wealth Solutions	English (EN)	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)	Utmost Wealth Solutions	English (EN)	Non Product Specific	FOS	New Policy	Published minimum residual values as at February 2021 Operational Forms Portfolio Bond Minimum Residual Value UWSQ PR \| 21018
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)	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	Non Product Specific		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
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	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	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 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)	Utmost Wealth Solutions	English (EN)	Non Product Specific		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
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)	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	European Executive Investment Bond – PRIIPs, Executive Investment Account, Executive Investment Bond, Executive Investment Plan, Executive Investment Portfolio, Executive Life Portfolio, Life Insurance Portfolio, 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
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	Utmost Wealth Solutions	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
Letter of authorisation for Authorised Custodian Account Form	This letter of authorisation permits the authorised individual to carry out actions 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)	Utmost Wealth Solutions	English (EN)	Non Product Specific		Making a change to your policy	This letter of authorisation permits the authorised individual to carry out actions 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
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)	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	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
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	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	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
Appointing a Discretionary Asset Manager to your Wealth Bond	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)	Utmost Wealth Solutions	English (EN)	Non Product Specific		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 Appointing a Discretionary Asset Manager to your Wealth Bond UWSQ PR \| 12370
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)	Utmost Wealth Solutions	English (EN)	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
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	English (EN)	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
Cheque Processing Form	This form is to be used when Wealth Interactive status is awaiting payment.	United Kingdom (UK)	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	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
Amendment to Wealth Interactive, Policyholder Online Service Terms	This form allows Trustee Policyholders to request online access for their Clients/Members.	Singapore (SG)	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	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
Bereavement Claim Form	Bereavement Claim Form for Life Assurance Bonds	United Kingdom (UK)	Utmost Wealth Solutions	English (EN)	Evolution, Selection	FOS	Surrender or Claim	Bereavement Claim Form for Life Assurance Bonds Operational Forms Bereavement Claim Form UWS PR 0182
Intermediary Registration Application QINTL IOM and QII	Intermediary Registration Application IOM and QII – for non UK intermediaries only	United Kingdom (UK)	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	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
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)	Utmost Wealth Solutions	English (EN)	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
Questionário Sobre a Origem do Património	Questionário Sobre a Origem do Património para fornecer detalhes sobre o património de um cliente	Portugal (PT)	Utmost Wealth Solutions	Portuguese (PT)	Apex (Portugal), Compass (Closed), Compass DFM (Closed), Private Wealth Portfolio - Portugal	FOS	Addition to your Policy, New Policy	Questionário Sobre a Origem do Património para fornecer detalhes sobre o património de um cliente Operational Forms Questionário Sobre a Origem do Património UWS PR 00473
Execution Only Form for Additional Single Premium Applicants	Execution Only Form for Additional Single Premium Applicants	United Kingdom (UK)	Utmost International - IoM	English (EN)	Estate Planning Bond, Evolution		New Policy	Execution Only Form for Additional Single Premium Applicants Operational Forms Execution Only Form for Additional Single Premium Applicants UWS PR 00210
Utmost International Trustee Solutions Client Agreement Form	For use with trusts incorporating a settlor’s investment direction (including terms of business, current fee scales and client money information sheet).	Hong Kong (HK), Middle East, Rest of the World, Singapore (SG)	Utmost International Trustee Solutions Limited	English (EN)	Non Product Specific	FOS	New Policy	For use with trusts incorporating a settlor’s investment direction (including terms of business, current fee scales and client money information sheet). Operational Forms Utmost International Trustee Solutions Client Agreement Form UTSQ PR \| 05921
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	English (EN)	Non Product Specific	FOS	Surrender or Claim	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
French Executive Portfolio Appointment of Fund Adviser Form	This form can be used if you wish to appoint a firm to act as a discretionary fund advisor on your French Executive Portfolio.	Europe Expat	Utmost PanEurope	English (EN)	Non Product Specific		Making a change to your policy	This form can be used if you wish to appoint a firm to act as a discretionary fund advisor on your French Executive Portfolio. Operational Forms French Executive Portfolio Appointment of Fund Adviser Form UPEQ PR \| 20844
Mutual Stipulations and Nomination Form Irish jointly Owned Products	This form should be used for policies subject to the laws of Belgium, Cyprus, Spain or Sweden. Complete this form if you are the policyholder and request for the mutual stipulations wording to be applied to your policy and also wish to nominate the beneficiary(ies) listed in the appointment of beneficiary(ies) for your policy.	Belgium (BE), Cyprus (CY), Spain (ES), Sweden (SE)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	This form should be used for policies subject to the laws of Belgium, Cyprus, Spain or Sweden. Complete this form if you are the policyholder and request for the mutual stipulations wording to be applied to your policy and also wish to nominate the beneficiary(ies) listed in the appointment of beneficiary(ies) for your policy. Operational Forms Mutual Stipulations and Nomination Form Irish jointly Owned Products UPEQ PR \| 21042
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	English (EN)	Non Product Specific	FOS	Making a change to your policy, Surrender or Claim	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
Utmost International Trustee Solutions Limited Client Agreement Form	This form is required to obtain information about an applicant’s tax status under Automatic Exchange of Information (AEOI) regulations, Utmost International.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	New Policy	This form is required to obtain information about an applicant’s tax status under Automatic Exchange of Information (AEOI) regulations, Utmost International. Operational Forms Utmost International Trustee Solutions Limited Client Agreement Form UTSQ PR \| 03482
Utmost International Trustee Solutions Discretionary Investment Manager Application Form	This form can be used to appoint a Discretionary investment manager to a bond in trust with Utmost International Trustee Solutions Limited	United Kingdom (UK)	Utmost International Trustee Solutions Limited	English (EN)	Non Product Specific	FOS	New Policy	This form can be used to appoint a Discretionary investment manager to a bond in trust with Utmost International Trustee Solutions Limited Operational Forms Utmost International Trustee Solutions Discretionary Investment Manager Application Form UTSQ PR \| 03409
Data Capture Online Form for Spanish Collective Investment Bond with Utmost PanEurope dac	Data Capture Online Form for Individual, Joint and Corporate Investors and is used to gather the necessary information to input new business online for the Spanish Collective Investment Bond on Wealth Interactive. Please note this is not an application form.	Spain (ES)	Utmost PanEurope	English (EN)	Spanish Collective Investment Bond	FOS	New Policy	Data Capture Online Form for Individual, Joint and Corporate Investors and is used to gather the necessary information to input new business online for the Spanish Collective Investment Bond on Wealth Interactive. Please note this is not an application form. Operational Forms Data Capture Online Form for Spanish Collective Investment Bond with Utmost PanEurope dac UPEQ PR \| 19543
French Executive Portfolio – Clause bénéficiaire démembrée avec quasi-usufruit	Please use this form if your client would like to nominate a beneficiary using a clause bénéficiaire démembrée specific to French law	France (FR)	Utmost PanEurope	French (FR)	Non Product Specific	FOS	New Policy	Please use this form if your client would like to nominate a beneficiary using a clause bénéficiaire démembrée specific to French law Operational Forms French Executive Portfolio – Clause bénéficiaire démembrée avec quasi-usufruit UPEQ PR \| 20688
Beneficiary Nomination Request for non UK residents	This is a Beneficiary Nomination Request form for non UK resident Policyholders for Utmost PanEurope dac	Europe Expat	Utmost PanEurope	English (EN)	Non Product Specific		Making a change to your policy	This is a Beneficiary Nomination Request form for non UK resident Policyholders for Utmost PanEurope dac Operational Forms Beneficiary Nomination Request for non UK residents UPEQ PR \| 14896
Swedish Executive Portfolio Loan Appendix Form	Complete this form if you wish for the Loan Appendix contained in this document to be incorporated into your policy.	Sweden (SE)	Utmost PanEurope	English (EN)	Swedish Executive Portfolio – PRIIPs		Making a change to your policy	Complete this form if you wish for the Loan Appendix contained in this document to be incorporated into your policy. Operational Forms Swedish Executive Portfolio Loan Appendix Form UPEQ PR \| 14654
Payment Instruction Form	This form is for use with Utmost PanEurope dac. Omega and Integra policies.	Europe Expat	Utmost PanEurope	English (EN)	Non Product Specific		Making a change to your policy	This form is for use with Utmost PanEurope dac. Omega and Integra policies. Operational Forms Payment Instruction Form UPEQ PR \| 19967
Data Capture Form	This form is for individual and joint investors and is used to gather the necessary information to input new business online for the European Executive Investment Bond and the European Collective Investment Bond on Wealth Interactive.	Europe Expat	Utmost PanEurope	English (EN)	European Executive Investment Bond – PRIIPs	FOS	New Policy	This form is for individual and joint investors and is used to gather the necessary information to input new business online for the European Executive Investment Bond and the European Collective Investment Bond on Wealth Interactive. Operational Forms Data Capture Form UPEQ PR \| 20132
Överföra tillgångar till din Swedish Executive Portfolio (Transferring Assets to your Swedish Executive Portfolio)	Använd det här formuläret vid överföring av externa tillgångar till en Swedish Executive Portfolio. Se till att skaffa och läsa den tillämpliga kundbroschyren och försäkringsvillkoren för din Swedish Executive Portfolio innan det här formuläret fylls i. This form should be used when transferring external assets to a Swedish Executive Portfolio.	Sweden (SE)	Utmost PanEurope	English (EN), Swedish (SV)	Swedish Executive Portfolio – PRIIPs		New Policy	Använd det här formuläret vid överföring av externa tillgångar till en Swedish Executive Portfolio. Se till att skaffa och läsa den tillämpliga kundbroschyren och försäkringsvillkoren för din Swedish Executive Portfolio innan det här formuläret fylls i. This form should be used when transferring external assets to a Swedish Executive Portfolio. Operational Forms Överföra tillgångar till din Swedish Executive Portfolio (Transferring Assets to your Swedish Executive Portfolio) UPEQ PR \| 12390
Utse en investeringsrådgivare till din Swedish Executive Portfolio (Appointing a Fund Adviser)	Denna blankett ska inte användas om ytterligare livförsäkringsskydd ingår (eller ska ingå) eller om försäkringstagaren har eller i framtiden kan komma att ha sin hemvist i storbritannien. Blanketten kan inte användas för att ta bort en livförsäkrad, utan endast för att lägga till livförsäkrade. Please use this form to appoint a fund adviser to a Swedish Executive Portfolio. The form must be completed by the policyholder and the fund adviser.	Sweden (SE)	Utmost PanEurope	English (EN), Swedish (SV)	Swedish Executive Portfolio – PRIIPs	FOS	New Policy	Denna blankett ska inte användas om ytterligare livförsäkringsskydd ingår (eller ska ingå) eller om försäkringstagaren har eller i framtiden kan komma att ha sin hemvist i storbritannien. Blanketten kan inte användas för att ta bort en livförsäkrad, utan endast för att lägga till livförsäkrade. Please use this form to appoint a fund adviser to a Swedish Executive Portfolio. The form must be completed by the policyholder and the fund adviser. Operational Forms Utse en investeringsrådgivare till din Swedish Executive Portfolio (Appointing a Fund Adviser) UPEQ PR \| 11705
Formulär för förordnande av förmånstagare för Swedish Executive Portfolio med en försäkringstagare (Nomination Form – to Nominate Beneficiaries Under the Swedish Executive Portfolio, with one Policyholder)	Fyll i det här formuläret om försäkringstagaren vill förordna att äganderätten till Swedish Executive Portfolio vid försäkringstagarens död ska övergå till de förmånstagare. (This form is to be used when the Policyholder wishes to nominate that the ownership of the Swedish Executive Portfolio is transferred upon death of the Policyholders to the beneficiaries nominated in this form. This form is to be used when there is only one policyholder.)	Sweden (SE)	Utmost PanEurope	English (EN), Swedish (SV)	Swedish Executive Portfolio – PRIIPs		New Policy	Fyll i det här formuläret om försäkringstagaren vill förordna att äganderätten till Swedish Executive Portfolio vid försäkringstagarens död ska övergå till de förmånstagare. (This form is to be used when the Policyholder wishes to nominate that the ownership of the Swedish Executive Portfolio is transferred upon death of the Policyholders to the beneficiaries nominated in this form. This form is to be used when there is only one policyholder.) Operational Forms Formulär för förordnande av förmånstagare för Swedish Executive Portfolio med en försäkringstagare (Nomination Form – to Nominate Beneficiaries Under the Swedish Executive Portfolio, with one Policyholder) UPEQ PR \| 12208
Begäran om byte av Förvaltare	Detta formulär kan användas för att begära att överföra vårdnad om tillgångar.This form can be used to request to transfer custodianship of assets.	Sweden (SE)	Utmost PanEurope	English (EN), Swedish (SV)	Non Product Specific, Swedish Executive Portfolio – PRIIPs	FOS	Making a change to your policy	Detta formulär kan användas för att begära att överföra vårdnad om tillgångar.This form can be used to request to transfer custodianship of assets. Operational Forms Begäran om byte av Förvaltare UPEQ PR \| 06987
Application Form for European Executive Investment Bond (QROPS/QNUPS/SIPP) with Utmost PanEurope dac	Application Form for Trustee Investors wishing to invest in a EEIB or ECIB via a QROPS, QNUPS or SIPP. Please note that you will also need to fill out the Tax Declaration and Self Certification document.	Malta (MT)	Utmost PanEurope	English (EN)	European Executive Investment Bond – PRIIPs	FOS	New Policy	Application Form for Trustee Investors wishing to invest in a EEIB or ECIB via a QROPS, QNUPS or SIPP. Please note that you will also need to fill out the Tax Declaration and Self Certification document. Operational Forms Application Form for European Executive Investment Bond (QROPS/QNUPS/SIPP) with Utmost PanEurope dac UPEQ PR \| 09310
Nomination of Investment Adviser Form for Apex France with Utmost PanEurope dac	This form can be used to nominate an Investment Advisor for your Apex France policy.	France (FR)	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	This form can be used to nominate an Investment Advisor for your Apex France policy. Operational Forms Nomination of Investment Adviser Form for Apex France with Utmost PanEurope dac UPE_WS PR 00119
Change of Beneficiary Form for Apex France with Utmost PanEurope dac	This form can be used to change the beneficiary of your Apex France policy.	France (FR)	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	This form can be used to change the beneficiary of your Apex France policy. Operational Forms Change of Beneficiary Form for Apex France with Utmost PanEurope dac UPE_WS PR 00120
Proof of Life Form for Apex France and PWP with Utmost PanEurope dac	This form can be used to confirm that the Life Assured is alive at the date of signing.	France (FR)	Utmost PanEurope	English (EN)	Apex (France)	FOS	New Policy	This form can be used to confirm that the Life Assured is alive at the date of signing. Operational Forms Proof of Life Form for Apex France and PWP with Utmost PanEurope dac UPE_WS PR 00121
Assignment of Policies Form for Apex France with Utmost PanEurope dac	This form can be used to reassign your Apex France policy to someone else.	France (FR)	Utmost PanEurope	English (EN)	Apex (France)	FOS	New Policy	This form can be used to reassign your Apex France policy to someone else. Operational Forms Assignment of Policies Form for Apex France with Utmost PanEurope dac UPE_WS PR 00122
Switch Form	This form enables you to switch your investments or change the funds in which your future regular investments are invested.	Europe Expat	Utmost PanEurope	English (EN)	Non Product Specific		Making a change to your policy	This form enables you to switch your investments or change the funds in which your future regular investments are invested. Operational Forms Switch Form UPEQ PR \| 03361
PWP España Formulario de cambio de nombre y domicilio	Operational Forms PWP España Formulario de cambio de nombre y domicilio UPE_WS PR 00058	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		Making a change to your policy	Operational Forms PWP España Formulario de cambio de nombre y domicilio UPE_WS PR 00058
PWP España Formulario de Autocertificación de Cumplimiento Fiscal Internacional	Operational Forms PWP España Formulario de Autocertificación de Cumplimiento Fiscal Internacional UPE_WS PR 00059	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		Making a change to your policy, New Policy	Operational Forms PWP España Formulario de Autocertificación de Cumplimiento Fiscal Internacional UPE_WS PR 00059
PWP España Solicitud de Acceso Directo a Información	Operational Forms PWP España Solicitud de Acceso Directo a Información UPE_WS PR 00060	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		New Policy	Operational Forms PWP España Solicitud de Acceso Directo a Información UPE_WS PR 00060
PWP España Formulario de firma	Operational Forms PWP España Formulario de firma UPE_WS PR 00061	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		New Policy	Operational Forms PWP España Formulario de firma UPE_WS PR 00061
PWP España Formulario de Condiciones Particulares del Seguro Extraviadas / Nunca Recibidas	Operational Forms PWP España Formulario de Condiciones Particulares del Seguro Extraviadas / Nunca Recibidas UPE_WS PR 00062	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		New Policy	Operational Forms PWP España Formulario de Condiciones Particulares del Seguro Extraviadas / Nunca Recibidas UPE_WS PR 00062
France Death Benefit Claim form	This form can be used to claim a death benefit for Apex France or PWP France policies	France (FR)	Utmost PanEurope	English (EN)	Apex (France), Private Wealth Portfolio (PWP) France	FOS	Surrender or Claim	This form can be used to claim a death benefit for Apex France or PWP France policies Operational Forms France Death Benefit Claim form UPE_WS PR 00114
Apex Portugal – Appointment of insurance intermediary	This form can be used to appoint an Insurance Intermediary for Apex Portugal policies.	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	Making a change to your policy	This form can be used to appoint an Insurance Intermediary for Apex Portugal policies. Operational Forms Apex Portugal – Appointment of insurance intermediary UPE_WS PR 00027
Apex Portugal Dealing Account Overdraft Clearance Instruction form	This form can be used to request an overdraft clearance for your Apex Portugal Dealing Account.	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	Making a change to your policy	This form can be used to request an overdraft clearance for your Apex Portugal Dealing Account. Operational Forms Apex Portugal Dealing Account Overdraft Clearance Instruction form UPE_WS PR 00029
Apex Portugal – Assignment of Policies	For assigning policies to individuals only.	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	Making a change to your policy	For assigning policies to individuals only. Operational Forms Apex Portugal – Assignment of Policies UPE_WS PR 00032
Apex Portugal – Insurance Intermediary Fund Authorisation form	This form should only be completed by the Policyholder where a Discretionary Fund Manager or Platform is not appointed and the Policyholder wish to authorise the Insurance Intermediary to execute external fund choices on their behalf.	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	Making a change to your policy	This form should only be completed by the Policyholder where a Discretionary Fund Manager or Platform is not appointed and the Policyholder wish to authorise the Insurance Intermediary to execute external fund choices on their behalf. Operational Forms Apex Portugal – Insurance Intermediary Fund Authorisation form UPE_WS PR 00036
APEX Portugal Guide for Additional Single Premium	Guide to help you complete the additional single premium form for APEX Portugal.	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	New Policy	Guide to help you complete the additional single premium form for APEX Portugal. Operational Forms APEX Portugal Guide for Additional Single Premium UPE_WS PR 00038
Apex Portugal – Nomination of Discretionary Fund Manager or Platform Agreement	This form can be used to nominate or replace an existing Discretionary Fund Manager (DFM) or Platform arrangement.	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	Making a change to your policy	This form can be used to nominate or replace an existing Discretionary Fund Manager (DFM) or Platform arrangement. Operational Forms Apex Portugal – Nomination of Discretionary Fund Manager or Platform Agreement UPE_WS PR 00042
Apex Portugal – Right to change your mind	Guide detailing why you might change your mind about your Utmost PanEurope dac policy within your 30 day grace period and how to cancel it	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	New Policy	Guide detailing why you might change your mind about your Utmost PanEurope dac policy within your 30 day grace period and how to cancel it Operational Forms Apex Portugal – Right to change your mind UPE_WS PR 00043
Apex Portugal Open Architecture Dealing Instruction Form	This form should be used for policies held on the Open Architecture basis only without a Discretionary Fund Manager or Platform arrangement.	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	Making a change to your policy	This form should be used for policies held on the Open Architecture basis only without a Discretionary Fund Manager or Platform arrangement. Operational Forms Apex Portugal Open Architecture Dealing Instruction Form UPE_WS PR 00052
Structured Products Client Disclaimer Form	This notice must be read and signed by the planholder. The notice states that Utmost PanEurope accepts no liability for any loss, damage and/or expense (including, but not limited to, legal fees) in connection with an investment in a structured product.	Finland (FI)	Utmost PanEurope	English (EN)	Professional Portfolio, UPE Unit-linked Products (Closed), Wealth Portfolio Finland	FOS	New Policy	This notice must be read and signed by the planholder. The notice states that Utmost PanEurope accepts no liability for any loss, damage and/or expense (including, but not limited to, legal fees) in connection with an investment in a structured product. Operational Forms Structured Products Client Disclaimer Form UPE_WS \| 4601
Fund Client Disclaimer Form	This notice must be read and signed by the planholder. The notice states that Utmost PanEurope accepts no liability for losses, damages and/or expenses (including, but not limited to, legal fees) in connection with the investment in the funds.	Finland (FI)	Utmost PanEurope	English (EN)	Professional Portfolio, UPE Unit-linked Products (Closed), Wealth Portfolio Finland	FOS	New Policy	This notice must be read and signed by the planholder. The notice states that Utmost PanEurope accepts no liability for losses, damages and/or expenses (including, but not limited to, legal fees) in connection with the investment in the funds. Operational Forms Fund Client Disclaimer Form UPE_WS \| 4602
Apex Portugal – Death Benefit Claim form	This form can be used to claim a death benefit for Apex Portugal policies	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	Surrender or Claim	This form can be used to claim a death benefit for Apex Portugal policies Operational Forms Apex Portugal – Death Benefit Claim form UPE_WS PR 00010
Apex Portugal – Change of Beneficiary Form	This form can be used to change the beneficiary of your Apex Portugal policy.	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	Making a change to your policy	This form can be used to change the beneficiary of your Apex Portugal policy. Operational Forms Apex Portugal – Change of Beneficiary Form UPE_WS PR 00022
Apex Portugal – Guide for individual applicants	Guide to help you complete the Apex Portugal application form.	Portugal (PT)	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	New Policy	Guide to help you complete the Apex Portugal application form. Operational Forms Apex Portugal – Guide for individual applicants UPE_WS PR 00016
Apex Portugal – Withdrawal or surrender form	This form should be used to withdraw from or surrender your Apex Portugal policy.	Europe Expat	Utmost PanEurope	English (EN)	Apex (Portugal)	FOS	Surrender or Claim	This form should be used to withdraw from or surrender your Apex Portugal policy. Operational Forms Apex Portugal – Withdrawal or surrender form UPE_WS PR 00009
PWP Italia Modulo di notifica della cessione della polizza	Modulo da compilarsi a cura dell’Investitore-Contraente per il trasferimento del titolo, della titolarità e di tutti i diritti derivanti dalla polizza in capo ad altra persona o ente.	Italy (IT)	Utmost PanEurope	Italian (IT)	Private Wealth Portfolio - Italy		Making a change to your policy	Modulo da compilarsi a cura dell’Investitore-Contraente per il trasferimento del titolo, della titolarità e di tutti i diritti derivanti dalla polizza in capo ad altra persona o ente. Operational Forms PWP Italia Modulo di notifica della cessione della polizza UPE_WS \| 4392
PWP Italia Modulo Variazione Nome, Indirizzo e Indirizzo Email	Modulo, da compilarsi a cura dell’Investitore-Contraente, per la modifica di nome, indirizzo o indirizzo email collegati alla polizza per PWP Italia.	Italy (IT)	Utmost PanEurope	Italian (IT)	Private Wealth Portfolio - Italy		Making a change to your policy	Modulo, da compilarsi a cura dell’Investitore-Contraente, per la modifica di nome, indirizzo o indirizzo email collegati alla polizza per PWP Italia. Operational Forms PWP Italia Modulo Variazione Nome, Indirizzo e Indirizzo Email UPE_WS \| 4382
UPE Deed of Assignment	UPE Deed of Assignment		Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	UPE Deed of Assignment Operational Forms UPE Deed of Assignment UPE_WS \| 4466
Autocertificazione Al Fini Fiscali Contraente Persona Fisica	Il presente modulo è necessario per segnalare accuratamente la vostra polizza ai sensi dei pertinenti accordi sullo scambio di informazioni fiscali, tra cui il Foreign Account Tax Compliance Act (FATCA) e le norme Common Reporting Standard (CRS). Il presente modulo deve essere utilizzato dai singoli assicurati, dalle persone autorizzate a firmare per conto dell’assicurato, ad esempio il loro procuratore o il loro sostituto nominato dal tribunale, e dalle persone collegate al trust di cui Utmost International Trustee Solutions Limited è il trustee designato.	Italy (IT)	Utmost Wealth Solutions	Italian (IT)	Non Product Specific	FOS	Making a change to your policy	Il presente modulo è necessario per segnalare accuratamente la vostra polizza ai sensi dei pertinenti accordi sullo scambio di informazioni fiscali, tra cui il Foreign Account Tax Compliance Act (FATCA) e le norme Common Reporting Standard (CRS). Il presente modulo deve essere utilizzato dai singoli assicurati, dalle persone autorizzate a firmare per conto dell’assicurato, ad esempio il loro procuratore o il loro sostituto nominato dal tribunale, e dalle persone collegate al trust di cui Utmost International Trustee Solutions Limited è il trustee designato. Operational Forms Autocertificazione Al Fini Fiscali Contraente Persona Fisica UPE_WS \| 4381
PWP UK – Death Benefit Claim Form	Private Wealth Portfolio UK – Death Benefit Claim Form	United Kingdom (UK)	Utmost PanEurope	English (EN)	Private Wealth Portfolio - UK	FOS	Surrender or Claim	Private Wealth Portfolio UK – Death Benefit Claim Form Operational Forms PWP UK – Death Benefit Claim Form UPE_WS \| 05213
PWP Italia Modulo per la richiesta del beneficio caso morte	Modulo da compilarsi a cura dei Beneficiari designati per la richiesta di liquidazione caso morte della prestazione assicurata.	Italy (IT)	Utmost PanEurope	Italian (IT)	Private Wealth Portfolio - Italy		Surrender or Claim	Modulo da compilarsi a cura dei Beneficiari designati per la richiesta di liquidazione caso morte della prestazione assicurata. Operational Forms PWP Italia Modulo per la richiesta del beneficio caso morte UPE_WS \| 4302
PWP Italia Modulo per la Richiesta di Riscatto	Modulo da compilarsi a cura dell’Investitore-Contraente per le richieste di riscatto totale o parziale della polizza per PWP Italia.	Italy (IT)	Utmost PanEurope	Italian (IT)	Private Wealth Portfolio - Italy		Surrender or Claim	Modulo da compilarsi a cura dell’Investitore-Contraente per le richieste di riscatto totale o parziale della polizza per PWP Italia. Operational Forms PWP Italia Modulo per la Richiesta di Riscatto UPE_WS \| 4071
Execution Only Client Disclaimer form	Execution Only Client Disclaimer for UK market	United Kingdom (UK)	Utmost PanEurope	English (EN)	Private Wealth Portfolio - UK	FOS	New Policy	Execution Only Client Disclaimer for UK market Operational Forms Execution Only Client Disclaimer form UPE_WS \| 04698
PWP Italia Modulo per la designazione del Beneficiario	PWP Italia – Modulo per la designazione da parte dell’Investitore-Contraente di uno o più Beneficiari della prestazione assicurata, ciascuno dei quali avrà poi diritto al pagamento della quota di capitale indicata in caso di decesso dell’Assicurato.	Italy (IT)	Utmost PanEurope	Italian (IT)	Private Wealth Portfolio - Italy		New Policy	PWP Italia – Modulo per la designazione da parte dell’Investitore-Contraente di uno o più Beneficiari della prestazione assicurata, ciascuno dei quali avrà poi diritto al pagamento della quota di capitale indicata in caso di decesso dell’Assicurato. Operational Forms PWP Italia Modulo per la designazione del Beneficiario UPE_WS \| 05068
Formulário de notificação de rescisão de posição contratual	Este formulário deve ser preenchido por todos os tomadores de seguro se pretenderem ceder o contrato a outra pessoa ou entidade.	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		Making a change to your policy, New Policy	Este formulário deve ser preenchido por todos os tomadores de seguro se pretenderem ceder o contrato a outra pessoa ou entidade. Operational Forms Formulário de notificação de rescisão de posição contratual UPE_WS \| 04733
PWP España Formulario de Prima Adicional	Operational Forms PWP España Formulario de Prima Adicional UPE_WS \| 04500	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		Making a change to your policy	Operational Forms PWP España Formulario de Prima Adicional UPE_WS \| 04500
PWP España Formulario de Notificación de Prenda	Operational Forms PWP España Formulario de Notificación de Prenda UPE_WS \| 04585	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		Making a change to your policy, New Policy	Operational Forms PWP España Formulario de Notificación de Prenda UPE_WS \| 04585
Notice of Assignment Form	Notice of Assignment Form for Private Wealth Portfolio UK	United Kingdom (UK)	Utmost PanEurope	English (EN)	Private Wealth Portfolio - UK	FOS	Making a change to your policy	Notice of Assignment Form for Private Wealth Portfolio UK Operational Forms Notice of Assignment Form UPE_WS \| 04674
PWP España Formulario de Designación de Beneficiarios	Operational Forms PWP España Formulario de Designación de Beneficiarios UPE_WS \| 04482	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		New Policy	Operational Forms PWP España Formulario de Designación de Beneficiarios UPE_WS \| 04482
Loan Agreement form	Loan Agreement form for PWP UK	United Kingdom (UK)	Utmost PanEurope	English (EN)	Private Wealth Portfolio - UK	FOS	New Policy	Loan Agreement form for PWP UK Operational Forms Loan Agreement form UPE_WS \| 04496
PWP España Formulario de Solicitud de Rescate y de Rescate regular	Operational Forms PWP España Formulario de Solicitud de Rescate y de Rescate regular UPE_WS \| 04481	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		New Policy	Operational Forms PWP España Formulario de Solicitud de Rescate y de Rescate regular UPE_WS \| 04481
PWP Portugal Formulário de Espécime de Assinatura	Operational Forms PWP Portugal Formulário de Espécime de Assinatura UPE_WS \| 04374	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		New Policy	Operational Forms PWP Portugal Formulário de Espécime de Assinatura UPE_WS \| 04374
PWP Portugal Formulário de Nomeação de Beneficiário	Operational Forms PWP Portugal Formulário de Nomeação de Beneficiário UPE_WS \| 04376	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Compass (Closed), Compass DFM (Closed), Private Wealth Portfolio - Portugal		Making a change to your policy, New Policy	Operational Forms PWP Portugal Formulário de Nomeação de Beneficiário UPE_WS \| 04376
PWP Portugal Formulário de Alteração de Nome e Endereço	Operational Forms PWP Portugal Formulário de Alteração de Nome e Endereço UPE_WS \| 04377	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		Making a change to your policy	Operational Forms PWP Portugal Formulário de Alteração de Nome e Endereço UPE_WS \| 04377
PWP Portugal Formulario de Condiciones Particulares da Apólice Extraviadas/Nunca Recebido	Operational Forms PWP Portugal Formulario de Condiciones Particulares da Apólice Extraviadas/Nunca Recebido UPE_WS \| 04379	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		New Policy	Operational Forms PWP Portugal Formulario de Condiciones Particulares da Apólice Extraviadas/Nunca Recebido UPE_WS \| 04379
PWP Portugal Formulário de pedido de pagamento de benefício por morte	Operational Forms PWP Portugal Formulário de pedido de pagamento de benefício por morte UPE_WS \| 04380	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		Surrender or Claim	Operational Forms PWP Portugal Formulário de pedido de pagamento de benefício por morte UPE_WS \| 04380
PWP Portugal Formulário de Notificação de Cancelamento	Operational Forms PWP Portugal Formulário de Notificação de Cancelamento UPE_WS \| 04355	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		Surrender or Claim	Operational Forms PWP Portugal Formulário de Notificação de Cancelamento UPE_WS \| 04355
Notice of Pledge Form – PWP Portugal Formulário de Notificação de Garantia	Operational Forms Notice of Pledge Form – PWP Portugal Formulário de Notificação de Garantia UPE_WS \| 04373	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		Making a change to your policy, New Policy	Operational Forms Notice of Pledge Form – PWP Portugal Formulário de Notificação de Garantia UPE_WS \| 04373
Portfolio Manager Undertaking form	Portfolio Manager Undertaking form for UK market	United Kingdom (UK)	Utmost PanEurope	English (EN)	Private Wealth Portfolio - UK		New Policy	Portfolio Manager Undertaking form for UK market Operational Forms Portfolio Manager Undertaking form UPE_WS \| 04007
PWP Portugal Formulário para pagamento de Prémio Adicional	Operational Forms PWP Portugal Formulário para pagamento de Prémio Adicional UPE_WS \| 04027	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		New Policy	Operational Forms PWP Portugal Formulário para pagamento de Prémio Adicional UPE_WS \| 04027
PWP Notice of Cancellation Form	Operational Forms PWP Notice of Cancellation Form UPE_WS \| 04244	Spain (ES)	Utmost PanEurope	English (EN)	Private Wealth Portfolio - Spain, Private Wealth Portfolio - UK	FOS	Surrender or Claim	Operational Forms PWP Notice of Cancellation Form UPE_WS \| 04244
PWP Portugal Formulário de Auto-Certificação de Conformidade Fiscal Internacional	Operational Forms PWP Portugal Formulário de Auto-Certificação de Conformidade Fiscal Internacional UPE_WS \| 04029	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		New Policy	Operational Forms PWP Portugal Formulário de Auto-Certificação de Conformidade Fiscal Internacional UPE_WS \| 04029
Formulaire de Changement de Coordonnées Personnelles	Ce formulaire est destiné aux clients d’Utmost PanEurope dac qui souhaitent nous informer de toute modification de leurs données personnelles, telles que le nom, le spécimen de signature, l’adresse, l’adresse e-mail ou le numéro de téléphone.	France (FR)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	Ce formulaire est destiné aux clients d’Utmost PanEurope dac qui souhaitent nous informer de toute modification de leurs données personnelles, telles que le nom, le spécimen de signature, l’adresse, l’adresse e-mail ou le numéro de téléphone. Operational Forms Formulaire de Changement de Coordonnées Personnelles UPE PR 12836
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	French (FR)	Non Product Specific	FOS	Making a change to your policy, New Policy, Surrender or Claim	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	Finland (FI), France (FR), Italy (IT), Portugal (PT), Spain (ES), United Kingdom (UK)	Utmost PanEurope	English (EN)	Apex (France), Apex (Portugal), Non Product Specific, Private Wealth Portfolio - Italy, Private Wealth Portfolio - Portugal, Private Wealth Portfolio - Spain, Private Wealth Portfolio - UK, Private Wealth Portfolio (PWP) France, Selection, Target	FOS	Surrender or Claim	Utmost Pan Europe dac Never Received or Lost Policy Schedule Declaration Operational Forms Never Received or Lost Policy Schedule Declaration (EN) UPE PR 12847
UPE Notification of Pledge Form	This Utmost PanEurope dac form is for completion by all policyholders, if they wish to pledge their policy to a pledgee/pledge creditor as security.	Europe Expat, Italy (IT), Portugal (PT), Spain (ES), United Kingdom (UK)	Utmost PanEurope	English (EN)	Advantage Corporate (Closed), Apex (France), Apex (Portugal), Compass (Closed), Non Product Specific, Private Wealth Portfolio - Italy, Private Wealth Portfolio - Portugal, Private Wealth Portfolio - Spain, Private Wealth Portfolio - UK, Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, New Policy	This Utmost PanEurope dac form is for completion by all policyholders, if they wish to pledge their policy to a pledgee/pledge creditor as security. Operational Forms UPE Notification of Pledge Form UPE PR 12834
Change of Discretionary Investment Strategy Form	This form is to be completed if you wish to change the discretionary investment strategies underlying your Utmost PanEurope dac Policy either in isolation or in association with an additional premium.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Private Wealth Portfolio - UK	FOS	Making a change to your policy, New Policy	This form is to be completed if you wish to change the discretionary investment strategies underlying your Utmost PanEurope dac Policy either in isolation or in association with an additional premium. Operational Forms Change of Discretionary Investment Strategy Form UPE PR 12850
Autocertificazione Ai Fini Fiscali Contraente Persona Guirdica eo Societá Fiduciaria (IT)	Al fine di poter riportare accuratamente la vostra polizza ai sensi dei pertinenti accordi sullo scambio di informazioni fiscali, inclusi il Foreign Account Tax Compliance Act (FATCA) e il Common Reporting Standard (CRS). Il presente modulo deve essere utilizzato dagli investitori giuridici quali società, trust aziendali o fondazioni.	Italy (IT)	Utmost Wealth Solutions	Italian (IT)	Non Product Specific	FOS	Making a change to your policy, New Policy	Al fine di poter riportare accuratamente la vostra polizza ai sensi dei pertinenti accordi sullo scambio di informazioni fiscali, inclusi il Foreign Account Tax Compliance Act (FATCA) e il Common Reporting Standard (CRS). Il presente modulo deve essere utilizzato dagli investitori giuridici quali società, trust aziendali o fondazioni. Operational Forms Autocertificazione Ai Fini Fiscali Contraente Persona Guirdica eo Societá Fiduciaria (IT) UPE PR 12862
UPE Pay-By-Link Euro	If you are an Utmost PanEurope dac client and you pay regular premiums into your European Capital Account, European Pensions Account or European Savings Account inEuro, regardless of your current payment method, you can use the Pay-By-Link service.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	If you are an Utmost PanEurope dac client and you pay regular premiums into your European Capital Account, European Pensions Account or European Savings Account inEuro, regardless of your current payment method, you can use the Pay-By-Link service. Operational Forms UPE Pay-By-Link Euro UPE PR 12772
UPE Pay-By-Link US Dollar	If you are an Utmost PanEurope dac client and you pay regular premiums into your European Capital Account, European Pensions Account or European Savings Account inUS Dollar, regardless of your current payment method, you can use the Pay-By-Link service.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	If you are an Utmost PanEurope dac client and you pay regular premiums into your European Capital Account, European Pensions Account or European Savings Account inUS Dollar, regardless of your current payment method, you can use the Pay-By-Link service. Operational Forms UPE Pay-By-Link US Dollar UPE PR 12773
UPE Pay-By-Link Pound Sterling	If you are an Utmost PanEurope dac client and you pay regular premiums into your European Capital Account, European Pensions Account or European Savings Account in Pound Sterling, regardless of your current payment method, you can use the Pay-By-Link service.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	If you are an Utmost PanEurope dac client and you pay regular premiums into your European Capital Account, European Pensions Account or European Savings Account in Pound Sterling, regardless of your current payment method, you can use the Pay-By-Link service. Operational Forms UPE Pay-By-Link Pound Sterling UPE PR 12774
Private Wealth Portfolio France Formulaire De Demande De Versement Complementaire	Formulaire De Demande De Versement Complementaire	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	Formulaire De Demande De Versement Complementaire Operational Forms Private Wealth Portfolio France Formulaire De Demande De Versement Complementaire UPE PR 12822
PWP Italia Dichiarazione di libera sottoscrizione (non-solicitation) dell’Investitore – Contraente	Dichiarazione di libera sottoscrizione della polizza (non-solicitation) del Proponente/ Investitore-Contraente residente fuori Italia al momento della stipula.	Italy (IT)	Utmost PanEurope	Italian (IT)	Private Wealth Portfolio - Italy		New Policy	Dichiarazione di libera sottoscrizione della polizza (non-solicitation) del Proponente/ Investitore-Contraente residente fuori Italia al momento della stipula. Operational Forms PWP Italia Dichiarazione di libera sottoscrizione (non-solicitation) dell’Investitore – Contraente UPE PR 12707
PWP Italia Dichiarazione di libera sottoscrizione (non-solicitation) dell’Intermediario – Assicurativo	Dichiarazione dell’Intermediario assicurativo di prestazione delle attività di consulenza e assistenza finalizzate al collocamento del prodotto nei confini del territorio Italiano (nei casi di Proponente/Investitore-Contraente residente fuori Italia).	Italy (IT)	Utmost PanEurope	Italian (IT)	Private Wealth Portfolio - Italy		New Policy	Dichiarazione dell’Intermediario assicurativo di prestazione delle attività di consulenza e assistenza finalizzate al collocamento del prodotto nei confini del territorio Italiano (nei casi di Proponente/Investitore-Contraente residente fuori Italia). Operational Forms PWP Italia Dichiarazione di libera sottoscrizione (non-solicitation) dell’Intermediario – Assicurativo UPE PR 12708
Client Information and Change of Details Form	This form is intended for most Utmost PanEurope dac customers who wish to inform us of any changes to their personal details, such as name, specimen signature, address, email address or telephone number.	Finland (FI), France (FR), Italy (IT), Portugal (PT), Spain (ES), United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	This form is intended for most Utmost PanEurope dac customers who wish to inform us of any changes to their personal details, such as name, specimen signature, address, email address or telephone number. Operational Forms Client Information and Change of Details Form UPE PR 12682
Client Information and Change of Details Form	This form is intended for Utmost PanEurope dac customers (with a Scottish Mutual International or Phoenix Life branded policy) who wish to inform us of any changes to their personal details, such as name, specimen signature, address, email address or telephone number.		Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	This form is intended for Utmost PanEurope dac customers (with a Scottish Mutual International or Phoenix Life branded policy) who wish to inform us of any changes to their personal details, such as name, specimen signature, address, email address or telephone number. Operational Forms Client Information and Change of Details Form UPE PR 12745
Formulaire d’arbitrage – Portefeuille en gestion conseillée	Formulaire d’arbitrage – Portefeuille en gestion conseillée Advisory Portfolio Dealing Instruction Form	France (FR)	Utmost PanEurope	English (EN), French (FR)	Private Wealth Portfolio (PWP) France		Making a change to your policy	Formulaire d’arbitrage – Portefeuille en gestion conseillée Advisory Portfolio Dealing Instruction Form Operational Forms Formulaire d’arbitrage – Portefeuille en gestion conseillée UPE PR 12738
Mandat d’accès à l’information	Ce formulaire doit etre complété et signé par le Souscripteur lorsqu’il souhaite recevoir /donner acces aux informations des actifs sous-jacents de son Contrat .	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France		New Policy	Ce formulaire doit etre complété et signé par le Souscripteur lorsqu’il souhaite recevoir /donner acces aux informations des actifs sous-jacents de son Contrat . Operational Forms Mandat d’accès à l’information UPE PR 12740
PWP France – Nomination of Investment Adviser	PWP France – Nomination of Investment Adviser	France (FR)	Utmost PanEurope	English (EN)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	PWP France – Nomination of Investment Adviser Operational Forms PWP France – Nomination of Investment Adviser UPE PR 12675
PWP España Declaración del tomador del seguro – Intención de trasladarse a España	Operational Forms PWP España Declaración del tomador del seguro – Intención de trasladarse a España UPE PR 12459	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		Making a change to your policy, New Policy	Operational Forms PWP España Declaración del tomador del seguro – Intención de trasladarse a España UPE PR 12459
Clause bénéficiaire démembrée avec quasi-usufruit	Ce formulaire est fourni strictement en qualité de projet pour examen par les conseillers juridiques du Souscripteur et devra etre adapté aux contextes et objectifs du Souscripteur qui sollicite une telle clause.	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	Ce formulaire est fourni strictement en qualité de projet pour examen par les conseillers juridiques du Souscripteur et devra etre adapté aux contextes et objectifs du Souscripteur qui sollicite une telle clause. Operational Forms Clause bénéficiaire démembrée avec quasi-usufruit UPE PR 12463
PWP España Formulario de Notificación de Asignación de Póliza	Operational Forms PWP España Formulario de Notificación de Asignación de Póliza UPE PR 12483	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		Making a change to your policy, New Policy	Operational Forms PWP España Formulario de Notificación de Asignación de Póliza UPE PR 12483
Gestion discrétionnaire – Transfert de titres	Ce formulaire doit être complété et signé par l’assuré et le gestionnaire de fonds discrétionnaire lorsqu’une prime additionnelle doit être versée par transfert de titres (prime en nature).	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, New Policy	Ce formulaire doit être complété et signé par l’assuré et le gestionnaire de fonds discrétionnaire lorsqu’une prime additionnelle doit être versée par transfert de titres (prime en nature). Operational Forms Gestion discrétionnaire – Transfert de titres UPE PR 12442
PWP Sales Consultant Declaration	Operational Forms PWP Sales Consultant Declaration UPE PR 12444	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		New Policy	Operational Forms PWP Sales Consultant Declaration UPE PR 12444
PWP Portugal Declaração Para Intermediário	Operational Forms PWP Portugal Declaração Para Intermediário UPE PR 12445	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		New Policy	Operational Forms PWP Portugal Declaração Para Intermediário UPE PR 12445
PWP Portugal Declaração Para Intermédio	Operational Forms PWP Portugal Declaração Para Intermédio UPE PR 12446	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		New Policy	Operational Forms PWP Portugal Declaração Para Intermédio UPE PR 12446
PWP Portugal Declaração Para Intermédiario Com Escritorio Em Portugal	Operational Forms PWP Portugal Declaração Para Intermédiario Com Escritorio Em Portugal UPE PR 12447	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		New Policy	Operational Forms PWP Portugal Declaração Para Intermédiario Com Escritorio Em Portugal UPE PR 12447
PWP Portugal Declaração Para o Tomador Da Apólice	Operational Forms PWP Portugal Declaração Para o Tomador Da Apólice UPE PR 12448	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		New Policy	Operational Forms PWP Portugal Declaração Para o Tomador Da Apólice UPE PR 12448
PWP Portugal Sales Consultant Declaration	Operational Forms PWP Portugal Sales Consultant Declaration UPE PR 12449	Portugal (PT)	Utmost PanEurope	English (EN)	Private Wealth Portfolio - Portugal		New Policy	Operational Forms PWP Portugal Sales Consultant Declaration UPE PR 12449
Demande de changement de clause bénéficiaire	Ce formulaire est a completer et signer par le Souscripteur pour demande de changement de clause bénéficiaire.	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	Ce formulaire est a completer et signer par le Souscripteur pour demande de changement de clause bénéficiaire. Operational Forms Demande de changement de clause bénéficiaire UPE PR 12415
Spécimen de signature	Ce formulaire est a completer et signer par le Souscripteur en cas de changement de nom ou sur demande de l’Assureur, ainsi que par l’exécuteur testamantaire.	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	Ce formulaire est a completer et signer par le Souscripteur en cas de changement de nom ou sur demande de l’Assureur, ainsi que par l’exécuteur testamantaire. Operational Forms Spécimen de signature UPE PR 12416
Déclaration de perte de la documentation contractuelle et demande de duplicata	Ce formulaire devra etre complété et signé par tous les Souscripteurs en cas de perte de la documentation contractuelle recue et demande de duplicata.	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, Surrender or Claim	Ce formulaire devra etre complété et signé par tous les Souscripteurs en cas de perte de la documentation contractuelle recue et demande de duplicata. Operational Forms Déclaration de perte de la documentation contractuelle et demande de duplicata UPE PR 12417
Demande de versement de capital décès	Ce formulaire devra etre complété et signé par le demandeur/ bénéficiaire afin qu’Utmost PanEurope dac (« Utmost PanEurope ») puisse verser le capital décés.	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Surrender or Claim	Ce formulaire devra etre complété et signé par le demandeur/ bénéficiaire afin qu’Utmost PanEurope dac (« Utmost PanEurope ») puisse verser le capital décés. Operational Forms Demande de versement de capital décès UPE PR 12418
Désignation d’un ‘Intermédiaire en Assurance	Ce formulaite est a remplir et signer par le Souscripteur et le nouvel Intermédiaire en Assurance qu’il souhaite désigner pour son Contrat.	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, New Policy	Ce formulaite est a remplir et signer par le Souscripteur et le nouvel Intermédiaire en Assurance qu’il souhaite désigner pour son Contrat. Operational Forms Désignation d’un ‘Intermédiaire en Assurance UPE PR 12413
Apex France Nomination of Discretionary Fund Manager, Platform or Custodian	This form can be used to nominate a Discretionary Fund Manager, Platform or Custodian to assist you with your Apex France policy	France (FR)	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	This form can be used to nominate a Discretionary Fund Manager, Platform or Custodian to assist you with your Apex France policy Operational Forms Apex France Nomination of Discretionary Fund Manager, Platform or Custodian UPE PR 00204
Formulaire de changement de nom et/ou d’adresse	Ce formulaire est a completer et signer par le Souscripteur en cas de changement de nom et/ou d’adresse postale.	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	Ce formulaire est a completer et signer par le Souscripteur en cas de changement de nom et/ou d’adresse postale. Operational Forms Formulaire de changement de nom et/ou d’adresse UPE PR 00227
Attestation D’Existence – PWP France	Attestation D’Existence	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, Surrender or Claim	Attestation D’Existence Operational Forms Attestation D’Existence – PWP France UPE PR 00229
Personne Politiquement Exposée	Document permettant d’identifier toute personne associée au contrat qui pourrait être considérée comme une personne politiquement exposée (PPE).	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, New Policy, Surrender or Claim	Document permettant d’identifier toute personne associée au contrat qui pourrait être considérée comme une personne politiquement exposée (PPE). Operational Forms Personne Politiquement Exposée UPE PR 00230
Private Wealth Portfolio France formulaire de rachat partiel ou total	Ce formulaire doit etre complété et signé par le Souscripteur lorsqu’il souhaite demander un rachat partiel our total de son contrat .	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Surrender or Claim	Ce formulaire doit etre complété et signé par le Souscripteur lorsqu’il souhaite demander un rachat partiel our total de son contrat . Operational Forms Private Wealth Portfolio France formulaire de rachat partiel ou total UPE PR 00233
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	French (FR)	Non Product Specific	FOS	Making a change to your policy, New Policy, Surrender or Claim	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
PWP Portugal Notice of Cancellation Form	Operational Forms PWP Portugal Notice of Cancellation Form UPE PR 00144	Portugal (PT)	Utmost PanEurope	English (EN)	Private Wealth Portfolio - Portugal		Surrender or Claim	Operational Forms PWP Portugal Notice of Cancellation Form UPE PR 00144
APEX France – Portfolio Undertaking Form	This form must be completed where an Additional Single Premium is to be paid via the transfer of assets (Premium in kind) from an existing Discretionary Fund Manager (DFM) account.	France (FR)	Utmost PanEurope	English (EN)	Apex (France)	FOS	New Policy	This form must be completed where an Additional Single Premium is to be paid via the transfer of assets (Premium in kind) from an existing Discretionary Fund Manager (DFM) account. Operational Forms APEX France – Portfolio Undertaking Form UPE PR 00145
Apex France Guide for Additional Single Premium	Please use this application form to add additional single premium to Apex France.	France (FR)	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	Please use this application form to add additional single premium to Apex France. Operational Forms Apex France Guide for Additional Single Premium UPE PR 00163
DÉSIGNATION D’UN CONSEILLER EN INVESTISSEMENT ET D’UN DÉPOSITAIRE	Ce formulaire permet au souscripteur de nommer ou changer un conseiller en investissement et/ou un dépositiaire pour son contrat d’assurance-vie.	France (FR)	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, New Policy	Ce formulaire permet au souscripteur de nommer ou changer un conseiller en investissement et/ou un dépositiaire pour son contrat d’assurance-vie. Operational Forms DÉSIGNATION D’UN CONSEILLER EN INVESTISSEMENT ET D’UN DÉPOSITAIRE UPE PR 00159
Delegation Guide to Trustee Application Form	Delegation Guide to Trustee Application Form	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation	FOS	New Policy	Delegation Guide to Trustee Application Form Operational Forms Delegation Guide to Trustee Application Form UPE PR 00122
Applicant Health Declaration (English) (PWP UK)	Applicant Health Declaration (English) (PWP UK)	United Kingdom (UK)	Utmost PanEurope	English (EN)	Private Wealth Portfolio - UK	FOS	New Policy	Applicant Health Declaration (English) (PWP UK) Operational Forms Applicant Health Declaration (English) (PWP UK) UPE PR 00127
Guide to Completing the Delegation Additional Single Premium Application for Trustee and Corporate Trustees	This guide has been designed to assist you with completing the additional single premium application form.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation	FOS	Making a change to your policy, New Policy	This guide has been designed to assist you with completing the additional single premium application form. Operational Forms Guide to Completing the Delegation Additional Single Premium Application for Trustee and Corporate Trustees UPE PR 00129
Apex France – Dealing instruction	This form should be used to buy and/or sell External Assets linked to your Policy. It cannot be used to buy or sell assets held by a Discretionary Fund Manager or those held on a Platform.	France (FR)	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	This form should be used to buy and/or sell External Assets linked to your Policy. It cannot be used to buy or sell assets held by a Discretionary Fund Manager or those held on a Platform. Operational Forms Apex France – Dealing instruction UPE PR 00130
Apex France – Dealing account overdraft clearance instruction form	This form can be used to request an overdraft clearance for your Apex France Dealing Account.	France (FR)	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	This form can be used to request an overdraft clearance for your Apex France Dealing Account. Operational Forms Apex France – Dealing account overdraft clearance instruction form UPE PR 00141
PWP Portugal Declaração Relativa de Saúde	Operational Forms PWP Portugal Declaração Relativa de Saúde UPE PR 00142	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		New Policy	Operational Forms PWP Portugal Declaração Relativa de Saúde UPE PR 00142
PWP España Declaración de Salud	Operational Forms PWP España Declaración de Salud UPE PR 00143	Spain (ES)	Utmost PanEurope	Spanish (ES)	Private Wealth Portfolio - Spain		New Policy	Operational Forms PWP España Declaración de Salud UPE PR 00143
Delegation DGT Discretionary Trust Deed	This Trust Deed is to be used to convert an existing Delegation bond into a Discounted Gift Trust.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation	FOS	Making a change to your policy	This Trust Deed is to be used to convert an existing Delegation bond into a Discounted Gift Trust. Operational Forms Delegation DGT Discretionary Trust Deed UPE PR 00092
Dichiarazione di Buono Stato di Salute	Dichiarazione dell’Assicurato, quale Proponente e futuro Contraente della polizza, di godere di buona salute psico-fisica e di non essere affetto da alcuna malattia terminale o implicante pericolo di vita.	Italy (IT)	Utmost PanEurope	Italian (IT)	Private Wealth Portfolio - Italy		New Policy	Dichiarazione dell’Assicurato, quale Proponente e futuro Contraente della polizza, di godere di buona salute psico-fisica e di non essere affetto da alcuna malattia terminale o implicante pericolo di vita. Operational Forms Dichiarazione di Buono Stato di Salute UPE PR 00117
Delegation DGT Absolute Trust Deed	This Trust Deed is to be used to convert an existing Delegation bond into a Discounted Gift Trust.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation	FOS	Making a change to your policy	This Trust Deed is to be used to convert an existing Delegation bond into a Discounted Gift Trust. Operational Forms Delegation DGT Absolute Trust Deed UPE PR 00091
PWP Portugal Formulário para solicitação de partilha de informação	PWP Portugal Direct Sharing of Information Request Form.	Portugal (PT)	Utmost PanEurope	Portuguese (PT)	Private Wealth Portfolio - Portugal		New Policy	PWP Portugal Direct Sharing of Information Request Form. Operational Forms PWP Portugal Formulário para solicitação de partilha de informação UPE PR 00037
Wijziging van de voornaamste kenmerken van een bestaand Intern Toegewezen Fonds	Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank Operational Forms Wijziging van de voornaamste kenmerken van een bestaand Intern Toegewezen Fonds ULU PCON1557
Olemassa olevan Sisäisen kohdistetun rahaston tärkeimpien ominaisuuksien muutos / Change of the main characteristics of an existing Internal Dedicated Fund	Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Non Product Specific	FOS		Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank Operational Forms Olemassa olevan Sisäisen kohdistetun rahaston tärkeimpien ominaisuuksien muutos / Change of the main characteristics of an existing Internal Dedicated Fund ULU PCON1558
Ändring av huvudsakliga egenskaper för en existerande Intern Dedikerad Fond / Change of the main characteristics of an existing Internal Dedicated Fund	Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank	Sweden (SE)	Utmost Luxembourg S.A	English (EN), Swedish (SV)	Non Product Specific	FOS		Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank Operational Forms Ändring av huvudsakliga egenskaper för en existerande Intern Dedikerad Fond / Change of the main characteristics of an existing Internal Dedicated Fund ULU PCON1559
Wechsel des Vermittlers	Use this form to request a change of Intermediary – Germany	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		Use this form to request a change of Intermediary – Germany Operational Forms Wechsel des Vermittlers ULU PCON1533
Request for Change of Investment Manager and Investment Strategy	Use this form to request a change of Investment Manager and Investment Strategy – Turkey	Turkey (TR)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request a change of Investment Manager and Investment Strategy – Turkey Operational Forms Request for Change of Investment Manager and Investment Strategy ULU PCON1553
Modification des caractéristiques principales d’un Fonds Interne Dédié existant	Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank Operational Forms Modification des caractéristiques principales d’un Fonds Interne Dédié existant ULU PCON1556
Switch Authorisation	Use this form to authorise the Insurer to perform switches of investments on your policy/contract – Sweden	Sweden (SE)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to authorise the Insurer to perform switches of investments on your policy/contract – Sweden Operational Forms Switch Authorisation ULU PCON1562
Edunsaajamääräyksen Muutoslomake / Change of Beneficiary Nomination	Use this form to request a change of Beneficiary – Finland	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Non Product Specific	FOS		Use this form to request a change of Beneficiary – Finland Operational Forms Edunsaajamääräyksen Muutoslomake / Change of Beneficiary Nomination ULU PCON1479
Lisähenkivakuutettu – Vakuutuksenottajan Pyyntö / Additional Life Assured – Policyholder’s Request	Annex to add additional Life Assureds to the contract/policy	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Non Product Specific	FOS		Annex to add additional Life Assureds to the contract/policy Operational Forms Lisähenkivakuutettu – Vakuutuksenottajan Pyyntö / Additional Life Assured – Policyholder’s Request ULU PCON1480
Declaration as to Loss of Polivy Schedule	Form to be used to declare the loss of policy documents – Turkey	Turkey (TR)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Form to be used to declare the loss of policy documents – Turkey Operational Forms Declaration as to Loss of Polivy Schedule ULU PCON1485
Request for Change of Investment Manager – Norwegian Market	Use this form to request a change of investment manager and Investment Strategy – Norway	Norway (NO)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request a change of investment manager and Investment Strategy – Norway Operational Forms Request for Change of Investment Manager – Norwegian Market ULU PCON1389
Désignation d’Intermédiaire	Use this form to request an appointment or change of broker	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to request an appointment or change of broker Operational Forms Désignation d’Intermédiaire ULU PCON1323
Request for Change of Custodian Bank	Use this form to request a change of Custodian Bank – Turkey	Turkey (TR)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request a change of Custodian Bank – Turkey Operational Forms Request for Change of Custodian Bank ULU PCON1346
Appointment of Broker	Use this form to request a change of Broker – Turkey	Turkey (TR)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request a change of Broker – Turkey Operational Forms Appointment of Broker ULU PCON1375
Wechsel des Versicherungsnehmers einer bestehenden Police	Use this form to request a change of policyholder on an existing policy/contract – Germany	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		Use this form to request a change of policyholder on an existing policy/contract – Germany Operational Forms Wechsel des Versicherungsnehmers einer bestehenden Police ULU PCON1299
Änderung der Laufzeit für bestehende Policen	Use this form to request a change of term to your policy/contract – Germany	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		Use this form to request a change of term to your policy/contract – Germany Operational Forms Änderung der Laufzeit für bestehende Policen ULU PCON1300
Übernahme einder bestehenden Police bei Ableben des Versicherungsnehmers	Use this form to request a transfer of your policy/contract to another policyholder – Germany	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		Use this form to request a transfer of your policy/contract to another policyholder – Germany Operational Forms Übernahme einder bestehenden Police bei Ableben des Versicherungsnehmers ULU PCON1301
Atto di Variazione del Fondo Interno Dedicato	Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOE FOS		Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank Operational Forms Atto di Variazione del Fondo Interno Dedicato ULU PCON1310
Richiesta di Modifica della Maggiorazione in caso di Decesso	Use this form to request a change of life cover – Italy (Branch)	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOE FOS		Use this form to request a change of life cover – Italy (Branch) Operational Forms Richiesta di Modifica della Maggiorazione in caso di Decesso ULU PCON1317
Aanstelling van Tussenpersoon	Use this form to request an appointment or change of broker	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		Use this form to request an appointment or change of broker Operational Forms Aanstelling van Tussenpersoon ULU PCON1322
Richiesta Cambio Intermediario	Use this form to request a change of Intermediary – Italy	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOE FOS		Use this form to request a change of Intermediary – Italy Operational Forms Richiesta Cambio Intermediario ULU PCON1243
Dichiarazione di Smarrimento	Form to be used to declare the loss of policy documents – Italy	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOE FOS		Form to be used to declare the loss of policy documents – Italy Operational Forms Dichiarazione di Smarrimento ULU PCON1244
Richiesta Cambio Contraente Persona Fisica	Use this form to request a change of Policyholder – Physical Person – Italy	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOE FOS		Use this form to request a change of Policyholder – Physical Person – Italy Operational Forms Richiesta Cambio Contraente Persona Fisica ULU PCON1245
Richiesta Cambio Contraente Persona Giuridica	Use this form to request a change of Policyholder – Corporate Entity – Italy	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOE FOS		Use this form to request a change of Policyholder – Corporate Entity – Italy Operational Forms Richiesta Cambio Contraente Persona Giuridica ULU PCON1246
Request for Change of Investment Manager to the Policyholder as Investment Manager	Use this form to request a change of Investment Manager to Policyholder as Investment Manager – Sweden	Sweden (SE)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request a change of Investment Manager to Policyholder as Investment Manager – Sweden Operational Forms Request for Change of Investment Manager to the Policyholder as Investment Manager ULU PCON1250
Request for Change of Investment Manager to the Policyholder as Investment Manager	Use this form to request a change of Investment Manager to Policyholder as Investment Manager – Finland	Finland (FI)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request a change of Investment Manager to Policyholder as Investment Manager – Finland Operational Forms Request for Change of Investment Manager to the Policyholder as Investment Manager ULU PCON1251
Request for Change of Investment Manager to the Policyholder as Investment Manager	Use this form to request a change of Investment Manager to Policyholder as Investment Manager – Norway	Norway (NO)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request a change of Investment Manager to Policyholder as Investment Manager – Norway Operational Forms Request for Change of Investment Manager to the Policyholder as Investment Manager ULU PCON1252
Bouppteckningsintyg	Use this form to initiate a death claim – Sweden	Sweden (SE)	Utmost Luxembourg S.A	Swedish (SV)	Non Product Specific	FOS		Use this form to initiate a death claim – Sweden Operational Forms Bouppteckningsintyg ULU PCON1253
Wechsel der Anlagestrategie (Fondsauswahl + Vermögensverwaltung)	Use this form to request a change of Investment Strategy (Fund Picking) – Germany	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		Use this form to request a change of Investment Strategy (Fund Picking) – Germany Operational Forms Wechsel der Anlagestrategie (Fondsauswahl + Vermögensverwaltung) ULU PCON1262
Richiesta Cambio Beneficiario	Use this form to request a change of Beneficiary – Italy	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOE FOS		Use this form to request a change of Beneficiary – Italy Operational Forms Richiesta Cambio Beneficiario ULU PCON1213
Request for Change of Investment Strategy	Use this form to request a change of Investment Strategy – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request a change of Investment Strategy – United Kingdom Operational Forms Request for Change of Investment Strategy ULU PCON1214
Requerimento Para Alteração Do Gestor De Investimento / Request for Change of Investment Manager	Use this form to request a change of Investment Manager – Portugal	Portugal (PT)	Utmost Luxembourg S.A	English (EN), Portuguese (PT)	Non Product Specific	FOS		Use this form to request a change of Investment Manager – Portugal Operational Forms Requerimento Para Alteração Do Gestor De Investimento / Request for Change of Investment Manager ULU PCON1193
Request for Change of Custodian Bank	Use this form to request a change of Custodian Bank	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request a change of Custodian Bank Operational Forms Request for Change of Custodian Bank ULU PCON1057
Formulaire Changement de Banque Dépositaire	Use this form to request a change of Custodian Bank	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to request a change of Custodian Bank Operational Forms Formulaire Changement de Banque Dépositaire ULU PCON1060
Demande de Changement de Gestionnaire et Stratégie d’Investissement	Use this form to request a change of Investment Manager and Investment Strategy – France	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to request a change of Investment Manager and Investment Strategy – France Operational Forms Demande de Changement de Gestionnaire et Stratégie d’Investissement ULU PCON1069
Request for Change of Investment manager	Use this form to request a change of Investment Manager – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request a change of Investment Manager – United Kingdom Operational Forms Request for Change of Investment manager ULU PCON1072
Declaration as to Loss of Policy Schedule	Form to be used to declare the loss of policy documents – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Form to be used to declare the loss of policy documents – United Kingdom Operational Forms Declaration as to Loss of Policy Schedule ULU PCON1042
Kuolintapaus / Death Claim	Use this form to initiate a death claim – Finland	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Non Product Specific	FOS	Surrender or Claim	Use this form to initiate a death claim – Finland Operational Forms Kuolintapaus / Death Claim ULU PCON1006
Automaattinen Tietojenvaihto – Itsesertifiointi / Automatic Exchange of Information – Self-Certification	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.	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Private Client Portfolio	FOS		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 Automaattinen Tietojenvaihto – Itsesertifiointi / Automatic Exchange of Information – Self-Certification ULU CONT4693
Självcertifiering / Self-Certification (FATCA)	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.	Sweden (SE)	Utmost Luxembourg S.A	English (EN), Swedish (SV)	Non Product Specific	FOS		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 Självcertifiering / Self-Certification (FATCA) ULU CONT4806
Itse sertifiointi / Self-Certification	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.	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Private Client Portfolio	FOS		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 Itse sertifiointi / Self-Certification ULU CONT4807
Nouvelle Unité de Compte constituée par un Fonds Interne Dédié	Annex to add additional Internal Dedicated Funds to the contract/policy	France (FR)	Utmost Luxembourg S.A	French (FR)	Private Client Portfolio	FOS	New Policy	Annex to add additional Internal Dedicated Funds to the contract/policy Operational Forms Nouvelle Unité de Compte constituée par un Fonds Interne Dédié ULU CONT4854
Nouvelle Unité de Compte constituée par un Fonds d’Assurance Spécialisé	Annex to add additional Specialised Assurance Funds to the contract/policy	France (FR)	Utmost Luxembourg S.A	French (FR)	Private Client Portfolio	FOS	New Policy	Annex to add additional Specialised Assurance Funds to the contract/policy Operational Forms Nouvelle Unité de Compte constituée par un Fonds d’Assurance Spécialisé ULU CONT4860
Mandat de réception d’instructions pour un Fonds d’Assurance Spécialisé	Power of Attorney for the reception of the instructions for the Specialised Assurance Fund – France	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS	New Policy	Power of Attorney for the reception of the instructions for the Specialised Assurance Fund – France Operational Forms Mandat de réception d’instructions pour un Fonds d’Assurance Spécialisé ULU CONT4874
Mandat de vérification d’instructions et de réception/ transmission d’ordres pour le Fonds d’Assurance Spécialisé	Power of Attorney for the verification of the instructions for the Specialised Assurance Fund – France	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS	New Policy	Power of Attorney for the verification of the instructions for the Specialised Assurance Fund – France Operational Forms Mandat de vérification d’instructions et de réception/ transmission d’ordres pour le Fonds d’Assurance Spécialisé ULU CONT4875
Regolamento del Fondo Interno Dedicato	Rules for Internal Dedicated Fund – Italy	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOS	New Policy	Rules for Internal Dedicated Fund – Italy Operational Forms Regolamento del Fondo Interno Dedicato ULU CONT4585
Power of Attorney / Procuration – Luxembourg Capitalisation Bond	Power of Attorney for the Investment Advisor – Luxembourg – Capitalisation Bond	Luxembourg (LU)	Utmost Luxembourg S.A	English (EN), French (FR)	Non Product Specific	FOS		Power of Attorney for the Investment Advisor – Luxembourg – Capitalisation Bond Operational Forms Power of Attorney / Procuration – Luxembourg Capitalisation Bond ULU CONT4549
Automatiskt Utbyte av Information Självcertifieringsformulär / Automatic Exchange of Information Self-Certification	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.	Sweden (SE)	Utmost Luxembourg S.A	English (EN), Swedish (SV)	Private Client Portfolio	FOS		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 Automatiskt Utbyte av Information Självcertifieringsformulär / Automatic Exchange of Information Self-Certification ULU CONT4691
Automatisert Utveksling av Informasjon Egenerklæringsskjema / Automatic Exchange of Information Self-Certification	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.	Norway (NO)	Utmost Luxembourg S.A	English (EN), Norwegian (NO)	Non Product Specific	FOS		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 Automatisert Utveksling av Informasjon Egenerklæringsskjema / Automatic Exchange of Information Self-Certification ULU CONT4692
Automaattinen Tietojenvaihto – Kontrollovia Henkilöitä Koskeva Todistuslomake	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.	Finland (FI)	Utmost Luxembourg S.A	Finnish (FI)	Non Product Specific	FOS		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 Automaattinen Tietojenvaihto – Kontrollovia Henkilöitä Koskeva Todistuslomake ULU CONT4267
Automatisert Utveksling av Informasjon – Egenerklæringsskjema for kontrollende personer	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.	Norway (NO)	Utmost Luxembourg S.A	English (EN), Norwegian (NO)	Non Product Specific	FOS		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 Automatisert Utveksling av Informasjon – Egenerklæringsskjema for kontrollende personer ULU CONT4268
Echange Automatique de Renseignements Formulaire d’Autocertification	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.	France (FR)	Utmost Luxembourg S.A	French (FR)	Liberté, Liberté Capitalisation	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 ULU CONT4271
Automaattinen Tietojenvaihto – Yksiköitä Koskeva Todistuslomake	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.	Finland (FI)	Utmost Luxembourg S.A	Finnish (FI)	Private Client Portfolio	FOS		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 Automaattinen Tietojenvaihto – Yksiköitä Koskeva Todistuslomake ULU CONT4255
Automatisert Utveksling av Informasjon Egenerklæringsskjema / Automatic Exchange of Information Self-Certification	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.	Norway (NO)	Utmost Luxembourg S.A	English (EN), Norwegian (NO)	Non Product Specific	FOS		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 Automatisert Utveksling av Informasjon Egenerklæringsskjema / Automatic Exchange of Information Self-Certification ULU CONT4256
Echange Automatique de Renseignements Formulaire d’Autocertification	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.	France (FR)	Utmost Luxembourg S.A	French (FR)	Liberté, Liberté Capitalisation	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 ULU CONT4259
Scambio Automatico di Informazioni – Modulo di Autocertificazione per persone che esercitano il controllo (FOS)	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.	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOS		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 Scambio Automatico di Informazioni – Modulo di Autocertificazione per persone che esercitano il controllo (FOS) ULU CONT4260
Intercambio Automático de Información – Formulario de Declaración para personas de control	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.	Mexico (MX), Peru (PE), Spain (ES)	Utmost Luxembourg S.A	Spanish (ES)	Non Product Specific	FOS		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 Intercambio Automático de Información – Formulario de Declaración para personas de control ULU CONT4261
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes détenant le contrôle	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.	Belgium (BE), Luxembourg (LU)	Utmost Luxembourg S.A	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
Automatischer Austausch von Informationen – Formular zur Selbstauskunft für beherrschende personen	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.	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		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 Automatischer Austausch von Informationen – Formular zur Selbstauskunft für beherrschende personen ULU CONT4263
Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor uiteindelijk belanghebbenden	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.	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		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 Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor uiteindelijk belanghebbenden ULU CONT4264
Troca Automática de Informações – Formulário de Autocertificação para pessoas que exercem o controlo	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.	Portugal (PT)	Utmost Luxembourg S.A	Portuguese (PT)	Non Product Specific	FOS		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 Troca Automática de Informações – Formulário de Autocertificação para pessoas que exercem o controlo ULU CONT4265
Automatiskt Utbyte av Information Självcertifieringsformulär för Person med bestämmande inflytande / Automatic Exchange of Information Self-Certification for Controlling Persons	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.	Sweden (SE)	Utmost Luxembourg S.A	English (EN), Swedish (SV)	Private Client Portfolio	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 Automatiskt Utbyte av Information Självcertifieringsformulär för Person med bestämmande inflytande / Automatic Exchange of Information Self-Certification for Controlling Persons ULU CONT4266
Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor natuurlijke personen	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.	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		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 Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor natuurlijke personen ULU CONT4243
Troca Automática de Informações – Formulário de Autocertificação para pessoas singulares	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.	Portugal (PT)	Utmost Luxembourg S.A	Portuguese (PT)	Non Product Specific	FOS		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 Troca Automática de Informações – Formulário de Autocertificação para pessoas singulares ULU CONT4244
Echange Automatique de Renseignements Formulaire d’Autocertification	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.	France (FR)	Utmost Luxembourg S.A	French (FR)	Liberté, Liberté Capitalisation	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 individual policyholders. Operational Forms Echange Automatique de Renseignements Formulaire d’Autocertification ULU CONT4247
Scambio Automatico di Informazioni – Modulo di Autocertificazione per persone giuridiche (FOS)	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.	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOS		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 Scambio Automatico di Informazioni – Modulo di Autocertificazione per persone giuridiche (FOS) ULU CONT4248
Intercambio Automático de Información – Formulario de Declaración para entidades	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.	Mexico (MX), Peru (PE), Spain (ES)	Utmost Luxembourg S.A	Spanish (ES)	Non Product Specific	FOS		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 Intercambio Automático de Información – Formulario de Declaración para entidades ULU CONT4249
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les entités	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.	Belgium (BE), Luxembourg (LU)	Utmost Luxembourg S.A	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
Automatischer Austausch von Informationen – Formular zur Selbstauskunft für rechtsträger	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.	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		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 Automatischer Austausch von Informationen – Formular zur Selbstauskunft für rechtsträger ULU CONT4251
Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor entiteiten	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.	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		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 Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor entiteiten ULU CONT4252
Troca Automática de Informações – Formulário de Autocertificação para entidades	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.	Portugal (PT)	Utmost Luxembourg S.A	Portuguese (PT)	Non Product Specific	FOS		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 Troca Automática de Informações – Formulário de Autocertificação para entidades ULU CONT4253
Automatiskt Utbyte av Information Självcertifieringsformulär för Enheter / Automatic Exchange of Information Self-Certification for Entities	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.	Sweden (SE)	Utmost Luxembourg S.A	English (EN), Swedish (SV)	Private Client Portfolio	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 Automatiskt Utbyte av Information Självcertifieringsformulär för Enheter / Automatic Exchange of Information Self-Certification for Entities ULU CONT4254
Déclaration des associés d’une société civile en tant que Preneur d’Assurance	Declaration of the partners of a civil partnership as policyholder	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Select Client Plan	FOS	New Policy	Declaration of the partners of a civil partnership as policyholder Operational Forms Déclaration des associés d’une société civile en tant que Preneur d’Assurance ULU CONT4191
Verklaring van de maten van een burgerlijke maatschap als Verzekeringnemer	Declaration of the partners of a civil partnership as policyholder	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Select Client Plan	FOS	New Policy	Declaration of the partners of a civil partnership as policyholder Operational Forms Verklaring van de maten van een burgerlijke maatschap als Verzekeringnemer ULU CONT4192
Scambio Automatico di Informazioni – Modulo di Autocertificazione per persone fisiche (FOS)	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.	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOS		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 Scambio Automatico di Informazioni – Modulo di Autocertificazione per persone fisiche (FOS) ULU CONT4239
Intercambio Automático de Información – Formulario de Declaración para personas físicas	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.	Mexico (MX), Peru (PE), Spain (ES)	Utmost Luxembourg S.A	Spanish (ES)	Non Product Specific	FOS		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 Intercambio Automático de Información – Formulario de Declaración para personas físicas ULU CONT4240
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes physiques	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.	Belgium (BE), Luxembourg (LU)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		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
Automatischer Austausch von Informationen – Formular zur Selbstauskunft Für Natürliche Personen	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.	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		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 Automatischer Austausch von Informationen – Formular zur Selbstauskunft Für Natürliche Personen ULU CONT4242
Bare Trust – Private Client Portfolio	Bare Trust form for the Private Client Portfolio product – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Private Client Portfolio	FOS	New Policy	Bare Trust form for the Private Client Portfolio product – United Kingdom Operational Forms Bare Trust – Private Client Portfolio ULU CONT4039
Avenant au contrat d’assurance-vie	“Prise de date” annex to the Liberté product – France	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS	New Policy	“Prise de date” annex to the Liberté product – France Operational Forms Avenant au contrat d’assurance-vie ULU CONT3909
Avenant au contrat de capitalisation	“Prise de date” annex to the Liberté Capitalisation product – France	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS	New Policy	“Prise de date” annex to the Liberté Capitalisation product – France Operational Forms Avenant au contrat de capitalisation ULU CONT3910
Unité de Compte du Contrat constituée par un Fonds Interne Dédié lié à plusieurs Contrats	Annex to add additional Internal Dedicated Funds to a multi-contract/policy on the Liberté product – France	France (FR)	Utmost Luxembourg S.A	French (FR)	Liberté	FOS	Addition to your Policy	Annex to add additional Internal Dedicated Funds to a multi-contract/policy on the Liberté product – France Operational Forms Unité de Compte du Contrat constituée par un Fonds Interne Dédié lié à plusieurs Contrats ULU CONT3769
Unité de Compte du Contrat constituée par un Fonds Interne Dédié lié à plusieurs Contrats	Annex to add additional Internal Dedicated Funds to a multi-contract/policy on the Liberté Capitalisation product – France	France (FR)	Utmost Luxembourg S.A	French (FR)	Liberté Capitalisation	FOS	Addition to your Policy	Annex to add additional Internal Dedicated Funds to a multi-contract/policy on the Liberté Capitalisation product – France Operational Forms Unité de Compte du Contrat constituée par un Fonds Interne Dédié lié à plusieurs Contrats ULU CONT3775
Select Client Plan – Caractéristiques principales du (family shared) Fonds interne dédié	Annex to add additional Family Shared Internal Dedicated Funds to the contract/policy	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Select Client Plan	FOS	New Policy	Annex to add additional Family Shared Internal Dedicated Funds to the contract/policy Operational Forms Select Client Plan – Caractéristiques principales du (family shared) Fonds interne dédié ULU CONT3788
Select Client Plan – Voornaamste kenmerken van het (family shared) Intern Toegewezen Fonds	Annex to add additional Family Shared Internal Dedicated Funds to the contract/policy	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Select Client Plan	FOS	New Policy	Annex to add additional Family Shared Internal Dedicated Funds to the contract/policy Operational Forms Select Client Plan – Voornaamste kenmerken van het (family shared) Intern Toegewezen Fonds ULU CONT3789
Select Client Plan (Multi-Support) – Bijkomend Intern Toegewezen Fonds	Annex to add additional Internal Dedicated Funds to the contract/policy	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Select Client Plan	FOS	New Policy	Annex to add additional Internal Dedicated Funds to the contract/policy Operational Forms Select Client Plan (Multi-Support) – Bijkomend Intern Toegewezen Fonds ULU CONT3632
Select Client Plan (Multi-Support) – Fonds Interne Dédié additionnel	Annex to add additional Internal Dedicated Funds to the contract/policy	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Select Client Plan	FOS	New Policy	Annex to add additional Internal Dedicated Funds to the contract/policy Operational Forms Select Client Plan (Multi-Support) – Fonds Interne Dédié additionnel ULU CONT3633
Uusi Erityisvakuutusrahasto / New Specialised Assurance Fund	Annex to add additional Specialised Assurance Funds to the contract/policy	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Private Client Portfolio	FOS	New Policy	Annex to add additional Specialised Assurance Funds to the contract/policy Operational Forms Uusi Erityisvakuutusrahasto / New Specialised Assurance Fund ULU CONT3476
Capitalisation Bond – Liite: Sisäisten yhteisrahastojen luettelo / Appendix: list of available Internal Collective Funds	List of available Internal Collective Funds for the Private Client Portfolio product – Finland	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Non Product Specific	FOS		List of available Internal Collective Funds for the Private Client Portfolio product – Finland Operational Forms Capitalisation Bond – Liite: Sisäisten yhteisrahastojen luettelo / Appendix: list of available Internal Collective Funds ULU CONT3555
Solicitação de Estatuto de Cliente Profissional / Request for Professional Client Status	Request for Professional Client Status	Portugal (PT)	Utmost Luxembourg S.A	English (EN), Portuguese (PT)	Non Product Specific	FOS		Request for Professional Client Status Operational Forms Solicitação de Estatuto de Cliente Profissional / Request for Professional Client Status ULU CONT3570
Vaatimus Asiakasluokan alentamisesta – Demand for Client Category Downgrade	Use this form to request a downgrade of your investment category	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Non Product Specific	FOS		Use this form to request a downgrade of your investment category Operational Forms Vaatimus Asiakasluokan alentamisesta – Demand for Client Category Downgrade ULU CONT3454
Pyyntö Asiakasluokan korottamisesta / Request for Client Category Upgrade	Use this form to request a upgrade of your investment category	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Non Product Specific	FOS		Use this form to request a upgrade of your investment category Operational Forms Pyyntö Asiakasluokan korottamisesta / Request for Client Category Upgrade ULU CONT3455
Change of Client Information	Use this form to request a change of Client information	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS	Making a change to your policy	Use this form to request a change of Client information Operational Forms Change of Client Information ULU CONT3473
Private Client Portfolio – Additional IDF / FID supplémentaire	Annex to add additional Internal Dedicated Funds to the contract/policy	Luxembourg (LU)	Utmost Luxembourg S.A	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
Private Client Portfolio – Additional SAF / FAS supplémentaire	Annex to add additional Specialised Assurance Funds to the contract/policy	Luxembourg (LU)	Utmost Luxembourg S.A	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
Power of Attorney / Procuration (Adviser)	Power of Attorney for the Investment Advisor – Luxembourg	Luxembourg (LU)	Utmost Luxembourg S.A	English (EN), French (FR)	Non Product Specific	FOS		Power of Attorney for the Investment Advisor – Luxembourg Operational Forms Power of Attorney / Procuration (Adviser) ULU CONT3198
Demande de Statut de Client Professionnel / Request for Professional Client Status	Request for Professional Client Status	Belgium (BE)	Utmost Luxembourg S.A	English (EN), French (FR)	Non Product Specific	FOS		Request for Professional Client Status Operational Forms Demande de Statut de Client Professionnel / Request for Professional Client Status ULU CONT3207
Aanvraag van het Statuut van Professionele Cliënt / Request for Professional Client Status	Request for Professional Client Status	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL), English (EN)	Non Product Specific	FOS		Request for Professional Client Status Operational Forms Aanvraag van het Statuut van Professionele Cliënt / Request for Professional Client Status ULU CONT3210
Beneficiary Nomination	Annex to the application form for beneficiary nomination	South Africa (ZA)	Utmost Luxembourg S.A	English (EN)	Private Client Portfolio	FOS	Making a change to your policy	Annex to the application form for beneficiary nomination Operational Forms Beneficiary Nomination ULU CONT3233
Choice Of Law	Use this form to perform a choice of law	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Choice Of Law ULU CONT3261
Costi amministrativi addizionali	Annex showing the activity-based charging grid	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOE FOS		Annex showing the activity-based charging grid Operational Forms Costi amministrativi addizionali ULU CONT3183
Overzicht van bijkomende administratieve vergoedingen	Annex showing the activity-based charging grid	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Overzicht van bijkomende administratieve vergoedingen ULU CONT3167
Aperçu des frais administratifs additionnels	Annex showing the activity-based charging grid	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Aperçu des frais administratifs additionnels ULU CONT3168
Détails des Frais de transaction	Annex showing the activity-based charging grid	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Détails des Frais de transaction ULU CONT3169
Schedule of Additional Administrative Charges	Annex showing the activity-based charging grid	Turkey (TR)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Schedule of Additional Administrative Charges ULU CONT3170
Listado de costes administrativos adicionales	Annex showing the activity-based charging grid	Spain (ES)	Utmost Luxembourg S.A	Spanish (ES)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Listado de costes administrativos adicionales ULU CONT3171
Schedule of Additional Administrative Charges	Annex showing the activity-based charging grid	Norway (NO)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Schedule of Additional Administrative Charges ULU CONT3177
Schedule of Additional Administrative Charges	Annex showing the activity-based charging grid	Sweden (SE)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Schedule of Additional Administrative Charges ULU CONT3178
Schedule of Additional Administrative Charges / Aperçu des frais administratifs additionnels	Annex showing the activity-based charging grid	Luxembourg (LU)	Utmost Luxembourg S.A	English (EN), French (FR)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Schedule of Additional Administrative Charges / Aperçu des frais administratifs additionnels ULU CONT3179
Tarifário de transações	Annex showing the activity-based charging grid	Portugal (PT)	Utmost Luxembourg S.A	Portuguese (PT)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Tarifário de transações ULU CONT3180
Schedule of Additional Administrative Charges	Annex showing the activity-based charging grid	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Schedule of Additional Administrative Charges ULU CONT3165
Einzelheiten zu Einmalgebühren für bestimmte Vorgänge	Annex showing the activity-based charging grid	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Einzelheiten zu Einmalgebühren für bestimmte Vorgänge ULU CONT3166
Mandat au titre de la lutte contre la déshérence (Multi-Support)	Annex for “Fight against Escheat” – France	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Annex for “Fight against Escheat” – France Operational Forms Mandat au titre de la lutte contre la déshérence (Multi-Support) ULU CONT2754
Declaration de statut de « Non-U.S. Person » (Multi-Support)	Use this form to declare a status of “Non-U.S. Person”	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Declaration de statut de « Non-U.S. Person » (Multi-Support) ULU CONT2755
Bijvoegsel bij de levensverzekeringsovereenkomst – Ontbinding van de overdracht van verzekeringsrechten	Annex to the application form for signing the dissolution of the transfer of insurance rights	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		Annex to the application form for signing the dissolution of the transfer of insurance rights Operational Forms Bijvoegsel bij de levensverzekeringsovereenkomst – Ontbinding van de overdracht van verzekeringsrechten ULU CONT2798
Avenant au contrat d’assurance-vie – Dissolution de cession de droits	Annex to the application form for signing the dissolution of the transfer of insurance rights	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Annex to the application form for signing the dissolution of the transfer of insurance rights Operational Forms Avenant au contrat d’assurance-vie – Dissolution de cession de droits ULU CONT2799
Bijvoegsel bij de levensverzekeringsovereenkomst – Aanvaarding van de begunstiging	Annex to the application form for beneficiary acceptance	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		Annex to the application form for beneficiary acceptance Operational Forms Bijvoegsel bij de levensverzekeringsovereenkomst – Aanvaarding van de begunstiging ULU CONT2802
Avenant au contrat d’assurance-vie – Acceptation du bénéfice	Annex to the application form for beneficiary acceptance	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Annex to the application form for beneficiary acceptance Operational Forms Avenant au contrat d’assurance-vie – Acceptation du bénéfice ULU CONT2803
Change Request to Fund Selection	Use this form to request a change to the Fund Selection – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Private Client Portfolio	FOS	Addition to your Policy, New Policy	Use this form to request a change to the Fund Selection – United Kingdom Operational Forms Change Request to Fund Selection ULU CONT2933
Intercambio Automático de Información – Formulario de Declaración para Fideicomisos	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 Trusts.	Mexico (MX), Spain (ES)	Utmost Luxembourg S.A	Spanish (ES)	Non Product Specific	FOS		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 Trusts. Operational Forms Intercambio Automático de Información – Formulario de Declaración para Fideicomisos ULU CONT2656
Addendum to Life Assurance Policy (PPB Addendum) – Discretionary Mandates	Addendum to the Personalised Portfolio Bond – Luxembourg	Luxembourg (LU), United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Addendum to the Personalised Portfolio Bond – Luxembourg Operational Forms Addendum to Life Assurance Policy (PPB Addendum) – Discretionary Mandates ULU CONT2688
Request for Change of Life Cover	Use this form to request a change of life cover	Finland (FI)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request a change of life cover Operational Forms Request for Change of Life Cover ULU CONT2732
Request for Professional Client Status	Request for Professional Client Status	Sweden (SE)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Request for Professional Client Status Operational Forms Request for Professional Client Status ULU CONT2733
Automatic Exchange of Information – Self-Certification for Controlling Persons	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.	ASIA, Belgium (BE), Cyprus (CY), Finland (FI), France (FR), Germany (DE), Gibraltar (GI), Israel (IL), Luxembourg (LU), Mexico (MX), Norway (NO), Portugal (PT), Spain (ES), Turkey (TR), United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		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
Benennung von Begünstigten für bestehende Policen	Use this form to nominate beneficiaries	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		Use this form to nominate beneficiaries Operational Forms Benennung von Begünstigten für bestehende Policen ULU CONT2623
?Benennung von unwiderruflichen Begünstigten für bestehende Policen	Use this form to nominate irrevocable beneficiaries	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		Use this form to nominate irrevocable beneficiaries Operational Forms ?Benennung von unwiderruflichen Begünstigten für bestehende Policen ULU CONT2624
Bijvoegsel bij de levensverzekeringsovereenkomst – Overeenkomst van Overdracht Post Mortem van de uit de Overeenkomst voortvloeiende rechten	Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy Operational Forms Bijvoegsel bij de levensverzekeringsovereenkomst – Overeenkomst van Overdracht Post Mortem van de uit de Overeenkomst voortvloeiende rechten ULU CONT2628
Avenant au contrat d’assurance-vie – Convention de Cession Post Mortem des droits découlant du Contrat	Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy Operational Forms Avenant au contrat d’assurance-vie – Convention de Cession Post Mortem des droits découlant du Contrat ULU CONT2629
Choix de la Loi Applicable / Choice of Law – Capitalisation Contract	Use this form to perform a choice of law	France (FR)	Utmost Luxembourg S.A	English (EN), French (FR)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Choix de la Loi Applicable / Choice of Law – Capitalisation Contract ULU CONT2602
Addendum to Life Assurance Policy (PPB Addendum)	Addendum to the Personalised Portfolio Bond – Portugal	Portugal (PT), United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Addendum to the Personalised Portfolio Bond – Portugal Operational Forms Addendum to Life Assurance Policy (PPB Addendum) ULU CONT2583
Automatic Exchange of Information – Self-Certification for Individuals	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.	ASIA, Belgium (BE), Cyprus (CY), Finland (FI), France (FR), Germany (DE), Gibraltar (GI), Israel (IL), Jersey (JE), Luxembourg (LU), Mexico (MX), Norway (NO), Portugal (PT), Spain (ES), Turkey (TR), United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		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
Automatic Exchange of Information – Self-Certification for Entities	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.	ASIA, Belgium (BE), Cyprus (CY), Finland (FI), France (FR), Germany (DE), Gibraltar (GI), Luxembourg (LU), Malta (MT), Mexico (MX), Norway (NO), Peru (PE), Portugal (PT), Spain (ES), Turkey (TR), United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		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
Choice of Law (Non-Residents)	Use this form to perform a choice of law	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Choice of Law (Non-Residents) ULU CONT2578
Addendum to Life Assurance Policy – Investment Enhancement	Addendum for Investment Enhancement for the Private Client Portfolio product – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Addendum for Investment Enhancement for the Private Client Portfolio product – United Kingdom Operational Forms Addendum to Life Assurance Policy – Investment Enhancement ULU CONT2371
Beneficiary Nomination	Use this form to nominate beneficiaries	Turkey (TR)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to nominate beneficiaries Operational Forms Beneficiary Nomination ULU CONT2378
Request for Enhanced Death Benefit	Use this form to request an enhanced death benefit – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request an enhanced death benefit – United Kingdom Operational Forms Request for Enhanced Death Benefit ULU CONT2381
Dichiarazione di Possesso della Qualifica di “Non-U.S. Person”	Use this form to declare a status of “Non-U.S. Person”	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOE FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Dichiarazione di Possesso della Qualifica di “Non-U.S. Person” ULU CONT2364
Dichiarazione di Scelta di Legge / Choice of Law (FOS)	Use this form to perform a choice of law	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Dichiarazione di Scelta di Legge / Choice of Law (FOS) ULU CONT2359
Lovvalg / Choice of Law	Use this form to perform a choice of law	Norway (NO)	Utmost Luxembourg S.A	English (EN), Norwegian (NO)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Lovvalg / Choice of Law ULU CONT2360
Loan Trust – Fixed Interest	Loan Trust agreement; Fixed Interest – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Loan Trust agreement; Fixed Interest – United Kingdom Operational Forms Loan Trust – Fixed Interest ULU CONT2205
Loan Trust – Discretionary	Discretionary Loan Trust Agreement – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Discretionary Loan Trust Agreement – United Kingdom Operational Forms Loan Trust – Discretionary ULU CONT2206
Loan Agreement	Loan agreement – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Loan agreement – United Kingdom Operational Forms Loan Agreement ULU CONT2207
Wealth Preservation Trust – Flexible Trust Deed	Flexibe Trust Deed form linked to the Wealth Preservation Trust product – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Flexibe Trust Deed form linked to the Wealth Preservation Trust product – United Kingdom Operational Forms Wealth Preservation Trust – Flexible Trust Deed ULU CONT2212
FATCA Autocertificazione (FOS)	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.	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOS		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 Autocertificazione (FOS) ULU CONT2170-7
FATCA Zelfcertificering	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.	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		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 Zelfcertificering ULU CONT2170-8
FATCA Egenklaering / Self Certification	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.	Norway (NO)	Utmost Luxembourg S.A	Norwegian (NO)	Non Product Specific	FOS		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 Egenklaering / Self Certification ULU CONT2170-9
FATCA Auto-Certification	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.	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		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 Auto-Certification ULU CONT2170
FATCA Autocertificação	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.	Portugal (PT)	Utmost Luxembourg S.A	Portuguese (PT)	Non Product Specific	FOS		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 Autocertificação ULU CONT2170-10
FATCA Auto-Certification	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.	France (FR)	Utmost Luxembourg S.A	French (FR)	Liberté, Liberté Capitalisation	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 FATCA Auto-Certification ULU CONT2170-2
FATCA Selbstzertifizierung	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.	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		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 Selbstzertifizierung ULU CONT2170-4
FATCA Self-Certification	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.	ASIA, Belgium (BE), France (FR), Germany (DE), Italy (IT), Luxembourg (LU), Mexico (MX), Portugal (PT), Spain (ES), Turkey (TR), United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		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
FATCA Autocertificación	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.	Mexico (MX), Spain (ES)	Utmost Luxembourg S.A	Spanish (ES)	Non Product Specific	FOS		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 Autocertificación ULU CONT2170-6
Addendum to Life Assurance Policy – Investment Enhancement	Addendum for Investment Enhancement for the Private Client Portfolio product – Sweden	Sweden (SE), United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Addendum for Investment Enhancement for the Private Client Portfolio product – Sweden Operational Forms Addendum to Life Assurance Policy – Investment Enhancement ULU CONT2061
Private Client Portfolio – Beneficiary Nomination Form	Annex to the application form for beneficiary nomination	Gibraltar (GI)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Annex to the application form for beneficiary nomination Operational Forms Private Client Portfolio – Beneficiary Nomination Form ULU CONT2073
Vakuutus ”Ei Yhdysvaltalainen Henkilö” Asemasta / Declaration of “Non-U.S. Person” Status	Use this form to declare a status of “Non-U.S. Person” for the Liberté Capitalisation product – France	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Non Product Specific	FOS		Use this form to declare a status of “Non-U.S. Person” for the Liberté Capitalisation product – France Operational Forms Vakuutus ”Ei Yhdysvaltalainen Henkilö” Asemasta / Declaration of “Non-U.S. Person” Status ULU CONT2039
Déclaration de Statut de « Non-U.S. Person »	Use this form to declare a status of “Non-U.S. Person”	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Déclaration de Statut de « Non-U.S. Person » ULU CONT2040
Declaration of “Non-U.S. Person” Status / Declaration de statut de « Non-U.S. Person »	Use this form to declare a status of “Non-U.S. Person”	Luxembourg (LU)	Utmost Luxembourg S.A	English (EN), French (FR)	Non Product Specific	FOS		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
Declaration of “Non-U.S. Person” Status / Declaration de statut de « Non-U.S. Person »	Use this form to declare a status of “Non-U.S. Person” for the Capitalisation Bond product – Luxembourg	Luxembourg (LU)	Utmost Luxembourg S.A	English (EN), French (FR)	Non Product Specific	FOS		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
Wealth Preservation Trust – Trust Deed	Trust Deed form linked to the Wealth Preservation Trust product – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Wealth Preservation Trust	FOS	New Policy	Trust Deed form linked to the Wealth Preservation Trust product – United Kingdom Operational Forms Wealth Preservation Trust – Trust Deed ULU CONT2009
Addendum to Life Assurance Policy – Personalised Portfolio Bond	Addendum to the Personalised Portfolio Bond – Sweden	Sweden (SE), United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Addendum to the Personalised Portfolio Bond – Sweden Operational Forms Addendum to Life Assurance Policy – Personalised Portfolio Bond ULU CONT1851
Désignation des Bénéficiaires	Use this form to nominate beneficiaries	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to nominate beneficiaries Operational Forms Désignation des Bénéficiaires ULU CONT1802
Benoeming van Begunstigden	Use this form to nominate beneficiaries	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		Use this form to nominate beneficiaries Operational Forms Benoeming van Begunstigden ULU CONT1803
Choix de la Loi Applicable / Choice of Law	Use this form to perform a choice of law	Belgium (BE)	Utmost Luxembourg S.A	English (EN), French (FR)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Choix de la Loi Applicable / Choice of Law ULU CONT1790
Keuze van de Toepasbare Wet / Choice of Law	Use this form to perform a choice of law	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL), English (EN)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Keuze van de Toepasbare Wet / Choice of Law ULU CONT1791
Lainvalinta / Choice of Law	Use this form to perform a choice of law	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Lainvalinta / Choice of Law ULU CONT1792
Deklaration om Val av Tillämplig Lag / Choice of Law	Use this form to perform a choice of law	Sweden (SE)	Utmost Luxembourg S.A	English (EN), Swedish (SV)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Deklaration om Val av Tillämplig Lag / Choice of Law ULU CONT1793
Choix de la Loi Applicable / Choice of Law	Use this form to perform a choice of law	France (FR)	Utmost Luxembourg S.A	English (EN), French (FR)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Choix de la Loi Applicable / Choice of Law ULU CONT1794
Elección de Ley Aplicable al Contrato / Choice of Law	Use this form to perform a choice of law	Spain (ES)	Utmost Luxembourg S.A	English (EN), Spanish (ES)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Elección de Ley Aplicable al Contrato / Choice of Law ULU CONT1796
Verklaring omtrent „Non-U.S. Person”-status	Use this form to declare a status of “Non-U.S. Person”	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Verklaring omtrent „Non-U.S. Person”-status ULU CONT1634
Declaración como « Persona no Estadounidense »	Use this form to declare a status of “Non-U.S. Person”	Spain (ES)	Utmost Luxembourg S.A	English (EN), Spanish (ES)	Non Product Specific	FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Declaración como « Persona no Estadounidense » ULU CONT1636
Deklaration om Status som ”Icke-Amerikansk Person” / Declaration of “Non-U.S. Person” Status	Use this form to declare a status of “Non-U.S. Person”	Sweden (SE)	Utmost Luxembourg S.A	English (EN), Swedish (SV)	Non Product Specific	FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Deklaration om Status som ”Icke-Amerikansk Person” / Declaration of “Non-U.S. Person” Status ULU CONT1637
Vakuutus ”Ei Yhdysvaltalainen Henkilö” Asemasta / Declaration of “Non-U.S. Person” Status	Use this form to declare a status of “Non-U.S. Person”	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Non Product Specific	FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Vakuutus ”Ei Yhdysvaltalainen Henkilö” Asemasta / Declaration of “Non-U.S. Person” Status ULU CONT1638
Déclaration de Statut de « Non-U.S. Person »	Use this form to declare a status of “Non-U.S. Person”	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Déclaration de Statut de « Non-U.S. Person » ULU CONT1632
Erklärung bezüglich des Status „Nicht-US -Person“	Use this form to declare a status of “Non-U.S. Person”	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Erklärung bezüglich des Status „Nicht-US -Person“ ULU CONT1633
Wealth Preservation Trust – Tax Notes	Tax notes linked to the Wealth Preservation Trust product – United Kingdom	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Wealth Preservation Trust	FOS	New Policy	Tax notes linked to the Wealth Preservation Trust product – United Kingdom Operational Forms Wealth Preservation Trust – Tax Notes ULU CONT1492
Utnevnelse av Forsikringstakeren til Investeringsforvalter / Appointment of the Policyholder as Investment Manager	Use this form to appoint an Investment Manager/Advisor – Norway	Norway (NO)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to appoint an Investment Manager/Advisor – Norway Operational Forms Utnevnelse av Forsikringstakeren til Investeringsforvalter / Appointment of the Policyholder as Investment Manager ULU CONT1452
Appointment of the Policyholder(s) as Investment Manager – Swedish Market	Use this form to appoint an Investment Manager/Advisor – Sweden	Sweden (SE)	Utmost Luxembourg S.A	English (EN), Swedish (SV)	Non Product Specific	FOS		Use this form to appoint an Investment Manager/Advisor – Sweden Operational Forms Appointment of the Policyholder(s) as Investment Manager – Swedish Market ULU CONT1452-2
Asiakirjojen sähköisessä allekirjoittamisessa käytettävien asiakkaan yhteystietojen vahvistaminen / Confirmation of Client contact details used for the Electronic Signing of documents	Confirmation of Client contact details used for the Electronic Signing of documents	Finland (FI)	Utmost Luxembourg S.A	English (EN), Finnish (FI)	Non Product Specific	FOS		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Asiakirjojen sähköisessä allekirjoittamisessa käytettävien asiakkaan yhteystietojen vahvistaminen / Confirmation of Client contact details used for the Electronic Signing of documents ULU CONNECT1054
Bekreftelse av kundens kontaktinformasjon brukt for elektronisk signering av dokumenter / Confirmation of Client contact details used for the Electronic Signing of documents	Confirmation of Client contact details used for the Electronic Signing of documents	Norway (NO)	Utmost Luxembourg S.A	English (EN), Norwegian (NO)	Non Product Specific	FOS		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Bekreftelse av kundens kontaktinformasjon brukt for elektronisk signering av dokumenter / Confirmation of Client contact details used for the Electronic Signing of documents ULU CONNECT1055
Confirmation of Client contact details used for the Electronic Signing of documents / Confirmation des coordonnées du Client utilisées pour la signature électronique des documents	Confirmation of Client contact details used for the Electronic Signing of documents	Luxembourg (LU)	Utmost Luxembourg S.A	English (EN), French (FR)	Non Product Specific	FOS		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
Confirmation des coordonnées du Client utilisées pour la signature électronique des documents	Confirmation of Client contact details used for the Electronic Signing of documents	France (FR)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Confirmation des coordonnées du Client utilisées pour la signature électronique des documents ULU CONNECT1057
Conferma dei dati di contatto del cliente utilizzati per la firma elettronica dei documenti	Confirmation of Client contact details used for the Electronic Signing of documents	Italy (IT)	Utmost Luxembourg S.A	Italian (IT)	Non Product Specific	FOE FOS		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Conferma dei dati di contatto del cliente utilizzati per la firma elettronica dei documenti ULU CONNECT1058
Request for Change of Life Cover	Change of Life Cover form	Sweden (SE)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Change of Life Cover form Operational Forms Request for Change of Life Cover ULU CONT1129
Change Request to Discretionary Mandate	Use this form to appoint an Investment Manager/Advisor	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to appoint an Investment Manager/Advisor Operational Forms Change Request to Discretionary Mandate ULU CONT1318
Private Client Portfolio – Discretionary Management Form – UK	Use this form to request the appointment of a discretionary Investment Manager	United Kingdom (UK)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Use this form to request the appointment of a discretionary Investment Manager Operational Forms Private Client Portfolio – Discretionary Management Form – UK ULU CONT1412
Confirmation des coordonnées du Client utilisées pour la signature électronique des documents	Confirmation of Client contact details used for the Electronic Signing of documents	Belgium (BE)	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOE FOS		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Confirmation des coordonnées du Client utilisées pour la signature électronique des documents ULU CONNECT1048
Bevestiging van contactgegevens van de Cliënt die worden gebruikt voor de elektronische ondertekening van documenten	Confirmation of Client contact details used for the Electronic Signing of documents	Belgium (BE)	Utmost Luxembourg S.A	Dutch (NL)	Non Product Specific	FOE FOS		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Bevestiging van contactgegevens van de Cliënt die worden gebruikt voor de elektronische ondertekening van documenten ULU CONNECT1049
Bestätigung der für die elektronische Unterzeichnung von Dokumenten verwendeten Kundenkontaktdaten	Confirmation of Client contact details used for the Electronic Signing of documents	Germany (DE)	Utmost Luxembourg S.A	German (DE)	Non Product Specific	FOS		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Bestätigung der für die elektronische Unterzeichnung von Dokumenten verwendeten Kundenkontaktdaten ULU CONNECT1050
Confirmación de los datos de contacto del cliente utilizados para la firma electrónica de documentos / Confirmation of Client contact details used for the Electronic Signing of documents	Confirmation of Client contact details used for the Electronic Signing of documents	Mexico (MX), Spain (ES)	Utmost Luxembourg S.A	English (EN), Spanish (ES)	Non Product Specific	FOS		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Confirmación de los datos de contacto del cliente utilizados para la firma electrónica de documentos / Confirmation of Client contact details used for the Electronic Signing of documents ULU CONNECT1051
Confirmação dos dados de contato do Cliente utilizados para a Assinatura Eletrónica de Documentos / Confirmation of Client contact details used for the Electronic Signing of documents	Confirmation of Client contact details used for the Electronic Signing of documents	Portugal (PT)	Utmost Luxembourg S.A	English (EN), Portuguese (PT)	Non Product Specific	FOS		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Confirmação dos dados de contato do Cliente utilizados para a Assinatura Eletrónica de Documentos / Confirmation of Client contact details used for the Electronic Signing of documents ULU CONNECT1052
Bekräftelse av de kontaktuppgifter till kunden som används för elektronisk signering av dokument / Confirmation of Client contact details used for the Electronic Signing of documents	Confirmation of Client contact details used for the Electronic Signing of documents	Sweden (SE)	Utmost Luxembourg S.A	English (EN), Swedish (SV)	Non Product Specific	FOS		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Bekräftelse av de kontaktuppgifter till kunden som används för elektronisk signering av dokument / Confirmation of Client contact details used for the Electronic Signing of documents ULU CONNECT1053
Policy Replacement Questionnaire and IFS-PR (English)	This Policy Replacement Questionnaire should be completed for all new applications. You only need to complete the IFS-PR if you have answered ‘yes’ or ‘Not yet decided’ in the Policy Replacement Questionnaire.	Hong Kong (HK)	Utmost International - IoM	English (EN)	Non Product Specific		New Policy	This Policy Replacement Questionnaire should be completed for all new applications. You only need to complete the IFS-PR if you have answered ‘yes’ or ‘Not yet decided’ in the Policy Replacement Questionnaire. Operational Forms Policy Replacement Questionnaire and IFS-PR (English) ULQ PR \| 21288
Policy Replacement Questionnaire and IFS-PR (Chinese)	Policy Replacement Questionnaire should be completed for all new application. You only need to complete the IFS-PR if you have answered ‘yes’ or ‘Not yet decided’ in the Policy Replacement Questionnaire.	Hong Kong (HK)	Utmost International - IoM	Chinese (Simplified) (ZH)	Non Product Specific		New Policy	Policy Replacement Questionnaire should be completed for all new application. You only need to complete the IFS-PR if you have answered ‘yes’ or ‘Not yet decided’ in the Policy Replacement Questionnaire. Operational Forms Policy Replacement Questionnaire and IFS-PR (Chinese) ULQ PR \| 21289
Request to Trustees for Loan Repayment and Acknowledgement of Receipt of Loan Payment	This document contains draft wording which the settlor can use to request the repayment of a loan from the trustees of a loan trust.It is for use with the settlor’s own legal advisers in relation to the Loan Trust, available with a Utmost International Bond.This document cannot be used to instruct Utmost International to make a surrender.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific		New Policy	This document contains draft wording which the settlor can use to request the repayment of a loan from the trustees of a loan trust.It is for use with the settlor’s own legal advisers in relation to the Loan Trust, available with a Utmost International Bond.This document cannot be used to instruct Utmost International to make a surrender. Operational Forms Request to Trustees for Loan Repayment and Acknowledgement of Receipt of Loan Payment ULQ PR \| 25158
Death Claim Form	This form can be used to notify us of the death of the policy holder on the Utmost International Isle of Man Life Insurance Portfolio, Silk Life Plan and Tailored Life Plan.	Middle East, Singapore (SG)	Utmost International - IoM	English (EN)	Silk Life Plan (Life Cover only), Silk Life Plan (Life Cover Plus)	FOS	Surrender or Claim	This form can be used to notify us of the death of the policy holder on the Utmost International Isle of Man Life Insurance Portfolio, Silk Life Plan and Tailored Life Plan. Operational Forms Death Claim Form ULQ PR \| 19714
Request to appoint a DAM (Singapore)	Request for Utmost International Isle of Man Limited to Appoint a Discretionary Asset Manager (On a Discretionary Basis) For use with the Executive Investment Account and Silk Life Plan only. For Singapore use only	Singapore (SG)	Utmost International - IoM	English (EN)	Executive Investment Account, Silk Life Plan (Life Cover only), Silk Life Plan (Life Cover Plus)		Making a change to your policy	Request for Utmost International Isle of Man Limited to Appoint a Discretionary Asset Manager (On a Discretionary Basis) For use with the Executive Investment Account and Silk Life Plan only. For Singapore use only Operational Forms Request to appoint a DAM (Singapore) ULQ PR \| 18474
Unit Linked Accounts Withdrawal/Closure/Maturity Form (English)	This form should only be used to request a partial, full surrender or maturity from the following Utmost International unit-linked products Managed Capital Account, Managed Savings Account, Managed Pension Account, Executive Wealthbuilder Account and European Capital Account.	Europe Expat, Hong Kong (HK), Middle East, Rest of the World, United Kingdom (UK)	Utmost International - IoM	English (EN)	Managed Capital Account	FOS	Surrender or Claim	This form should only be used to request a partial, full surrender or maturity from the following Utmost International unit-linked products Managed Capital Account, Managed Savings Account, Managed Pension Account, Executive Wealthbuilder Account and European Capital Account. Operational Forms Unit Linked Accounts Withdrawal/Closure/Maturity Form (English) ULQ PR \| 13694
Enhanced Trail Commission Singapore version	This document describes the terms on which Utmost International Isle of Man Limited (Utmost International) agrees to pay enhanced trail commission (‘ETC’) to the Intermediary.	Singapore (SG)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	This document describes the terms on which Utmost International Isle of Man Limited (Utmost International) agrees to pay enhanced trail commission (‘ETC’) to the Intermediary. Operational Forms Enhanced Trail Commission Singapore version ULQ PR \| 13055
Tax Declaration and Self-Certification for Trustee and Corporate Investors – Hong Kong (FATCA/CRS)	This form is to be used by Trustee and Corporate Trustee Investors, in the Hong Kong market only, to confirm their country of Tax Residence and related Tax Identification Numbers. Bilingual – Chinese/English	Hong Kong (HK)	Utmost International - IoM	Chinese (Traditional) (ZH), English (EN)	Non Product Specific	FOS	New Policy	This form is to be used by Trustee and Corporate Trustee Investors, in the Hong Kong market only, to confirm their country of Tax Residence and related Tax Identification Numbers. Bilingual – Chinese/English Operational Forms Tax Declaration and Self-Certification for Trustee and Corporate Investors – Hong Kong (FATCA/CRS) ULQ PR \| 13276
Tax Declaration and Self Certification for Individual Investors – Hong Kong (FATCA/CRS)	This form is to be used by Individual Investors, in the Hong Kong market only, to confirm their country of Tax Residence and related Tax Identification Numbers. Bilingual – Chinese/English	Hong Kong (HK)	Utmost International - IoM	Chinese (Traditional) (ZH), English (EN)	Non Product Specific	FOS	New Policy	This form is to be used by Individual Investors, in the Hong Kong market only, to confirm their country of Tax Residence and related Tax Identification Numbers. Bilingual – Chinese/English Operational Forms Tax Declaration and Self Certification for Individual Investors – Hong Kong (FATCA/CRS) ULQ PR \| 13273
Advisory Fee Authority – Unit-linked Plans	This form can be used if you wish to make arrangements to pay an advisory fee to an intermediary for advice provided in respect of your Utmost International Isle of Man account.	Singapore (SG)	Utmost International - IoM	English (EN)	Non Product Specific		Making a change to your policy	This form can be used if you wish to make arrangements to pay an advisory fee to an intermediary for advice provided in respect of your Utmost International Isle of Man account. Operational Forms Advisory Fee Authority – Unit-linked Plans ULQ PR \| 13326
Wealth Management Plan – Request to Change Tier Form (Bilingual)	Please complete this form if you want to request access to Tier 2 Assets under your Wealth Management Plan.For use in Hong Kong and the Wealth Management Plan only.	Hong Kong (HK)	Utmost International - IoM	Chinese (Traditional) (ZH), English (EN)	Wealth Portfolio – Life, Wealth Portfolio – Redemption		Making a change to your policy	Please complete this form if you want to request access to Tier 2 Assets under your Wealth Management Plan.For use in Hong Kong and the Wealth Management Plan only. Operational Forms Wealth Management Plan – Request to Change Tier Form (Bilingual) ULQ PR \| 11148
Deed of Assignment Singapore	Deed of assignment for one or more assignees. This deed should be used for Utmost International Isle of Man Singapore products only.	Singapore (SG)	Utmost International - IoM	English (EN)	Non Product Specific		Making a change to your policy	Deed of assignment for one or more assignees. This deed should be used for Utmost International Isle of Man Singapore products only. Operational Forms Deed of Assignment Singapore ULQ PR \| 11553
Skatteuppgifter och försäkran För individer (Tax Info and Self-Certification for Individual Investors) (FATCA/CRS)	Använd detta formulär för att bekräfta skattestatusen för enskilda sökande. Please use this form to confirm the tax status for individual applicants.	Sweden (SE)	Utmost International - IoM	English (EN), Swedish (SV)	Non Product Specific		New Policy	Använd detta formulär för att bekräfta skattestatusen för enskilda sökande. Please use this form to confirm the tax status for individual applicants. Operational Forms Skatteuppgifter och försäkran För individer (Tax Info and Self-Certification for Individual Investors) (FATCA/CRS) ULQ PR \| 12689
Skatteuppgifter och försäkran För enheter (Tax Info and Self-Certification for Entity Investors) (FATCA/CRS)	Vänligen använd det här formuläret för att bekräfta skattestatusen för förvaltare och företagssökande. Please use this form to confirm the tax status for Trustee and Corporate applicants.	Sweden (SE)	Utmost International - IoM	English (EN), Swedish (SV)	Non Product Specific		New Policy	Vänligen använd det här formuläret för att bekräfta skattestatusen för förvaltare och företagssökande. Please use this form to confirm the tax status for Trustee and Corporate applicants. Operational Forms Skatteuppgifter och försäkran För enheter (Tax Info and Self-Certification for Entity Investors) (FATCA/CRS) ULQ PR \| 12690
Affordability Declaration (Bilingual)	This document can be used by applicants over aged 60 – to declare the affordability of the relevant premium invested.	Hong Kong (HK)	Utmost International - IoM	Chinese (Simplified) (ZH), English (EN)	Non Product Specific		New Policy	This document can be used by applicants over aged 60 – to declare the affordability of the relevant premium invested. Operational Forms Affordability Declaration (Bilingual) ULQ PR \| 10967
Professional Investor Declaration for Individual Applicants	This is a Professional Investor Declaration for Investment in investment linked assurance scheme and non SFC authorised underlying asset choices for individual applicants.	Hong Kong (HK)	Utmost International - IoM	Chinese (Simplified) (ZH), English (EN)	Non Product Specific		New Policy	This is a Professional Investor Declaration for Investment in investment linked assurance scheme and non SFC authorised underlying asset choices for individual applicants. Operational Forms Professional Investor Declaration for Individual Applicants ULQ PR \| 10108
Professional Investor Declaration Corporate Partnership Applicants (Bilingual)	This is a Professional Investor Declaration for Investment in investment linked assurance scheme and non SFC authorised underlying asset choices for corporate partnership applicants.	Hong Kong (HK)	Utmost International - IoM	Chinese (Simplified) (ZH), English (EN)	Non Product Specific		New Policy	This is a Professional Investor Declaration for Investment in investment linked assurance scheme and non SFC authorised underlying asset choices for corporate partnership applicants. Operational Forms Professional Investor Declaration Corporate Partnership Applicants (Bilingual) ULQ PR \| 10109
Professional Investor Declaration Corporate Trust (ie trust corporation) Applicants	This is a Professional Investor Declaration for Investment in investment linked assurance scheme and non SFC authorised underlying asset choices for corporate trust (ie trust corporation) applicants.	Hong Kong (HK)	Utmost International - IoM	Chinese (Simplified) (ZH), English (EN)	Non Product Specific		New Policy	This is a Professional Investor Declaration for Investment in investment linked assurance scheme and non SFC authorised underlying asset choices for corporate trust (ie trust corporation) applicants. Operational Forms Professional Investor Declaration Corporate Trust (ie trust corporation) Applicants ULQ PR \| 10110
Supplementary Declaration and Application for SILK Life Plans	This is a supplementary declaration and application for Hong Kong and Singapore SILK Life plan clients. It can be used to declare that you accept the addition, amendments and corrections to your application.	Singapore (SG)	Utmost International - IoM	English (EN)	Silk Life Plan (Life Cover only)	FOS	New Policy	This is a supplementary declaration and application for Hong Kong and Singapore SILK Life plan clients. It can be used to declare that you accept the addition, amendments and corrections to your application. Operational Forms Supplementary Declaration and Application for SILK Life Plans ULQ PR \| 10225
Declaration form for Continued Insurability SILK Life Plan	This form should be used to declare continued insurability for the SILK Life Plan.	Singapore (SG)	Utmost International - IoM	English (EN)	Silk Life Plan (Life Cover only)		New Policy	This form should be used to declare continued insurability for the SILK Life Plan. Operational Forms Declaration form for Continued Insurability SILK Life Plan ULQ PR \| 10226
Telegraphic Transfer Details for Utmost International Isle of Man Limited	This document contains the telegraphic transfer details for transferring money to Utmost International Isle of Man Limited via Wealth Interactive.	Europe Expat, Hong Kong (HK), Middle East, Sweden (SE), United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	New Policy	This document contains the telegraphic transfer details for transferring money to Utmost International Isle of Man Limited via Wealth Interactive. Operational Forms Telegraphic Transfer Details for Utmost International Isle of Man Limited ULQ PR \| 09352
Letter of Authorisation- Silk Life Plan	This document can be used to authorise an individual or entity to make investment decisions and provide instructions to the Authorised Custodian in respect of your Utmost International Isle of Man Limited Silk Life Plan.	Singapore (SG)	Utmost International - IoM	English (EN)	Silk Life Plan (Life Cover only)		Making a change to your policy	This document can be used to authorise an individual or entity to make investment decisions and provide instructions to the Authorised Custodian in respect of your Utmost International Isle of Man Limited Silk Life Plan. Operational Forms Letter of Authorisation- Silk Life Plan ULQ PR \| 09556
Investment Account Application Form – Individual Investors	This form can only be used for top-ups as this product is closed to new business. Use this application for individual investors.Please note that you will also need to fill out the Tax Declaration and Self Certification document.	Singapore (SG)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	New Policy	This form can only be used for top-ups as this product is closed to new business. Use this application for individual investors.Please note that you will also need to fill out the Tax Declaration and Self Certification document. Operational Forms Investment Account Application Form – Individual Investors ULQ PR \| 09305
Appointment of a Lead Policyholder on the Flexible Investment Account	This form can be used to appoint a lead policyholder – for use with the Flexible Investment Account	Singapore (SG)	Utmost International - IoM	English (EN)	Non Product Specific		Making a change to your policy	This form can be used to appoint a lead policyholder – for use with the Flexible Investment Account Operational Forms Appointment of a Lead Policyholder on the Flexible Investment Account ULQ PR \| 08425
Wealth Interactive – Master User Registration Form for Existing Firms	Please use this form to appoint a master user to Wealth Interactive for adviser firms who already have terms of business with us.This form will allow us access to a nominated master user within your firm who can then grant access to other users (including other master users within your firm).	Hong Kong (HK), Middle East, Rest of the World, Singapore (SG), United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	New Policy	Please use this form to appoint a master user to Wealth Interactive for adviser firms who already have terms of business with us.This form will allow us access to a nominated master user within your firm who can then grant access to other users (including other master users within your firm). Operational Forms Wealth Interactive – Master User Registration Form for Existing Firms ULQ PR \| 08775
QROPS QNUPS SIPP Investment Adviser Appointment Authorisation Executive Investment Account	This form is to be used by the Trustees to appoint the Pension Member as an Investment Adviser on the Executive Investment Account.	Singapore (SG)	Utmost International - IoM	English (EN)	Executive Investment Account	FOS	Making a change to your policy	This form is to be used by the Trustees to appoint the Pension Member as an Investment Adviser on the Executive Investment Account. Operational Forms QROPS QNUPS SIPP Investment Adviser Appointment Authorisation Executive Investment Account ULQ PR \| 08940
Adding to Your Executive Wealthbuilder Account Form	Utmost International Isle of Man Limited top-up form. This document should be used by financial advisers, their staff or families (that have been offered the Executive Wealthbuilder Account special terms). This form can only be used for top-ups as this product is closed to new business.	Middle East	Utmost International - IoM	English (EN)	Legacy Product (Closed)	FOS	Addition to your Policy, Making a change to your policy	Utmost International Isle of Man Limited top-up form. This document should be used by financial advisers, their staff or families (that have been offered the Executive Wealthbuilder Account special terms). This form can only be used for top-ups as this product is closed to new business. Operational Forms Adding to Your Executive Wealthbuilder Account Form ULQ PR \| 08509
Underrättelse Om PantNotification of Pledge Form (Bilingual)	This notification of pledge form can be used for pension agreement for Executive Investment Bond – Sweden.It is bilingual – English and Swedish.	Sweden (SE)	Utmost International - IoM	English (EN), Swedish (SV)	Executive Investment Bond		Making a change to your policy	This notification of pledge form can be used for pension agreement for Executive Investment Bond – Sweden.It is bilingual – English and Swedish. Operational Forms Underrättelse Om PantNotification of Pledge Form (Bilingual) ULQ PR \| 07174
Utnämning Av InvesteringsrådgivareAppointment of Fund Adviser Form	This is an appointment of fund adviser form for Executive Investment Bond – Sweden.It is bilingual – English and Swedish.	Sweden (SE)	Utmost International - IoM	English (EN), Swedish (SV)	Executive Investment Bond	FOS	Making a change to your policy	This is an appointment of fund adviser form for Executive Investment Bond – Sweden.It is bilingual – English and Swedish. Operational Forms Utnämning Av InvesteringsrådgivareAppointment of Fund Adviser Form ULQ PR \| 07192
Beneficiary Nomination Request Form – for Accountholders Policyholders	This form can be used where the Accountholders wish to transfer the ownership of the Contract on the death of the Relevant Accountholder and this does not bring the Contract to an end;orFor use by both Individual and Corporate Accountholders. Where the Accountholders wish to transfer the ownership of the benefits on the death of the Relevant Life Assured and this brings the Contract to an end.	Hong Kong (HK), Middle East, United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific		New Policy	This form can be used where the Accountholders wish to transfer the ownership of the Contract on the death of the Relevant Accountholder and this does not bring the Contract to an end;orFor use by both Individual and Corporate Accountholders. Where the Accountholders wish to transfer the ownership of the benefits on the death of the Relevant Life Assured and this brings the Contract to an end. Operational Forms Beneficiary Nomination Request Form – for Accountholders Policyholders ULQ PR \| 07959
Singapore Trust Beneficiary Form 6 – Notice of Revocation of Revocable Nomination	This form can only be used to give notice of the revocation, under section 49M(7)(a) or (b) of the Insurance Act (Cap. Executive Redemption Bond – PRIIPs), of revocable nomination made in respect of one relevant policy.	Singapore (SG)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	This form can only be used to give notice of the revocation, under section 49M(7)(a) or (b) of the Insurance Act (Cap. Executive Redemption Bond – PRIIPs), of revocable nomination made in respect of one relevant policy. Operational Forms Singapore Trust Beneficiary Form 6 – Notice of Revocation of Revocable Nomination ULQ PR \| 07058
Singapore Trust Beneficiary Form 5 – Revocation of Revocable Nomination	This form can only be used to revoke a revocable nomination made in respect of one relevant policy. For use in the Singapore market only.	Singapore (SG)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	This form can only be used to revoke a revocable nomination made in respect of one relevant policy. For use in the Singapore market only. Operational Forms Singapore Trust Beneficiary Form 5 – Revocation of Revocable Nomination ULQ PR \| 07057
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	English (EN)	Non Product Specific	FOS	Surrender or Claim	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
Collective Investment Account Appointment Form	This form is for use where the applicant for, or existing Bond Owner of, an Utmost International Isle of Man Limited is UK resident and has requested the underlying investment choice for the Bond to be a Collective Investment Account (‘CIA’) provided by Quilter Investment Platform Limited.This is suitable for the following products: International Portfolio Bond – Life / International Portfolio Bond – Redemption, Collective Redemption Bond / Collective Investment Bond or Executive Redemption Bond / Executive Investment Bond.	United Kingdom (UK)	Utmost International - IoM	English (EN)	International Investment Bond Redemption – ME	FOS	Making a change to your policy	This form is for use where the applicant for, or existing Bond Owner of, an Utmost International Isle of Man Limited is UK resident and has requested the underlying investment choice for the Bond to be a Collective Investment Account (‘CIA’) provided by Quilter Investment Platform Limited.This is suitable for the following products: International Portfolio Bond – Life / International Portfolio Bond – Redemption, Collective Redemption Bond / Collective Investment Bond or Executive Redemption Bond / Executive Investment Bond. Operational Forms Collective Investment Account Appointment Form ULQ PR \| 05924
Singapore Trust Beneficiary Nomination Form 1	The Trust Beneficiary Nomination for is for use in the Singapore market only and is to be used to make a trust nomination in respect of one relevant policy only.	Singapore (SG)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	The Trust Beneficiary Nomination for is for use in the Singapore market only and is to be used to make a trust nomination in respect of one relevant policy only. Operational Forms Singapore Trust Beneficiary Nomination Form 1 ULQ PR \| 07053
Singapore Trust Beneficiary Revocation of Nomination Form 2	This form can only be used to revoke a trust nomination made in respect of one relevant policy.	Singapore (SG)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	This form can only be used to revoke a trust nomination made in respect of one relevant policy. Operational Forms Singapore Trust Beneficiary Revocation of Nomination Form 2 ULQ PR \| 07054
Singapore Trust Beneficiary Form 4 – Revocable Nomination	This form can only be used to make a revocable nomination in respect of one relevant policy. For use in the Singapore market only.	Singapore (SG)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	This form can only be used to make a revocable nomination in respect of one relevant policy. For use in the Singapore market only. Operational Forms Singapore Trust Beneficiary Form 4 – Revocable Nomination ULQ PR \| 07056
Utmost International Isle of Man Letter of Wishes Form	This form can be used should the settlors like to include additional wishes be taken into account with regard to the Declaration of Trust.	Rest of the World, United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	New Policy	This form can be used should the settlors like to include additional wishes be taken into account with regard to the Declaration of Trust. Operational Forms Utmost International Isle of Man Letter of Wishes Form ULQ PR \| 05862
Declaration of Loss or Non-receipt of Policy Form	This declaration form can be used if your Utmost International Isle of Manpolicy documents were lost, destroyed or never received.	Middle East, Rest of the World, Singapore (SG)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	New Policy	This declaration form can be used if your Utmost International Isle of Manpolicy documents were lost, destroyed or never received. Operational Forms Declaration of Loss or Non-receipt of Policy Form ULQ PR \| 01944
Depåfullmakt för Placeringsberättigad Executive Investment Bond	Detta formulär kan användas med Executive Investment Bonds som ett fullmaktsbrev för investeringar.This form can be used with Executive Investment Bonds as a letter of authorisation for investment.	Sweden (SE)	Utmost International - IoM	English (EN), Swedish (SV)	Executive Investment Bond		Making a change to your policy	Detta formulär kan användas med Executive Investment Bonds som ett fullmaktsbrev för investeringar.This form can be used with Executive Investment Bonds as a letter of authorisation for investment. Operational Forms Depåfullmakt för Placeringsberättigad Executive Investment Bond ULQ PR \| 02484
Isle of Man Unit-Linked Policy Switch Form	This form can be used to switch your clients’ investments or change the funds in which future regular investments are invested for Utmost International Isle of Man Limited unit-linked policies, including – Managed Capital Account, Managed Pension Account, Managed Savings Account or Executive Wealth builder Account.	Europe Expat, Middle East, Rest of the World, Singapore (SG)	Utmost International - IoM	English (EN)	Managed Capital Account	FOS	Making a change to your policy	This form can be used to switch your clients’ investments or change the funds in which future regular investments are invested for Utmost International Isle of Man Limited unit-linked policies, including – Managed Capital Account, Managed Pension Account, Managed Savings Account or Executive Wealth builder Account. Operational Forms Isle of Man Unit-Linked Policy Switch Form ULQ PR \| 00837
Delegated Switching Authority Form	This form can be used by clients to delegate the switching of funds to their funds adviser. The fund adviser will then be able to switch funds at any time without the need for client approval.	Middle East, Rest of the World	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	This form can be used by clients to delegate the switching of funds to their funds adviser. The fund adviser will then be able to switch funds at any time without the need for client approval. Operational Forms Delegated Switching Authority Form ULQ PR \| 00838
Unit Linked Individual Investor Premium Amendment form for use with Heritage products	Utmost International Isle of Man Limited form that can be used to increase or decrease regular premiums, to pay an additional single premium (top-up), to change frequency or to reinstate a policy. It can be used with Managed Savings Account, Managed Pension Account, Managed Capital Account and Executive Wealthbuilder Account.		Utmost International - IoM	English (EN)	Legacy Product (Closed), Managed Capital Account	FOS	Addition to your Policy, Making a change to your policy	Utmost International Isle of Man Limited form that can be used to increase or decrease regular premiums, to pay an additional single premium (top-up), to change frequency or to reinstate a policy. It can be used with Managed Savings Account, Managed Pension Account, Managed Capital Account and Executive Wealthbuilder Account. Operational Forms Unit Linked Individual Investor Premium Amendment form for use with Heritage products ULQ PR \| 03451
Automatic Exchange of Information – Self-Certification (FOE)	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.	Italy (IT)	Utmost Luxembourg S.A. - Italian Branch	English (EN)	Non Product Specific	FOE		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 (FOE) ULIT CONT4245
Automatic Exchange of Information – Self-Certification (FOE)	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.	Italy (IT)	Utmost Luxembourg S.A. - Italian Branch	English (EN)	Non Product Specific	FOE		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 (FOE) ULIT CONT4257
Automatic Exchange of Information – Self-Certification (FOE)	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.	Italy (IT)	Utmost Luxembourg S.A. - Italian Branch	English (EN)	Non Product Specific	FOE		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 (FOE) ULIT CONT4269
Scambio Automatico di Informazioni – Modulo di Autocertificazione (FOE)	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.	Italy (IT)	Utmost Luxembourg S.A. - Italian Branch	Italian (IT)	Non Product Specific	FOE		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 Scambio Automatico di Informazioni – Modulo di Autocertificazione (FOE) ULIT CONT2594
Scambio Automatico di Informazioni – Modulo di Autocertificazione (FOE)	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.	Italy (IT)	Utmost Luxembourg S.A. - Italian Branch	Italian (IT)	Non Product Specific	FOE		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 Scambio Automatico di Informazioni – Modulo di Autocertificazione (FOE) ULIT CONT2597
Scambio Automatico di Informazioni – Modulo di Autocertificazione (FOE)	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.	Italy (IT)	Utmost Luxembourg S.A. - Italian Branch	Italian (IT)	Non Product Specific	FOE		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 Scambio Automatico di Informazioni – Modulo di Autocertificazione (FOE) ULIT CONT2600
FATCA Autocertificazione (FOE)	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.	Italy (IT)	Utmost Luxembourg S.A. - Italian Branch	Italian (IT)	Non Product Specific	FOE		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 FATCA Autocertificazione (FOE) ULIT CONT2170-3
Dichiarazione di Scelta di Legge / Choice of Law (FOE)	Use this form to perform a choice of law	Italy (IT)	Utmost Luxembourg S.A. - Italian Branch	English (EN), Italian (IT)	Non Product Specific	FOE		Use this form to perform a choice of law Operational Forms Dichiarazione di Scelta di Legge / Choice of Law (FOE) ULIT CONT1795
Modification des caractéristiques principales d’un Fonds Interne Dédié existant	Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Non Product Specific	FOE		Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank Operational Forms Modification des caractéristiques principales d’un Fonds Interne Dédié existant ULBE PCON1560
Désignation d’Intermédiaire	Use this form to request an appointment or change of broker	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Non Product Specific	FOE		Use this form to request an appointment or change of broker Operational Forms Désignation d’Intermédiaire ULBE PCON1429
Aanstelling van Tussenpersoon	Use this form to request an appointment or change of broker	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Non Product Specific	FOE		Use this form to request an appointment or change of broker Operational Forms Aanstelling van Tussenpersoon ULBE PCON1430
Wijziging van de voornaamste kenmerken van een bestaand Intern Toegewezen Fonds	Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Non Product Specific	FOE		Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank Operational Forms Wijziging van de voornaamste kenmerken van een bestaand Intern Toegewezen Fonds ULBE PCON1561
Désignation des Bénéficiaires	Use this form to nominate beneficiaries	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Non Product Specific	FOE		Use this form to nominate beneficiaries Operational Forms Désignation des Bénéficiaires ULBE CONT4382
Benoeming van Begunstigden	Use this form to nominate beneficiaries	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Non Product Specific	FOE		Use this form to nominate beneficiaries Operational Forms Benoeming van Begunstigden ULBE CONT4383
Select Client Policy (Multi-Support) – Bijkomend Intern Toegewezen Fonds	Annex to add additional Internal Dedicated Funds to the contract/policy	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Select Client Policy	FOE	New Policy	Annex to add additional Internal Dedicated Funds to the contract/policy Operational Forms Select Client Policy (Multi-Support) – Bijkomend Intern Toegewezen Fonds ULBE CONT3634
Select Client Policy (Multi-Support) – Fonds Interne Dédié additionnel	Annex to add additional Internal Dedicated Funds to the contract/policy	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Select Client Policy	FOE	New Policy	Annex to add additional Internal Dedicated Funds to the contract/policy Operational Forms Select Client Policy (Multi-Support) – Fonds Interne Dédié additionnel ULBE CONT3635
Select Client Policy – Caractéristiques principales du (family shared) Fonds interne dédié	Annex to add additional Family Shared Internal Dedicated Funds to the contract/policy	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Select Client Policy	FOE	New Policy	Annex to add additional Family Shared Internal Dedicated Funds to the contract/policy Operational Forms Select Client Policy – Caractéristiques principales du (family shared) Fonds interne dédié ULBE CONT3786
Select Client Policy – Voornaamste kenmerken van het (family shared) Intern Toegewezen Fonds	Annex to add additional Family Shared Internal Dedicated Funds to the contract/policy	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Select Client Policy	FOE	New Policy	Annex to add additional Family Shared Internal Dedicated Funds to the contract/policy Operational Forms Select Client Policy – Voornaamste kenmerken van het (family shared) Intern Toegewezen Fonds ULBE CONT3787
Aanvraag van het Statuut van Professionele Cliënt / Request for Professional Client Status (Branch)	Request for Professional Client Status	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL), English (EN)	Non Product Specific	FOE		Request for Professional Client Status Operational Forms Aanvraag van het Statuut van Professionele Cliënt / Request for Professional Client Status (Branch) ULBE CONT3208
Demande de Statut de Client Professionnel / Request for Professional Client Status (Branch)	Request for Professional Client Status	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	English (EN), French (FR)	Non Product Specific	FOE		Request for Professional Client Status Operational Forms Demande de Statut de Client Professionnel / Request for Professional Client Status (Branch) ULBE CONT3209
Choix de la Loi Applicable / Choice of Law (Branch)	Use this form to perform a choice of law	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	English (EN), French (FR)	Non Product Specific	FOE		Use this form to perform a choice of law Operational Forms Choix de la Loi Applicable / Choice of Law (Branch) ULBE CONT3195
Keuze van de Toepasbare Wet / Choice of Law	Use this form to perform a choice of law	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL), English (EN)	Non Product Specific	FOE		Use this form to perform a choice of law Operational Forms Keuze van de Toepasbare Wet / Choice of Law ULBE CONT3196
FATCA Zelfcertificering	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.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Non Product Specific	FOE		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 FATCA Zelfcertificering ULBE CONT2824
FATCA Auto-certification	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.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Non Product Specific	FOE		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 FATCA Auto-certification ULBE CONT2825
FATCA Self-Certification	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.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	English (EN)	Non Product Specific	FOE		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 FATCA Self-Certification ULBE CONT2826
Overzicht van bijkomende administratieve vergoedingen	Annex showing the activity-based charging grid	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Non Product Specific	FOE		Annex showing the activity-based charging grid Operational Forms Overzicht van bijkomende administratieve vergoedingen ULBE CONT3181
Aperçu des frais administratifs additionnels	Annex showing the activity-based charging grid	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Non Product Specific	FOE		Annex showing the activity-based charging grid Operational Forms Aperçu des frais administratifs additionnels ULBE CONT3182
Avenant au contrat d’assurance-vie – Dissolution de cession de droits (Branch)	Annex to the application form for signing the dissolution of the transfer of insurance rights	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Non Product Specific	FOE		Annex to the application form for signing the dissolution of the transfer of insurance rights Operational Forms Avenant au contrat d’assurance-vie – Dissolution de cession de droits (Branch) ULBE CONT2801
Bijvoegsel bij de levensverzekeringsovereenkomst – Aanvaarding van de begunstiging (Branch)	Annex to the application form for beneficiary acceptance	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Non Product Specific	FOE		Annex to the application form for beneficiary acceptance Operational Forms Bijvoegsel bij de levensverzekeringsovereenkomst – Aanvaarding van de begunstiging (Branch) ULBE CONT2804
Avenant au contrat d’assurance-vie – Acceptation du bénéfice (Branch)	Annex to the application form for beneficiary acceptance	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Non Product Specific	FOE		Annex to the application form for beneficiary acceptance Operational Forms Avenant au contrat d’assurance-vie – Acceptation du bénéfice (Branch) ULBE CONT2805
Bijvoegsel bij de levensverzekeringsovereenkomst – Overeenkomst van Overdracht Post Mortem van de uit de Overeenkomst voortvloeiende rechten (Branch)	Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Non Product Specific	FOE		Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy Operational Forms Bijvoegsel bij de levensverzekeringsovereenkomst – Overeenkomst van Overdracht Post Mortem van de uit de Overeenkomst voortvloeiende rechten (Branch) ULBE CONT2788
Avenant au contrat d’assurance-vie – Convention de Cession Post Mortem des droits découlant du Contrat (Branch)	Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Non Product Specific	FOE		Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy Operational Forms Avenant au contrat d’assurance-vie – Convention de Cession Post Mortem des droits découlant du Contrat (Branch) ULBE CONT2789
Automatische Uitwisseling van Inlichtingen Zelfcertificering	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.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Non Product Specific	FOE		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 Automatische Uitwisseling van Inlichtingen Zelfcertificering ULBE CONT2791
Automatische Uitwisseling van Inlichtingen Zelfcertificering	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.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Non Product Specific	FOE		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 Automatische Uitwisseling van Inlichtingen Zelfcertificering ULBE CONT2792
Automatische Uitwisseling van Inlichtingen Zelfcertificering	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.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Non Product Specific	FOE		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 Automatische Uitwisseling van Inlichtingen Zelfcertificering ULBE CONT2793
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes physiques (Branch)	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.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Non Product Specific	FOE		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 (Branch) ULBE CONT2794
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les entités (Branch)	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.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Non Product Specific	FOE		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 (Branch) ULBE CONT2795
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes détenant le contrôle (Branch)	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.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	Non Product Specific	FOE		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 (Branch) ULBE CONT2796
Bijvoegsel bij de levensverzekeringsovereenkomst – Ontbinding van de overdracht van verzekeringsrechten (Branch)	Annex to the application form for signing the dissolution of the transfer of insurance rights	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	Non Product Specific	FOE		Annex to the application form for signing the dissolution of the transfer of insurance rights Operational Forms Bijvoegsel bij de levensverzekeringsovereenkomst – Ontbinding van de overdracht van verzekeringsrechten (Branch) ULBE CONT2800
Novation Agreement	This agreement is used where the servicing rights for a number of Utmost International Isle of Man Limited policies, former Quilter UPE policies or Alpha International products, administered by Utmost Wealth Solutions are being transferred from one financial adviser firm to another following a novation.This form is to be completed by financial advisers only.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	This agreement is used where the servicing rights for a number of Utmost International Isle of Man Limited policies, former Quilter UPE policies or Alpha International products, administered by Utmost Wealth Solutions are being transferred from one financial adviser firm to another following a novation.This form is to be completed by financial advisers only. Operational Forms Novation Agreement UL PR 0243
Online Application Guide for Financial Advisers	This is a PowerPoint which can be used by Financial Advisers to help their clients complete an online application form.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Evolution		New Policy	This is a PowerPoint which can be used by Financial Advisers to help their clients complete an online application form. Operational Forms Online Application Guide for Financial Advisers UL PR 0270
Guide for Evolution Trustee and Corporate Trustee Applicants	This guide has been designed to assist with completing the application form for Evolution Trustee and Corporate Trustee Applicants.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Evolution	FOS	New Policy	This guide has been designed to assist with completing the application form for Evolution Trustee and Corporate Trustee Applicants. Operational Forms Guide for Evolution Trustee and Corporate Trustee Applicants UL PR 0236
Guide for Evolution Corporate Applicants	This guide has been designed to assist with completing the application form for Evolution Corporate Applicants.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Evolution	FOS	New Policy	This guide has been designed to assist with completing the application form for Evolution Corporate Applicants. Operational Forms Guide for Evolution Corporate Applicants UL PR 0237
Pay-By-Link Multi-Currency Bilingual English and Traditional Chinese	This document describes how to use our Pay-By-Link service.If you are an Utmost International Isle of Man Limited Hong Kong Branch client and pay regular premiums into your Executive Wealthbuilder Account, International Mortgage Account, Managed Account Plus, Managed Capital Account, Managed Pension Account, or Managed Savings Account, regardless of your current payment method, you can use the Pay-By-Link service.	Hong Kong (HK)	Utmost International - IoM	English (EN)	Non Product Specific		Making a change to your policy, New Policy	This document describes how to use our Pay-By-Link service.If you are an Utmost International Isle of Man Limited Hong Kong Branch client and pay regular premiums into your Executive Wealthbuilder Account, International Mortgage Account, Managed Account Plus, Managed Capital Account, Managed Pension Account, or Managed Savings Account, regardless of your current payment method, you can use the Pay-By-Link service. Operational Forms Pay-By-Link Multi-Currency Bilingual English and Traditional Chinese UL PR 00451
Cuentas Unit Linked Formulario de Retiro/Cierre/VencimientoUnit Linked Unit Linked Accounts Withdrawal/Closure/Maturity Form	Este es un Formulario de Retiro/ Cierre/Vendimiento bilingüe en español e inglés para utilizar con los productos Managed Capital Account, Managed Savings Account and Managed Pension Account.This is a bilingual Spanish and English Withdrawal/Closure/Maturity Form for use with the Managed Capital Account, Managed Savings Account and Managed Pension Account products.	Spain (ES)	Utmost International - IoM	English (EN), Spanish (ES)	Managed Capital Account	FOS	Surrender or Claim	Este es un Formulario de Retiro/ Cierre/Vendimiento bilingüe en español e inglés para utilizar con los productos Managed Capital Account, Managed Savings Account and Managed Pension Account.This is a bilingual Spanish and English Withdrawal/Closure/Maturity Form for use with the Managed Capital Account, Managed Savings Account and Managed Pension Account products. Operational Forms Cuentas Unit Linked Formulario de Retiro/Cierre/VencimientoUnit Linked Unit Linked Accounts Withdrawal/Closure/Maturity Form UL PR 00431
UIIOM Pay-By-Link Hong Kong Dollar	This document describes how to use our Pay-By-Link service.If you are an Utmost International Isle of Man Limited client and you pay regular premiums in Hong Kong Dollar, regardless of your current payment method, you can use the Pay-By-Link service to pay into your Executive Wealthbuilder Account, Guaranteed Mortgage and Investment Plan, International Mortgage Account, International Portable Pension Plan, Managed Account Plus, Managed Capital Account, Managed Pension Account, Managed Savings Account or Pension Wealthbuilder Account.	Hong Kong (HK)	Utmost International - IoM	English (EN)	Managed Capital Account, Non Product Specific		Making a change to your policy	This document describes how to use our Pay-By-Link service.If you are an Utmost International Isle of Man Limited client and you pay regular premiums in Hong Kong Dollar, regardless of your current payment method, you can use the Pay-By-Link service to pay into your Executive Wealthbuilder Account, Guaranteed Mortgage and Investment Plan, International Mortgage Account, International Portable Pension Plan, Managed Account Plus, Managed Capital Account, Managed Pension Account, Managed Savings Account or Pension Wealthbuilder Account. Operational Forms UIIOM Pay-By-Link Hong Kong Dollar UL PR 00437
Pay-By-Link US Dollar	This document describes how to use our Pay-By-Link service.If you are an Utmost International Isle of Man Limited client and you pay regular premiums into your Executive Wealthbuilder Account, Guaranteed Mortgage and Investment Plan, International Mortgage Account, International Portable Pension Plan, Managed Account Plus, Managed Capital Account, Managed Pension Account, Managed Savings Account or Pension Wealthbuilder Account inUS Dollar, regardless of your current payment method, you can use the Pay-By-Link service.	Europe Expat, Middle East, Rest of the World, United Kingdom (UK)	Utmost International - IoM	English (EN)	Managed Capital Account, Non Product Specific	FOS	Making a change to your policy	This document describes how to use our Pay-By-Link service.If you are an Utmost International Isle of Man Limited client and you pay regular premiums into your Executive Wealthbuilder Account, Guaranteed Mortgage and Investment Plan, International Mortgage Account, International Portable Pension Plan, Managed Account Plus, Managed Capital Account, Managed Pension Account, Managed Savings Account or Pension Wealthbuilder Account inUS Dollar, regardless of your current payment method, you can use the Pay-By-Link service. Operational Forms Pay-By-Link US Dollar UL PR 00438
UIIOM Pay-By-Link Euro	This document describes how to use our Pay-By-Link service.If you are an Utmost International Isle of Man Limited client and you pay regular premiums into your Executive Wealthbuilder Account, Guaranteed Mortgage and Investment Plan, International Mortgage Account, International Portable Pension Plan, Managed Account Plus, Managed Capital Account, Managed Pension Account, Managed Savings Account or Pension Wealthbuilder Account inEuro, regardless of your current payment method, you can use the Pay-By-Link service.	Europe Expat, Middle East, Rest of the World, United Kingdom (UK)	Utmost International - IoM	English (EN)	Managed Capital Account, Non Product Specific	FOS	Making a change to your policy	This document describes how to use our Pay-By-Link service.If you are an Utmost International Isle of Man Limited client and you pay regular premiums into your Executive Wealthbuilder Account, Guaranteed Mortgage and Investment Plan, International Mortgage Account, International Portable Pension Plan, Managed Account Plus, Managed Capital Account, Managed Pension Account, Managed Savings Account or Pension Wealthbuilder Account inEuro, regardless of your current payment method, you can use the Pay-By-Link service. Operational Forms UIIOM Pay-By-Link Euro UL PR 00439
Assignment of Policy Segments for Immediate Surrender (for use with Former Quilter Products)	This form is to be used to assign Policy segments for an immediate surrender for use with Former Quilter products only.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Executive Investment Bond	FOS	Surrender or Claim	This form is to be used to assign Policy segments for an immediate surrender for use with Former Quilter products only. Operational Forms Assignment of Policy Segments for Immediate Surrender (for use with Former Quilter Products) UL PR 00432
UIIOM Pay-By-Link Pound Sterling	This document describes how to use our Pay-By-Link service.If you are an Utmost International Isle of Man Limited client and you pay regular premiums into your Executive Wealthbuilder Account, Guaranteed Mortgage and Investment Plan, International Mortgage Account, International Portable Pension Plan, Managed Account Plus, Managed Capital Account, Managed Pension Account, Managed Savings Account or Pension Wealthbuilder Account inPound Sterling, regardless of your current payment method, you can use the Pay-By-Link service.	Europe Expat, Middle East, Rest of the World, United Kingdom (UK)	Utmost International - IoM	English (EN)	Managed Capital Account, Non Product Specific	FOS	Making a change to your policy	This document describes how to use our Pay-By-Link service.If you are an Utmost International Isle of Man Limited client and you pay regular premiums into your Executive Wealthbuilder Account, Guaranteed Mortgage and Investment Plan, International Mortgage Account, International Portable Pension Plan, Managed Account Plus, Managed Capital Account, Managed Pension Account, Managed Savings Account or Pension Wealthbuilder Account inPound Sterling, regardless of your current payment method, you can use the Pay-By-Link service. Operational Forms UIIOM Pay-By-Link Pound Sterling UL PR 00450
Notifying us of a Bereavement	This document describes how to notify us of a death and what our certification requirements are in relation to Death Certificate and Grant of Probate.This document is issued by Utmost International Isle of Man and is only relevant to UK resident individuals.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific		Making a change to your policy	This document describes how to notify us of a death and what our certification requirements are in relation to Death Certificate and Grant of Probate.This document is issued by Utmost International Isle of Man and is only relevant to UK resident individuals. Operational Forms Notifying us of a Bereavement UL PR 00377
Assignment of Policies Form	Please use this form to assign ownership of segments to an individual, including splitting out segments to form a new bond.This is only for use with former Quilter International products.	Middle East, Rest of the World, United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	Please use this form to assign ownership of segments to an individual, including splitting out segments to form a new bond.This is only for use with former Quilter International products. Operational Forms Assignment of Policies Form UL PR 00417
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)	Utmost Wealth Solutions	English (EN)	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
Utmost International Isle of Man Client Information and Change of Details Form	This form is intended for Utmost International Isle of Man Limited customers who wish to inform us of any changes to their personal details, such as name, specimen signature, address, email address or telephone number.	Middle East, Rest of the World, Singapore (SG), Sweden (SE), United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	This form is intended for Utmost International Isle of Man Limited customers who wish to inform us of any changes to their personal details, such as name, specimen signature, address, email address or telephone number. Operational Forms Utmost International Isle of Man Client Information and Change of Details Form UL PR 00397
Know Your Client – Source of Funding and Verification of Identity	This form is issued by Utmost International Isle of Man and should be completed by all clients, trustees and corporate clients, where an application form does not already contain both a source of funding and verification of customer identity section.	Europe Expat, Middle East, Rest of the World, Singapore (SG), Sweden (SE), United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	New Policy	This form is issued by Utmost International Isle of Man and should be completed by all clients, trustees and corporate clients, where an application form does not already contain both a source of funding and verification of customer identity section. Operational Forms Know Your Client – Source of Funding and Verification of Identity UL PR 00391
Terms of Appointment of Investment Adviser	This document explains the terms of appointing an Investment Adviser.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	New Policy	This document explains the terms of appointing an Investment Adviser. Operational Forms Terms of Appointment of Investment Adviser UL PR 00350
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	English (EN)	Non Product Specific	FOS	Surrender or Claim	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
Switch Instruction form	This Switch Instruction Form outlines the bond switch details along with the bond owners, both personal and corporate investors.For products formerly Scottish Mutual International.		Utmost PanEurope	English (EN)	Non Product Specific		Making a change to your policy	This Switch Instruction Form outlines the bond switch details along with the bond owners, both personal and corporate investors.For products formerly Scottish Mutual International. Operational Forms Switch Instruction form UIC PR 00189
Unit Linked Encashment Form	This form can be used to request unit linked encashment. It can be used with a small number of older products.		Utmost PanEurope	English (EN)	UPE Unit-linked Products (Closed)	FOS	Surrender or Claim	This form can be used to request unit linked encashment. It can be used with a small number of older products. Operational Forms Unit Linked Encashment Form UIC PR 00190
Protecting Your Identity	This leaflet provides advice on protecting yourself against identity theft and fraud and what to do if you become a victim of these crimes.For products formerly Scottish Mutual International.		Utmost PanEurope	English (EN)	Non Product Specific		New Policy	This leaflet provides advice on protecting yourself against identity theft and fraud and what to do if you become a victim of these crimes.For products formerly Scottish Mutual International. Operational Forms Protecting Your Identity UIC PR 00191
Guide to further requirements for Corporates Policies	This document details some extra supporting documents we may require for Corporates Policies.For products formerly branded Phoenix Life guide to further requirements for Corporates Policies.		Utmost PanEurope	English (EN)	Non Product Specific		New Policy	This document details some extra supporting documents we may require for Corporates Policies.For products formerly branded Phoenix Life guide to further requirements for Corporates Policies. Operational Forms Guide to further requirements for Corporates Policies UIC PR 00195
Confirmation of Bank Details	This form can be used to request bank details from clients for Utmost International Isle of Man polices.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	New Policy	This form can be used to request bank details from clients for Utmost International Isle of Man polices. Operational Forms Confirmation of Bank Details UL PR 00303
Declaration of Health	This Medical Questionnaire needs to be completed to consent to Utmost PanEurope dac seeking and processing medical information at any time as this application will form the basis of the contract with Utmost PanEurope dac.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	New Policy	This Medical Questionnaire needs to be completed to consent to Utmost PanEurope dac seeking and processing medical information at any time as this application will form the basis of the contract with Utmost PanEurope dac. Operational Forms Declaration of Health UIC PR 00178
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	English (EN)	Non Product Specific	FOS	Surrender or Claim	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
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	English (EN)	Non Product Specific	FOS	Surrender or Claim	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
Overseas Transfer Declaration	Declaration form to confirm that the transfer request conforms to the requirements of the Occupational Pension Schemes and Personal Retirement Savings Accounts and is for bona fide purpose.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	Declaration form to confirm that the transfer request conforms to the requirements of the Occupational Pension Schemes and Personal Retirement Savings Accounts and is for bona fide purpose. Operational Forms Overseas Transfer Declaration UIC PR 00183
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	English (EN)	Non Product Specific	FOS	Surrender or Claim	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
Executive Pension Request to Transfer to an Approved Retirement Fund	Request to transfer the fund or part of the fund accrued under the scheme or scheme(s) in respect of the Member’s retirement benefits to an approved retirement fund.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	Request to transfer the fund or part of the fund accrued under the scheme or scheme(s) in respect of the Member’s retirement benefits to an approved retirement fund. Operational Forms Executive Pension Request to Transfer to an Approved Retirement Fund UIC PR 00185
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	English (EN)	Non Product Specific		Surrender or Claim	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
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	English (EN)	Non Product Specific		Surrender or Claim	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 Request Form – Personal Pension Plans	This retirement request form includes a list of options available on retirement and discharge for non-pension payments.This form is used with a small number of older products.		Utmost PanEurope	English (EN)	Non Product Specific		Making a change to your policy	This retirement request form includes a list of options available on retirement and discharge for non-pension payments.This form is used with a small number of older products. Operational Forms Retirement Request Form – Personal Pension Plans UIC PR 00188
Erklärung Wohnsitzdefinition	This declaration must be signed by policyholders who are neither resident nor ordinarily resident in Ireland or by personal representatives signing on behalf of deceased persons.	Germany (DE)	Utmost PanEurope	German (DE)	Non Product Specific	FOS	Making a change to your policy, New Policy	This declaration must be signed by policyholders who are neither resident nor ordinarily resident in Ireland or by personal representatives signing on behalf of deceased persons. Operational Forms Erklärung Wohnsitzdefinition UIC PR 00163
Switch Instruction Form	This Switch Instruction Form can be used to capture the bond switch details along with the bond owners for both personal and corporate investors.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	This Switch Instruction Form can be used to capture the bond switch details along with the bond owners for both personal and corporate investors. Operational Forms Switch Instruction Form UIC PR 00170
Benefit Crystallisation Events Declaration	This Declaration should be completed and given to the administrator of the pension arrangement prior to the payment of any benefits from that arrangement.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	New Policy	This Declaration should be completed and given to the administrator of the pension arrangement prior to the payment of any benefits from that arrangement. Operational Forms Benefit Crystallisation Events Declaration UIC PR 00172
Benefit Crystallisation Events Declaration	This Declaration should be completed and given to the administrator of the pension arrangement prior to the payment of any benefits from that arrangement.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	New Policy	This Declaration should be completed and given to the administrator of the pension arrangement prior to the payment of any benefits from that arrangement. Operational Forms Benefit Crystallisation Events Declaration UIC PR 00173
Declaration of Continued Good Health	Declaration form to provide details regarding your health situation or any medical conditions while consenting to Utmost PanEurope dac seeking and processing medical information at any time in order to process your claims.	Europe Expat, United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	New Policy	Declaration form to provide details regarding your health situation or any medical conditions while consenting to Utmost PanEurope dac seeking and processing medical information at any time in order to process your claims. Operational Forms Declaration of Continued Good Health UIC PR 00176
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	English (EN)	Non Product Specific	FOS	Surrender or Claim	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
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	German (DE)	Non Product Specific	FOS	Surrender or Claim	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
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	German (DE)	Non Product Specific	FOS	Surrender or Claim	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
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	English (EN)	Non Product Specific	FOS	Surrender or Claim	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
Appointment of Fund Adviser Form	For Products formerly Scottish Mutual International Fund Adviser Form used to request the appointment of a Fund Adviser to the contract.		Utmost PanEurope	English (EN)	Non Product Specific		New Policy	For Products formerly Scottish Mutual International Fund Adviser Form used to request the appointment of a Fund Adviser to the contract. Operational Forms Appointment of Fund Adviser Form UIC PR 00155
Dealing Instructions Form	This form is used for dealing instructions carried out wherever possible, at the next available price immediately following receipt by Utmost PanEurope dac of these duly completed instructions.		Utmost PanEurope	English (EN)	Non Product Specific		Making a change to your policy	This form is used for dealing instructions carried out wherever possible, at the next available price immediately following receipt by Utmost PanEurope dac of these duly completed instructions. Operational Forms Dealing Instructions Form UIC PR 00156
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	German (DE)	Non Product Specific	FOS	Making a change to your policy, Surrender or Claim	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
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	English (EN)	Non Product Specific	FOS	Making a change to your policy, Surrender or Claim	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
Execution Only Form for Additional Single Premium Applicants	You must read and sign this declaration should you wish to apply an additional premium investment to your existing bond without seeking financial advice.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation, Selection		New Policy	You must read and sign this declaration should you wish to apply an additional premium investment to your existing bond without seeking financial advice. Operational Forms Execution Only Form for Additional Single Premium Applicants UI PR 00152
Discounted Gift Trust for Conversion of an Existing Selection Bond – Absolute Trust	This trust deed is designed to be used only with pre-existing Selection bonds (written on a capital redemption basis and issued at least 12 months ago) now being converted to a discounted gift trust arrangement.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Selection	FOS	Making a change to your policy	This trust deed is designed to be used only with pre-existing Selection bonds (written on a capital redemption basis and issued at least 12 months ago) now being converted to a discounted gift trust arrangement. Operational Forms Discounted Gift Trust for Conversion of an Existing Selection Bond – Absolute Trust UI PR 00117
Group Risk Scheme – Renewal and Rate Review Notification Template	Group Risk Scheme – Renewal and Rate Review Notification Template for adding to the OSC			English (EN)	Global Risk Solutions (GRS), UCS (PE) Group Accidental Death, UCS (PE) Group Critical Illness, UCS (PE) Group Life Cover, UCS (PE) Group LTD	FOS		Group Risk Scheme – Renewal and Rate Review Notification Template for adding to the OSC Operational Forms Group Risk Scheme – Renewal and Rate Review Notification Template UCS_LD \| 25208
Group Risk Scheme – Confirmation of Rate Guarantee Template	Group Risk Scheme – Confirmation of Rate Guarantee Template for upload to the OSC			English (EN)	Global Risk Solutions (GRS), UCS (PE) Group Accidental Death, UCS (PE) Group Critical Illness, UCS (PE) Group Life Cover, UCS (PE) Group LTD, UCS (UW) Group Risk	FOS		Group Risk Scheme – Confirmation of Rate Guarantee Template for upload to the OSC Operational Forms Group Risk Scheme – Confirmation of Rate Guarantee Template UCS_LD \| 25209
Additional Single Premium Application Guide Individual Applicants	This is an application form and guide for Additional single premium for Individual Applicants for Utmost International Isle of Man Limited’s Evolution.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Evolution		Making a change to your policy	This is an application form and guide for Additional single premium for Individual Applicants for Utmost International Isle of Man Limited’s Evolution. Operational Forms Additional Single Premium Application Guide Individual Applicants IOM PR 0270
Utmost International Isle of Man Limited Guide for Estate Planning Bond Applicants	This guide has been designed to assist you with completing the application form for Utmost International Isle of Man Limited’s Estate Planning Bond.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Estate Planning Bond	FOS	New Policy	This guide has been designed to assist you with completing the application form for Utmost International Isle of Man Limited’s Estate Planning Bond. Operational Forms Utmost International Isle of Man Limited Guide for Estate Planning Bond Applicants IOM PR 0119
Multi-Product Nomination of External Manager or Custodian	This form can be used to nominate or replace an External Manager or Custodian.This is not for use with ex-Quilter products.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific		Making a change to your policy, New Policy	This form can be used to nominate or replace an External Manager or Custodian.This is not for use with ex-Quilter products. Operational Forms Multi-Product Nomination of External Manager or Custodian IOM PR 0110
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)	Utmost Wealth Solutions	English (EN)	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
Terms of Business and Application Form for Intermediaries	These Terms of Business regulate the relationship between Utmost International Isle of Man Limited and the Intermediary.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	New Policy	These Terms of Business regulate the relationship between Utmost International Isle of Man Limited and the Intermediary. Operational Forms Terms of Business and Application Form for Intermediaries IOM PR 0058
Utmost International Isle of Man Limited Drip-feeding and Portfolio Rebalancing Form	This form allows you to change or begin a Drip-feeding strategy, or change or begin a Portfolio Rebalancing strategy.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Estate Planning Bond, Evolution		Making a change to your policy	This form allows you to change or begin a Drip-feeding strategy, or change or begin a Portfolio Rebalancing strategy. Operational Forms Utmost International Isle of Man Limited Drip-feeding and Portfolio Rebalancing Form IOM PR 0047
Nomination of Investment Adviser – Utmost International Isle of Man	Please use this form to nominate an investment adviser.This form is not for use with form Quilter International policies.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Estate Planning Bond, Non Product Specific		Making a change to your policy	Please use this form to nominate an investment adviser.This form is not for use with form Quilter International policies. Operational Forms Nomination of Investment Adviser – Utmost International Isle of Man IOM PR 0057
Adviser Charges Pack – Agreement for Individuals, Trustees and Corporate Policyholders	This document explains charges for advice which are fees that are agreed between you (or where appropriate your trustees) and your Financial Adviser, Investment Adviser or External Manager and/or Custodian for the advice and related services you receive.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Estate Planning Bond, Evolution	FOS	New Policy	This document explains charges for advice which are fees that are agreed between you (or where appropriate your trustees) and your Financial Adviser, Investment Adviser or External Manager and/or Custodian for the advice and related services you receive. Operational Forms Adviser Charges Pack – Agreement for Individuals, Trustees and Corporate Policyholders IOM PR 0064
Declaration of Health Form	Please use this form in order to give us information about your health	United Kingdom (UK)	Utmost International - IoM	English (EN)	Estate Planning Bond, Family Legacy Bond, Generation Planning Bond		New Policy	Please use this form in order to give us information about your health Operational Forms Declaration of Health Form IOM PR 0028
Appointment of Financial Adviser – Utmost International Isle of Man	Please use this form to appointment a financial adviser.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	Please use this form to appointment a financial adviser. Operational Forms Appointment of Financial Adviser – Utmost International Isle of Man IOM PR 0032
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)	Utmost International - IoM	English (EN)	Non Product Specific		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 IOM PR 0021
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	English (EN)	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
Online dealing access authorisation form for clients	This form provides access for UK investment advisers to place deals online	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS		This form provides access for UK investment advisers to place deals online Operational Forms Online dealing access authorisation form for clients IOM PR 0034
Guide for Evolution Individual Applicants	This is a guide for Evolution for Individual Applicants	United Kingdom (UK)	Utmost International - IoM	English (EN)	Evolution		New Policy	This is a guide for Evolution for Individual Applicants Operational Forms Guide for Evolution Individual Applicants IOM PR 0037
Investment Switch Request Form	This form should be used for policies that are invested within Guided Architecture only.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific		Making a change to your policy	This form should be used for policies that are invested within Guided Architecture only. Operational Forms Investment Switch Request Form IOM PR 0012
Investor Declaration – UK Products	For Utmost International Isle of Man Limited policies within the UK market. You must read and sign this Declaration if you wish to link your bond to unregulated collective investment schemes and certain close substitutes, together known as non-mainstream pooled investments, which are investments that are generally restricted to sophisticated investors and high net worth individuals.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	For Utmost International Isle of Man Limited policies within the UK market. You must read and sign this Declaration if you wish to link your bond to unregulated collective investment schemes and certain close substitutes, together known as non-mainstream pooled investments, which are investments that are generally restricted to sophisticated investors and high net worth individuals. Operational Forms Investor Declaration – UK Products IOM PR 0011
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)	Utmost Wealth Solutions	English (EN)	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
Utmost PanEurope Online Dealing Access Authorisation Form	Online Dealing Access Authorisation Form for Policyholders for Utmost PanEurope dac.This is not suitable for Corporate or Trust cases.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	New Policy	Online Dealing Access Authorisation Form for Policyholders for Utmost PanEurope dac.This is not suitable for Corporate or Trust cases. Operational Forms Utmost PanEurope Online Dealing Access Authorisation Form ALE PR 0066
Online Dealing Access Authorisation Form for Investment Advisers	Online Dealing Access Authorisation Form for Investment Advisers for Utmost PanEurope dac.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Non Product Specific	FOS	New Policy	Online Dealing Access Authorisation Form for Investment Advisers for Utmost PanEurope dac. Operational Forms Online Dealing Access Authorisation Form for Investment Advisers ALE PR 0067
Lost Policy Declaration	Please use this form to declare that your Utmost International Isle of Man Limited policy is lost.	United Kingdom (UK)	Utmost International - IoM	English (EN)	Non Product Specific	FOS	Making a change to your policy	Please use this form to declare that your Utmost International Isle of Man Limited policy is lost. Operational Forms Lost Policy Declaration AWI PR 0011
Guide for Selection Individual Applicants	Guide for Selection Individual Applicants.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Selection	FOS	New Policy	Guide for Selection Individual Applicants. Operational Forms Guide for Selection Individual Applicants ALE PR 0043
Switch of Investment Objective and/or Risk Profile Form for Delegation only	Switch of investment objective and/or risk profile form for Utmost PanEurope dac’s Delegation product only.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation	FOS	Making a change to your policy	Switch of investment objective and/or risk profile form for Utmost PanEurope dac’s Delegation product only. Operational Forms Switch of Investment Objective and/or Risk Profile Form for Delegation only ALE PR 0022
Adviser Charges Pack Agreement for Individuals, Trustees and Corporate Policyholders Form for Delegation and Selection	Adviser charges pack agreement form for individuals, trustees and corporate policyholders for Utmost PanEurope dac’s Delegation and Selection.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation, Selection	FOS	New Policy	Adviser charges pack agreement form for individuals, trustees and corporate policyholders for Utmost PanEurope dac’s Delegation and Selection. Operational Forms Adviser Charges Pack Agreement for Individuals, Trustees and Corporate Policyholders Form for Delegation and Selection ALE PR 0023
Investor Declaration Form for Delegation and Selection	Investor declaration form for Utmost PanEurope dac’s Delegation and Selection.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation, Selection	FOS	New Policy	Investor declaration form for Utmost PanEurope dac’s Delegation and Selection. Operational Forms Investor Declaration Form for Delegation and Selection ALE PR 0024
Utmost PanEurope Terms of Business Statement and Application Form for Intermediaries	These Terms of Business regulate the relationship between Utmost PanEurope dac and the intermediary whose details are set out on the signatory page of these Terms of Business which are for the UK market.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation, Generation Planning Bond, Private Wealth Portfolio - UK, Selection	FOS	Making a change to your policy, New Policy	These Terms of Business regulate the relationship between Utmost PanEurope dac and the intermediary whose details are set out on the signatory page of these Terms of Business which are for the UK market. Operational Forms Utmost PanEurope Terms of Business Statement and Application Form for Intermediaries ALE PR 0026
Nomination of Investment Adviser Form for Generation Planning Bond and Selection	Selection nomination of external manager and/or custodian form for use with Utmost PanEurope dac’s Selection bonds only.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Generation Planning Bond, Selection	FOS	Making a change to your policy	Selection nomination of external manager and/or custodian form for use with Utmost PanEurope dac’s Selection bonds only. Operational Forms Nomination of Investment Adviser Form for Generation Planning Bond and Selection ALE PR 0016
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)	Utmost Wealth Solutions	English (EN)	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
Appointment of Financial Adviser Form	Please use this for to appoint a financial adviser for Utmost PanEurope dac’s Selection product.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Selection	FOS	Making a change to your policy	Please use this for to appoint a financial adviser for Utmost PanEurope dac’s Selection product. Operational Forms Appointment of Financial Adviser Form ALE PR 0019
Delegation – Investor Declaration and Non-Mainstream Pooled Investments (NMPIS) Opt in Form	Investor declaration and non-mainstream pooled investments opt-in form for Utmost PanEurope dac’s Delegation product.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation		Making a change to your policy	Investor declaration and non-mainstream pooled investments opt-in form for Utmost PanEurope dac’s Delegation product. Operational Forms Delegation – Investor Declaration and Non-Mainstream Pooled Investments (NMPIS) Opt in Form ALE PR 0020
Assignment of Policies form	Assignment of policies	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation, Selection	FOS	Making a change to your policy	Assignment of policies Operational Forms Assignment of Policies form ALE PR 0017
Nomination of External Manager and/or Custodian Form for Selection	Selection nomination of external manager and/or custodian form for use with Utmost PanEurope dac’s Selection bonds only.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Selection	FOS	Making a change to your policy, New Policy	Selection nomination of external manager and/or custodian form for use with Utmost PanEurope dac’s Selection bonds only. Operational Forms Nomination of External Manager and/or Custodian Form for Selection ALE PR 0015
Nomination of External Manager and or Custodian Form for Delegation	Nomination of external manager and or custodian form for Utmost PanEurope dac’s Delegation product.	United Kingdom (UK)	Utmost PanEurope	English (EN)	Delegation		Making a change to your policy	Nomination of external manager and or custodian form for Utmost PanEurope dac’s Delegation product. Operational Forms Nomination of External Manager and or Custodian Form for Delegation ALE PR 0021

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