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Title	Description	Insurer	Language	Regime	Process	Excerpt
Aanvraag van het Statuut van Professionele Cliënt / Request for Professional Client Status	Request for Professional Client Status	Utmost Luxembourg S.A	Dutch (NL), English (EN)	FOS		Request for Professional Client Status Operational Forms Aanvraag van het Statuut van Professionele Cliënt / Request for Professional Client Status ULU CONT3210
Demande de Statut de Client Professionnel / Request for Professional Client Status	Request for Professional Client Status	Utmost Luxembourg S.A	English (EN), French (FR)	FOS		Request for Professional Client Status Operational Forms Demande de Statut de Client Professionnel / Request for Professional Client Status ULU CONT3207
Demande de Statut de Client Professionnel / Request for Professional Client Status (Branch)	Request for Professional Client Status	Utmost Luxembourg S.A. - Belgian Branch	English (EN), French (FR)	FOE		Request for Professional Client Status Operational Forms Demande de Statut de Client Professionnel / Request for Professional Client Status (Branch) ULBE CONT3209
Aanvraag van het Statuut van Professionele Cliënt / Request for Professional Client Status (Branch)	Request for Professional Client Status	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL), English (EN)	FOE		Request for Professional Client Status Operational Forms Aanvraag van het Statuut van Professionele Cliënt / Request for Professional Client Status (Branch) ULBE CONT3208
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	Utmost Wealth Solutions	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
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.	Utmost PanEurope	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
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	Utmost Luxembourg S.A	Dutch (NL)	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
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	Utmost Luxembourg S.A	French (FR)	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
Formulaire de changement de moyen de communication et utilisation des signatures électroniques	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	Utmost Luxembourg S.A	French (FR)	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 Formulaire de changement de moyen de communication et utilisation des signatures électroniques ULU PCON1521
Wijziging van het communicatiemiddel voor correspondentie en het gebruik van elektronische handtekeningen	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	Utmost Luxembourg S.A	Dutch (NL)	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 Wijziging van het communicatiemiddel voor correspondentie en het gebruik van elektronische handtekeningen ULU PCON1520
Aanstelling van Tussenpersoon	Use this form to request an appointment or change of broker	Utmost Luxembourg S.A	Dutch (NL)	FOS		Use this form to request an appointment or change of broker Operational Forms Aanstelling van Tussenpersoon ULU PCON1322
Désignation d’Intermédiaire	Use this form to request an appointment or change of broker	Utmost Luxembourg S.A	French (FR)	FOS		Use this form to request an appointment or change of broker Operational Forms Désignation d’Intermédiaire ULU PCON1323
Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor uiteindelijk belanghebbenden (AEoI)	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.	Utmost Luxembourg S.A	Dutch (NL)	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 (AEoI) ULU CONT4264
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes détenant le contrôle (AEoI)	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.	Utmost Luxembourg S.A	French (FR)	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 (AEoI) ULU CONT4262
Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor entiteiten (AEoI)	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.	Utmost Luxembourg S.A	Dutch (NL)	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 (AEoI) ULU CONT4252
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les entités (AEoI)	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.	Utmost Luxembourg S.A	French (FR)	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 (AEoI) ULU CONT4250
Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor natuurlijke personen (AEoI)	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.	Utmost Luxembourg S.A	Dutch (NL)	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 (AEoI) ULU CONT4243
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes physiques (AEoI)	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.	Utmost Luxembourg S.A	French (FR)	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 (AEoI) ULU CONT4241
Avenant au contrat d’assurance-vie – Acceptation du bénéfice	Annex to the application form for beneficiary acceptance	Utmost Luxembourg S.A	French (FR)	FOS		Annex to the application form for beneficiary acceptance Operational Forms Avenant au contrat d’assurance-vie – Acceptation du bénéfice ULU CONT2803
Bijvoegsel bij de levensverzekeringsovereenkomst – Aanvaarding van de begunstiging	Annex to the application form for beneficiary acceptance	Utmost Luxembourg S.A	Dutch (NL)	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 – Dissolution de cession de droits	Annex to the application form for signing the dissolution of the transfer of insurance rights	Utmost Luxembourg S.A	French (FR)	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 – Ontbinding van de overdracht van verzekeringsrechten	Annex to the application form for signing the dissolution of the transfer of insurance rights	Utmost Luxembourg S.A	Dutch (NL)	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 – 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	Utmost Luxembourg S.A	French (FR)	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
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	Utmost Luxembourg S.A	Dutch (NL)	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
Automatic Exchange of Information – Self-Certification for Controlling Persons (AEoI)	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.	Utmost Luxembourg S.A	English (EN)	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 (AEoI) ULU CONT2599
Automatic Exchange of Information – Self-Certification for Entities (AEoI)	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.	Utmost Luxembourg S.A	English (EN)	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 (AEoI) ULU CONT2596
Automatic Exchange of Information – Self-Certification for Individuals (AEoI)	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.	Utmost Luxembourg S.A	English (EN)	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 (AEoI) ULU CONT2593
Tax on Insurance Transactions	Annex on the advance payment of the premium tax	Utmost Luxembourg S.A	English (EN)	FOS		Annex on the advance payment of the premium tax Operational Forms Tax on Insurance Transactions ULU CONT2466
Taxe sur les Opérations d’Assurance	Annexe relative au paiement anticipé de la taxe sur les primes	Utmost Luxembourg S.A	French (FR)	FOS		Annexe relative au paiement anticipé de la taxe sur les primes Operational Forms Taxe sur les Opérations d’Assurance ULU CONT2263
Taks op de Verzekeringsverrichtingen	Bijlage inzake de voorafbetaling van de premietaks	Utmost Luxembourg S.A	Dutch (NL)	FOS		Bijlage inzake de voorafbetaling van de premietaks Operational Forms Taks op de Verzekeringsverrichtingen ULU CONT2262
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.	Utmost Luxembourg S.A	Dutch (NL)	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 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.	Utmost Luxembourg S.A	English (EN)	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 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.	Utmost Luxembourg S.A	French (FR)	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
Benoeming van Begunstigden	Use this form to nominate beneficiaries	Utmost Luxembourg S.A	Dutch (NL)	FOS		Use this form to nominate beneficiaries Operational Forms Benoeming van Begunstigden ULU CONT1803
Désignation des Bénéficiaires	Use this form to nominate beneficiaries	Utmost Luxembourg S.A	French (FR)	FOS		Use this form to nominate beneficiaries Operational Forms Désignation des Bénéficiaires ULU CONT1802
Keuze van de Toepasbare Wet / Choice of Law	Use this form to perform a choice of law	Utmost Luxembourg S.A	Dutch (NL), English (EN)	FOS		Use this form to perform a choice of law Operational Forms Keuze van de Toepasbare Wet / Choice of Law ULU CONT1791
Choix de la Loi Applicable / Choice of Law	Use this form to perform a choice of law	Utmost Luxembourg S.A	English (EN), French (FR)	FOS		Use this form to perform a choice of law Operational Forms Choix de la Loi Applicable / Choice of Law ULU CONT1790
Verklaring omtrent „Non-U.S. Person”-status	Use this form to declare a status of “Non-U.S. Person”	Utmost Luxembourg S.A	Dutch (NL)	FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Verklaring omtrent „Non-U.S. Person”-status ULU CONT1634
Déclaration de Statut de « Non-U.S. Person »	Use this form to declare a status of “Non-U.S. Person”	Utmost Luxembourg S.A	French (FR)	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
Confirmation des coordonnées du Client utilisées pour la signature électronique des documents	Confirmation of Client contact details used for the Electronic Signing of documents	Utmost Luxembourg S.A	French (FR)	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	Utmost Luxembourg S.A	Dutch (NL)	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
Formulaire de Choix Option « Opt-Out » (FR)	Operational Forms Formulaire de Choix Option « Opt-Out » (FR) ULBE PR 00008	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	FOE	Addition to your Policy, Making a change to your policy	Operational Forms Formulaire de Choix Option « Opt-Out » (FR) ULBE PR 00008
Keuzeformulier Voor de ‘Opt-Out’-Optie	Operational Forms Keuzeformulier Voor de ‘Opt-Out’-Optie ULBE PR 00007	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	FOE	Addition to your Policy, Making a change to your policy	Operational Forms Keuzeformulier Voor de ‘Opt-Out’-Optie ULBE PR 00007
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	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	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
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	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	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
Formulaire de changement de moyen de communication et utilisation des signatures électroniques	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	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	FOE		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 Formulaire de changement de moyen de communication et utilisation des signatures électroniques ULBE PCON1530
Aanstelling van Tussenpersoon	Use this form to request an appointment or change of broker	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	FOE		Use this form to request an appointment or change of broker Operational Forms Aanstelling van Tussenpersoon ULBE PCON1430
Wijziging van het communicatiemiddel voor correspondentie en het gebruik van elektronische handtekeningen	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	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	FOE		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 Wijziging van het communicatiemiddel voor correspondentie en het gebruik van elektronische handtekeningen ULBE PCON1529
Désignation d’Intermédiaire	Use this form to request an appointment or change of broker	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	FOE		Use this form to request an appointment or change of broker Operational Forms Désignation d’Intermédiaire ULBE PCON1429
Benoeming van Begunstigden	Use this form to nominate beneficiaries	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	FOE		Use this form to nominate beneficiaries Operational Forms Benoeming van Begunstigden ULBE CONT4383
Désignation des Bénéficiaires	Use this form to nominate beneficiaries	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	FOE		Use this form to nominate beneficiaries Operational Forms Désignation des Bénéficiaires ULBE CONT4382
Choix de la Loi Applicable / Choice of Law (Branch)	Use this form to perform a choice of law	Utmost Luxembourg S.A. - Belgian Branch	English (EN), French (FR)	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	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL), English (EN)	FOE		Use this form to perform a choice of law Operational Forms Keuze van de Toepasbare Wet / Choice of Law ULBE CONT3196
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.	Utmost Luxembourg S.A. - Belgian Branch	English (EN)	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
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.	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	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.	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	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
Bijvoegsel bij de levensverzekeringsovereenkomst – Aanvaarding van de begunstiging (Branch)	Annex to the application form for beneficiary acceptance	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	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	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	FOE		Annex to the application form for beneficiary acceptance Operational Forms Avenant au contrat d’assurance-vie – Acceptation du bénéfice (Branch) ULBE CONT2805
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes détenant le contrôle (Branch) (AEoI)	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.	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	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) (AEoI) 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	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	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
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	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	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
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les entités (Branch) (AEoI)	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.	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	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) (AEoI) ULBE CONT2795
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes physiques (Branch) (AEoI)	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.	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	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) (AEoI) ULBE CONT2794
Automatische Uitwisseling van Inlichtingen Zelfcertificering (AEoI)	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.	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	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 (AEoI) ULBE CONT2793
Automatische Uitwisseling van Inlichtingen Zelfcertificering (AEoI)	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.	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	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 (AEoI) ULBE CONT2792
Automatische Uitwisseling van Inlichtingen Zelfcertificering (AEoI)	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.	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	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 (AEoI) ULBE CONT2791
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	Utmost Luxembourg S.A. - Belgian Branch	French (FR)	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
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	Utmost Luxembourg S.A. - Belgian Branch	Dutch (NL)	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

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