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Documents

Title	Description	Market	Language	Regime	Process	Excerpt
Transferring Assets to Your Bond/Account	Please use this form when transferring assets to your Plan/Bond/Policy. For use withformer Quilter International Products, not for use in Hong Kong.	Europe Expat, Rest of the World, Singapore (SG), Spain (ES), Sweden (SE), United Kingdom (UK)	English (EN)	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)	English (EN)	FOS	Making a change to your policy, New Policy	Please use this form to pay an ongoing service fee or ongoing service charge to your financial adviser. For use withformer Quilter International Products only. Operational Forms Request Remuneration to Your Financial Adviser UWSQ PR 25129
Doing business with Utmost International – Electronic Submissions in UK	The processes highlighted in this document apply to Utmost International Isle of Man Limited and Utmost PanEurope dac.	United Kingdom (UK)	English (EN)	FOS	New Policy	The processes highlighted in this document apply to Utmost International Isle of Man Limited and Utmost PanEurope dac. Operational Forms Doing business with Utmost International – Electronic Submissions in UK UWSQ PR 25126
Deferring a Policy Fund Entitlement	This form needs to be completed when a client requests to change their Policy Fund entitlements.	Middle East, Rest of the World, United Kingdom (UK)	English (EN)	FOS	Making a change to your policy	This form needs to be completed when a client requests to change their Policy Fund entitlements. Operational Forms Deferring a Policy Fund Entitlement UWSQ PR \| 25162
Additional Loan Agreement and Acknowledgement of Receipt of Loan by Trustees	This agreement is for use with the existing Loan Trusts offered by Utmost International.	United Kingdom (UK)	English (EN)		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)	English (EN)	FOS	New Policy	Published minimum residual values as at February 2021 Operational Forms Portfolio Bond Minimum Residual Value UWSQ PR \| 21018
Appointing a Fund Adviser	This form can be used with Utmost International Isle of Man Limited orUtmost PanEurope dac a range of portfolio bonds available in all regions (except Hong Kong).	Middle East, Singapore (SG)	English (EN)	FOS	Making a change to your policy	This form can be used with Utmost International Isle of Man Limited orUtmost PanEurope dac a range of portfolio bonds available in all regions (except Hong Kong). Operational Forms Appointing a Fund Adviser UWSQ PR \| 20985
Appointing an Authorised Custodian – Wealth bond	Please use this form to request Utmost International Isle of Man Limited or Utmost PanEurope dac to appoint an authorised custodian. This form is only for use with the International Wealth Bond or European Wealth Bond.	United Kingdom (UK)	English (EN)		Making a change to your policy	Please use this form to request Utmost International Isle of Man Limited or Utmost PanEurope dac to appoint an authorised custodian. This form is only for use with the International Wealth Bond or European Wealth Bond. Operational Forms Appointing an Authorised Custodian – Wealth bond UWSQ PR \| 20951
Request to Restrict Assets – Wealth Bond	Please use this form if you wish to request Utmost International Isle of Man Limited or Utmost PanEurope dac to restrict the assets to a International Wealth Bond or European Wealth Bond.	United Kingdom (UK)	English (EN)	FOS	New Policy	Please use this form if you wish to request Utmost International Isle of Man Limited or Utmost PanEurope dac to restrict the assets to a International Wealth Bond or European Wealth Bond. Operational Forms Request to Restrict Assets – Wealth Bond UWSQ PR \| 20912
Source of Wealth Questionnaire	This questionnaire seeks to obtain information and documentation from the adviser to establish the source of wealth of high-risk clients of Utmost International Isle of Man Limited and Utmost PanEurope dac	Not country specific	English (EN)	FOS	Addition to your Policy, New Policy	This questionnaire seeks to obtain information and documentation from the adviser to establish the source of wealth of high-risk clients of Utmost International Isle of Man Limited and Utmost PanEurope dac Operational Forms Source of Wealth Questionnaire UWSQ PR \| 20888
Digital Signature Application Form – Non UK	Digital signature application form – not for use in the UK	Europe Expat, Middle East, Rest of the World, Singapore (SG)	English (EN)	FOS	New Policy	Digital signature application form – not for use in the UK Operational Forms Digital Signature Application Form – Non UK UWSQ PR \| 20815
Request to Add or Remove a Life Assured Form	This form can be used to add or remove a life assured on your Utmost International Portfolio Bond.	Europe Expat	English (EN)	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
Letter of authorisation for Authorised Custodian Account Form	This letter of authorisation permits an authorised third-party individual to make investment decisions in respect of the accounts opened by Utmost International Isle of Man Limited or Utmost PanEurope dac. with the authorised custodian.	Europe Expat, Middle East, Singapore (SG), United Kingdom (UK)	English (EN)	FOS	Making a change to your policy	This letter of authorisation permits an authorised third-party individual to make investment decisions in respect of the accounts opened by Utmost International Isle of Man Limited or Utmost PanEurope dac. with the authorised custodian. Operational Forms Letter of authorisation for Authorised Custodian Account Form UWSQ PR \| 20660
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)	English (EN)		Making a change to your policy	This form is for you, or someone you have authorised to represent you, to request a copy of the personal information we hold for you. Operational Forms Data Subject Access Request Form UWSQ PR \| 18031
Authorised Custodian Internet Service Request Form	This form can be used to request access to the view only internet service provided by the authorised custodian.	Europe Expat, Middle East	English (EN)	FOS	Making a change to your policy	This form can be used to request access to the view only internet service provided by the authorised custodian. Operational Forms Authorised Custodian Internet Service Request Form UWSQ PR \| 17990
Portfolio Bond Transaction Account Overdraft Limit	The published overdraft limit of transaction accounts for applicable portfolio bonds.	Europe Expat, Hong Kong (HK), Middle East, Rest of the World, Singapore (SG), Sweden (SE), United Kingdom (UK)	English (EN)	FOS	New Policy	The published overdraft limit of transaction accounts for applicable portfolio bonds. Operational Forms Portfolio Bond Transaction Account Overdraft Limit UWSQ PR \| 14355
Portfolio Bond Withdrawal / Surrender Form	Surrender and Withdrawal Request Form for Portfolio Bond	Europe Expat, Hong Kong (HK), Middle East, Rest of the World, Singapore (SG), Sweden (SE), United Kingdom (UK)	English (EN)	FOS	Surrender or Claim	Surrender and Withdrawal Request Form for Portfolio Bond Operational Forms Portfolio Bond Withdrawal / Surrender Form UWSQ PR \| 13485
Failed Regular Withdrawal Form	This form is to be completed where a regular withdrawal has not been paid due to insufficient value in the nominated asset.	Singapore (SG)	English (EN)		New Policy	This form is to be completed where a regular withdrawal has not been paid due to insufficient value in the nominated asset. Operational Forms Failed Regular Withdrawal Form UWSQ PR \| 12576
Tax Declaration and Self Certification for Entity Investors	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for Entity investors such as, companies, corporate trusts or foundations.	Finland (FI), France (FR), Hong Kong (HK), Italy (IT), Mexico (MX), Middle East, Portugal (PT), Singapore (SG), Spain (ES), Sweden (SE), Switzerland (CH), United Kingdom (UK)	English (EN)	FOS	Making a change to your policy, New Policy	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for Entity investors such as, companies, corporate trusts or foundations. Operational Forms Tax Declaration and Self Certification for Entity Investors UWSQ PR \| 12415
Tax Declaration and Self Certification for Individual Investors	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders, persons authorised to sign on behalf of the policyholder, for example their Power of Attorney or court appointed Deputy, and individuals linked to the trust where Utmost International Trustee Solutions Limited are the appointed trustee.	ASIA, Europe Expat, Finland (FI), France (FR), Germany (DE), Hong Kong (HK), Italy (IT), Mexico (MX), Middle East, Peru (PE), Portugal (PT), Singapore (SG), Spain (ES), Sweden (SE), Switzerland (CH), United Kingdom (UK)	English (EN)	FOS	Addition to your Policy, Making a change to your policy, New Policy, Surrender or Claim	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders, persons authorised to sign on behalf of the policyholder, for example their Power of Attorney or court appointed Deputy, and individuals linked to the trust where Utmost International Trustee Solutions Limited are the appointed trustee. Operational Forms Tax Declaration and Self Certification for Individual Investors UWSQ PR \| 12373
Request for Utmost to Appoint a new/additional Discretionary Asset Manager	This form should be used for International Wealth Bond or European Wealth Bond policyholders only, who would like to change their discretionary asset manager. This form should be used where you have not requested Quilter International to restrict the asset range.	United Kingdom (UK)	English (EN)	FOS	Making a change to your policy	This form should be used for International Wealth Bond or European Wealth Bond policyholders only, who would like to change their discretionary asset manager. This form should be used where you have not requested Quilter International to restrict the asset range. Operational Forms Request for Utmost to Appoint a new/additional Discretionary Asset Manager UWSQ PR \| 12370
Amendment to Wealth Interactive, Policyholder Online Service Terms	This form allows Trustee Policyholders to request online access for their Clients/Members.	Singapore (SG)	English (EN)	FOS	Making a change to your policy	This form allows Trustee Policyholders to request online access for their Clients/Members. Operational Forms Amendment to Wealth Interactive, Policyholder Online Service Terms UWSQ PR \| 11729
Amendment to Wealth Interactive, Policyholder Online Service Terms (Providing Limited Access)	This form allows Trustee Policyholders to request online access for their Clients/Members.	Singapore (SG)	English (EN)	FOS	Making a change to your policy	This form allows Trustee Policyholders to request online access for their Clients/Members. Operational Forms Amendment to Wealth Interactive, Policyholder Online Service Terms (Providing Limited Access) UWSQ PR \| 11544
Nominated asset for regular withdrawals	To ensure regular withdrawals are paid, you must select one or more asset from which the payment will be made. Alternatively, the Transaction Account can be selected to fund withdrawals. Please tick the appropriate box below	Europe Expat, Middle East, Singapore (SG), United Kingdom (UK)	English (EN)	FOS	New Policy	To ensure regular withdrawals are paid, you must select one or more asset from which the payment will be made. Alternatively, the Transaction Account can be selected to fund withdrawals. Please tick the appropriate box below Operational Forms Nominated asset for regular withdrawals UWSQ PR \| 10347
Deed of Absolute Appointment in Favour of one or more Discretionary Beneficiaries (Manx Law)	This deed is for guidance only and may be considered suitable where an Utmost International Isle of Man Limited orUtmost PanEurope dac discretionary trust subject to Manx Law has been used.	United Kingdom (UK)	English (EN)	FOS	New Policy	This deed is for guidance only and may be considered suitable where an Utmost International Isle of Man Limited orUtmost PanEurope dac discretionary trust subject to Manx Law has been used. Operational Forms Deed of Absolute Appointment in Favour of one or more Discretionary Beneficiaries (Manx Law) UWSQ PR \| 09637
Cheque Processing Form	This form is to be used when Wealth Interactive status is awaiting payment.	United Kingdom (UK)	English (EN)		New Policy	This form is to be used when Wealth Interactive status is awaiting payment. Operational Forms Cheque Processing Form UWSQ PR \| 09466
Request to Appoint a Discretionary Asset Manager (on an Advisory or Discretionary Authority)	Please use this form to appoint a discretionary asset manager on an advisory or discretionary authority.	Europe Expat, Middle East, United Kingdom (UK)	English (EN)		New Policy	Please use this form to appoint a discretionary asset manager on an advisory or discretionary authority. Operational Forms Request to Appoint a Discretionary Asset Manager (on an Advisory or Discretionary Authority) UWSQ PR \| 08887
Change of Financial Adviser	Please use this form if you wish to appoint a new or remove a financial adviser. If you remove a financial adviser this will stop all correspondence or information in respect of your policy going through that financial adviser.	Europe Expat, Hong Kong (HK), Middle East, Rest of the World, Singapore (SG), United Kingdom (UK)	English (EN)	FOS	Making a change to your policy	Please use this form if you wish to appoint a new or remove a financial adviser. If you remove a financial adviser this will stop all correspondence or information in respect of your policy going through that financial adviser. Operational Forms Change of Financial Adviser UWSQ PR \| 05271
Discounted Gift Trust Declaration of Continuing Good Health Form	This declaration should be completed by the settlor to confirm that their health has not changed since the date of the original application toUtmost Innternational Isle of Man Limited, Utmost International Trustee Solutions Limited orUtmost PanEurope dac.	United Kingdom (UK)	English (EN)	FOS	Making a change to your policy	This declaration should be completed by the settlor to confirm that their health has not changed since the date of the original application toUtmost Innternational Isle of Man Limited, Utmost International Trustee Solutions Limited orUtmost PanEurope dac. Operational Forms Discounted Gift Trust Declaration of Continuing Good Health Form UWSQ PR \| 04612
Intermediary Registration Application QINTL IOM and QII	Intermediary Registration Application IOM and QII – for non UK intermediaries only	United Kingdom (UK)	English (EN)	FOS	New Policy	Intermediary Registration Application IOM and QII – for non UK intermediaries only Operational Forms Intermediary Registration Application QINTL IOM and QII UWSQ PR \| 02230
Portfolio Bond Endorsement Request Form	This form can be used to endorse highly personalised bonds and bring into the UK regulations as well as reduce tax implications.	Europe Expat, Hong Kong (HK), Singapore (SG), Sweden (SE)	English (EN)	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
Varallisuuden Lähde	Varallisuuden Lähde asiakkaan varallisuustietojen toimittamisesta	Finland (FI)	Finnish (FI)	FOS	Making a change to your policy, New Policy	Varallisuuden Lähde asiakkaan varallisuustietojen toimittamisesta Operational Forms Varallisuuden Lähde UWS PR 00433
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)	English (EN)	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)	English (EN)	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
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	English (EN)		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
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	English (EN)	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 – 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)	French (FR)	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
Payment Instruction Form	This form is for use with Utmost PanEurope dac. Omega and Integra policies.	Europe Expat	English (EN)		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
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	English (EN)		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
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)	English (EN), Swedish (SV)	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
Switch Form	This form enables you to switch your investments or change the funds in which your future regular investments are invested.	Europe Expat	English (EN)		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
UPE Deed of Assignment	UPE Deed of Assignment		English (EN)	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)	Italian (IT)	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
Declaração Fiscal e Auto Certificação para Investidores Individuais	Este formulário deve ser preenchido para informar com precisão a sua apólice nos termos dos acordos de troca de informações fiscais relevantes, incluindo a Lei de Conformidade Fiscal de Contas Estrangeiras (FATCA) e os regulamentos da Norma Comum de Comunicação (CRS). Este formulário deve ser utilizado por segurados individuais, pessoas autorizadas a assinar em nome do segurado, por exemplo, o seu procurador ou representante nomeado pelo tribunal, e indivíduos ligados ao fundo fiduciário em que a Utmost International Trustee Solutions Limited é o administrador fiduciário nomeado.	Europe Expat, Portugal (PT), United Kingdom (UK)	Portuguese (PT)	FOS	Making a change to your policy, New Policy, Surrender or Claim	Este formulário deve ser preenchido para informar com precisão a sua apólice nos termos dos acordos de troca de informações fiscais relevantes, incluindo a Lei de Conformidade Fiscal de Contas Estrangeiras (FATCA) e os regulamentos da Norma Comum de Comunicação (CRS). Este formulário deve ser utilizado por segurados individuais, pessoas autorizadas a assinar em nome do segurado, por exemplo, o seu procurador ou representante nomeado pelo tribunal, e indivíduos ligados ao fundo fiduciário em que a Utmost International Trustee Solutions Limited é o administrador fiduciário nomeado. Operational Forms Declaração Fiscal e Auto Certificação para Investidores Individuais UPE_WS \| 04029
Ilmoitus Verosääntöjen Noudattamisesta Oikeushenkilöille (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)	English (EN), Finnish (FI)	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 Verosääntöjen Noudattamisesta Oikeushenkilöille (Tax Declaration and Self-Certification for Entity Investors) Bilingual FI/EN UPE PR 12865
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)	Italian (IT)	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
Declaração Fiscal e Auto Certificação para Entidades	Preencha este formulário para informar com precisão a sua apólice nos termos dos acordos de troca de informações fiscais relevantes, incluindo as regulamentações da Lei de Conformidade Fiscal de Contas Estrangeiras (FATCA) e da Norma Comum de Comunicação (CRS). Este formulário deve ser utilizado por investidores coletivos, tais como empresas, fundos fiduciários corporativos ou fundações.	Europe Expat, Portugal (PT), United Kingdom (UK)	Portuguese (PT)	FOS	Making a change to your policy, New Policy	Preencha este formulário para informar com precisão a sua apólice nos termos dos acordos de troca de informações fiscais relevantes, incluindo as regulamentações da Lei de Conformidade Fiscal de Contas Estrangeiras (FATCA) e da Norma Comum de Comunicação (CRS). Este formulário deve ser utilizado por investidores coletivos, tais como empresas, fundos fiduciários corporativos ou fundações. Operational Forms Declaração Fiscal e Auto Certificação para Entidades UPE PR 12860
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)	French (FR)	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	Chile (CL), Finland (FI), France (FR), Italy (IT), Mexico (MX), Portugal (PT), Spain (ES), United Kingdom (UK)	English (EN)	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
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)	English (EN)	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
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.	Chile (CL), Europe Expat, Italy (IT), Mexico (MX), Portugal (PT), Spain (ES), United Kingdom (UK)	English (EN)	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
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)	English (EN)	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
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)	English (EN)	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 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)	English (EN)	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
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.		English (EN)	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
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.	Chile (CL), Finland (FI), France (FR), Italy (IT), Mexico (MX), Portugal (PT), Spain (ES), United Kingdom (UK)	English (EN)	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
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)	French (FR)	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
Declaración Fiscal y Autocertificación para Trusts/Fideicomisos	Rellene este formulario para que Utmost pueda informar con precisión sobre su póliza en virtud de los acuerdos de intercambio de información fiscal pertinentes, incluidas las normas de la Ley de Cumplimiento Tributario de Cuentas Extranjeras (FATCA) y el Estándar Común de Comunicación de Reporte (CRS). Este formulario debe utilizarse para trusts en los que todos los fideicomisarios sean personas físicas. Debe ser rellenado por un fideicomisario en nombre del trust.	Europe Expat, Spain (ES), United Kingdom (UK)	Spanish (ES)	FOS	Making a change to your policy, New Policy	Rellene este formulario para que Utmost pueda informar con precisión sobre su póliza en virtud de los acuerdos de intercambio de información fiscal pertinentes, incluidas las normas de la Ley de Cumplimiento Tributario de Cuentas Extranjeras (FATCA) y el Estándar Común de Comunicación de Reporte (CRS). Este formulario debe utilizarse para trusts en los que todos los fideicomisarios sean personas físicas. Debe ser rellenado por un fideicomisario en nombre del trust. Operational Forms Declaración Fiscal y Autocertificación para Trusts/Fideicomisos ULQ PR \| 21019
Declaración Fiscal y Autocertificación para Personas Fisicas	Rellene este formulario para permitir que Utmost informe con precisión sobre su póliza en virtud de los acuerdos de intercambio de información fiscal pertinentes, incluidas las normas de la Ley de Cumplimiento Tributario de Cuentas Extranjeras (FATCA) y el Estándar Común de Comunicación de Información (CRS). Este formulario debe utilizarse para los titulares de pólizas individuales, las personas autorizadas para firmar en nombre del titular de la póliza, por ejemplo, su apoderado o representante designado por un tribunal, y las personas vinculadas al fideicomiso en el que Utmost International Trustee Solutions Limited es el fideicomisario designado.	Europe Expat, Spain (ES), United Kingdom (UK)	Spanish (ES)	FOS	Making a change to your policy, New Policy	Rellene este formulario para permitir que Utmost informe con precisión sobre su póliza en virtud de los acuerdos de intercambio de información fiscal pertinentes, incluidas las normas de la Ley de Cumplimiento Tributario de Cuentas Extranjeras (FATCA) y el Estándar Común de Comunicación de Información (CRS). Este formulario debe utilizarse para los titulares de pólizas individuales, las personas autorizadas para firmar en nombre del titular de la póliza, por ejemplo, su apoderado o representante designado por un tribunal, y las personas vinculadas al fideicomiso en el que Utmost International Trustee Solutions Limited es el fideicomisario designado. Operational Forms Declaración Fiscal y Autocertificación para Personas Fisicas ULQ PR \| 13271
Change of Bank Details	This form can be used to request and change bank details from clients for Utmost International Isle of Man and Utmost PanEurope polices.	United Kingdom (UK)	English (EN)	FOS	New Policy	This form can be used to request and change bank details from clients for Utmost International Isle of Man and Utmost PanEurope polices. Operational Forms Change of Bank Details UL PR 00303
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.		English (EN)		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.		English (EN)		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
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.		English (EN)		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
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.		English (EN)		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
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.		English (EN)		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 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.		English (EN)		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
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)	English (EN)	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
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)	English (EN)	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
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)	English (EN)	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
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)	English (EN)	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
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)	English (EN)	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)	English (EN)	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
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)	English (EN)	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)	English (EN)	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
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)	English (EN)	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)	English (EN)	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
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.		German (DE)	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.		English (EN)	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
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	German (DE)	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
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.		English (EN)	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
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)	German (DE)	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
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)	English (EN)	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
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)	German (DE)	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
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.		English (EN)		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
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.		English (EN)		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
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)	English (EN)	FOS	Surrender or Claim	This form should only be used for surrender or withdrawal requests from products designed forUtmost International Isle of Man Limited within the UK market or for any product where the policyholder is now UK resident. Operational Forms UWS Multi-Product Withdrawal and Surrender Form IOM PR 0027
Assignment of Policies Form	This form should be used for assigning ownership of segments to an individual including slitting out segments to from a new bond.This is not for use with exQuilter policies.	United Kingdom (UK)	English (EN)	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
Online Dealing Access Authorisation Form for Investment Advisers	Online Dealing Access Authorisation Form for Investment Advisers for Utmost PanEurope dac.	United Kingdom (UK)	English (EN)	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
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)	English (EN)	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

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