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Title	Description	Insurer	Market	Asset Type	Product	Regime	Process	Excerpt
Dynamic Selection Portfolio – Beheersinformatie	This document provides you with key information about this investment option, provided by the investment manager	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Life Protect Plan 2, Life Protect Policy	FOS		This document provides you with key information about this investment option, provided by the investment manager Investment literature/Strategies Dynamic Selection Portfolio – Beheersinformatie ULU_Portfolio_Selection_Dynamic_Report_NL PR
Balanced Selection Portfolio – Beheersinformatie	This document provides you with key information about this investment option, provided by the investment manager	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Life Protect Plan 2, Life Protect Policy	FOS		This document provides you with key information about this investment option, provided by the investment manager Investment literature/Strategies Balanced Selection Portfolio – Beheersinformatie ULU_Portfolio_Selection_Balanced_Report_NL PR
Dynamic Heritage Portfolio – Beheersinformatie	This document provides you with key information about this investment option, provided by the investment manager	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Life Protect Plan 2	FOS		This document provides you with key information about this investment option, provided by the investment manager Investment literature/Strategies Dynamic Heritage Portfolio – Beheersinformatie ULU_Portfolio_Heritage_Dynamic_Report_NL PR
Conservative Heritage Portfolio – Beheersinformatie	This document provides you with key information about this investment option, provided by the investment manager	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Life Protect Plan 2	FOS		This document provides you with key information about this investment option, provided by the investment manager Investment literature/Strategies Conservative Heritage Portfolio – Beheersinformatie ULU_Portfolio_Heritage_Conservative_Report_NL PR
Balanced Heritage Portfolio – Beheersinformatie	This document provides you with key information about this investment option, provided by the investment manager	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Life Protect Plan 2	FOS		This document provides you with key information about this investment option, provided by the investment manager Investment literature/Strategies Balanced Heritage Portfolio – Beheersinformatie ULU_Portfolio_Heritage_Balanced_Report_NL PR
Balanced Universal Portfolio – Institutionele fiche	This document provides you with key information about this investment option, provided by the investment manager	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Life Protect Plan 2, Life Protect Policy	FOS		This document provides you with key information about this investment option, provided by the investment manager Investment literature/Strategies Balanced Universal Portfolio – Institutionele fiche ULU_Portfolio_Universal_Balanced_Report_NL PR
Balanced Generation Portfolio – Institutionele fiche	This document provides you with key information about this investment option, provided by the investment manager	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Life Protect Plan 2	FOS		This document provides you with key information about this investment option, provided by the investment manager Investment literature/Strategies Balanced Generation Portfolio – Institutionele fiche ULU_Portfolio_Generation_Balanced_Report_NL PR
Essentiële-informatiedocument (“Eid”)	This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.	Belgium (BE)	Utmost Luxembourg S.A	Key Information Document	Select Client Plan	FOS		This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses. Key Information Document Essentiële-informatiedocument (“Eid”) ULU_KID_LU_BE_EUR_SCP-HO_NL PR
Essentiële-informatiedocument (“Eid”)	This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.	Belgium (BE)	Utmost Luxembourg S.A	Key Information Document	Private Client Portfolio	FOS		This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses. Key Information Document Essentiële-informatiedocument (“Eid”) ULU_KID_LU_BE_EUR_PCP-HO_NL PR
Essentiële-informatiedocument (“Eid”)	This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.	Belgium (BE)	Utmost Luxembourg S.A	Key Information Document	Life Protect Plan 2	FOS		This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses. Key Information Document Essentiële-informatiedocument (“Eid”) ULU_KID_LU_BE_EUR_LPP-HO_NL PR
Essentiële-informatiedocument (“Eid”)	This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.	Belgium (BE)	Utmost Luxembourg S.A	Key Information Document	Corporate Select Plan	FOS		This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses. Key Information Document Essentiële-informatiedocument (“Eid”) ULU_KID_LU_BE_EUR_CSP-HO_NL PR
Connect Gebruikershandleiding – Gedeeltelijke afkoop	This Connect User Guide shows how to request a regular withdrawal – in Dutch	Belgium (BE)	Utmost Luxembourg S.A	Product Guides/Brochures/Snapshots and Training Materials	Non Product Specific	FOE FOS		This Connect User Guide shows how to request a regular withdrawal – in Dutch Product Guides/Brochures/Snapshots and Training Materials Connect Gebruikershandleiding – Gedeeltelijke afkoop ULU PROD2154
Information Disclosure Agreement for the National Bank of Belgium (NL)	Please use this Information Disclosure Agreement for sharing client information with the National Bank of Belgium	Belgium (BE)	Utmost Luxembourg S.A	Client Letters/Indemnity/Data Protection	Non Product Specific	FOS		Please use this Information Disclosure Agreement for sharing client information with the National Bank of Belgium Client Letters/Indemnity/Data Protection Information Disclosure Agreement for the National Bank of Belgium (NL) ULU PR 00099
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	Operational Forms	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
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	Belgium (BE)	Utmost Luxembourg S.A	Operational Forms	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 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	Belgium (BE)	Utmost Luxembourg S.A	Operational Forms	Non Product Specific	FOS		Use this form to request an appointment or change of broker Operational Forms Aanstelling van Tussenpersoon ULU PCON1322
Verklaring van Verlies van Polisdocument	Form to be used to declare the loss of policy documents – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Client Letters/Indemnity/Data Protection	Non Product Specific	FOS		Form to be used to declare the loss of policy documents – Belgium (FOS) – Dutch version Client Letters/Indemnity/Data Protection Verklaring van Verlies van Polisdocument ULU PCON1088
Aanvraag tot Regelmatige Terugtrekking	Use this form to request a regular withdrawal from your policy/contract – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Surrender/Claim/Withdrawal/Switch	Non Product Specific	FOS		Use this form to request a regular withdrawal from your policy/contract – Belgium (FOS) – Dutch version Surrender/Claim/Withdrawal/Switch Aanvraag tot Regelmatige Terugtrekking ULU PCON1077
Formulier voor de storting van een bijkomende Premie	Use this form for an addition to your policy/contract – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Top Up/Additional Investment	Select Client Plan	FOS	Addition to your Policy	Use this form for an addition to your policy/contract – Belgium (FOS) – Dutch version Top Up/Additional Investment Formulier voor de storting van een bijkomende Premie ULU PCON1048
Arbitrageverzoek	Use this form to request a switch of investments on your policy/contract – Belgium (FOS) – French version	Belgium (BE)	Utmost Luxembourg S.A	Surrender/Claim/Withdrawal/Switch	Non Product Specific	FOS		Use this form to request a switch of investments on your policy/contract – Belgium (FOS) – French version Surrender/Claim/Withdrawal/Switch Arbitrageverzoek ULU PCON1035
Verzoek tot Afkoop	Use this form to request the surrender of your policy/contract – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Surrender/Claim/Withdrawal/Switch	Non Product Specific	FOS		Use this form to request the surrender of your policy/contract – Belgium (FOS) – Dutch version Surrender/Claim/Withdrawal/Switch Verzoek tot Afkoop ULU PCON1026
Aanvraag tot Gedeeltelijke Afkoop	Use this form to request a withdrawal from your policy/contract – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Surrender/Claim/Withdrawal/Switch	Non Product Specific	FOS		Use this form to request a withdrawal from your policy/contract – Belgium (FOS) – Dutch version Surrender/Claim/Withdrawal/Switch Aanvraag tot Gedeeltelijke Afkoop ULU PCON1017
Afkoop na Overlijden	Use this form to initiate a death claim – Belgium (Dutch version)	Belgium (BE)	Utmost Luxembourg S.A	Surrender/Claim/Withdrawal/Switch	Non Product Specific	FOS		Use this form to initiate a death claim – Belgium (Dutch version) Surrender/Claim/Withdrawal/Switch Afkoop na Overlijden ULU PCON1008
Connect Overview – Customer Guide (Dutch)	Connect Overview – Customer Guide (Dutch)	Belgium (BE)	Utmost Luxembourg S.A	Guides and Supporting Documents	Non Product Specific	FOE FOS		Connect Overview – Customer Guide (Dutch) Guides and Supporting Documents Connect Overview – Customer Guide (Dutch) ULU MARK2352
User Guide Connect Digitale Onderschrijving – België	This is a Connect User Guide for digital subscription – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Guides and Supporting Documents	Non Product Specific	FOE FOS		This is a Connect User Guide for digital subscription – Dutch version Guides and Supporting Documents User Guide Connect Digitale Onderschrijving – België ULU MARK2303
Connect Gebruikershandleiding – Volledige Afkoop	Connect User Manual – Full Redemption (Dutch)	Belgium (BE)	Utmost Luxembourg S.A	Guides and Supporting Documents	Non Product Specific	FOE FOS		Connect User Manual – Full Redemption (Dutch) Guides and Supporting Documents Connect Gebruikershandleiding – Volledige Afkoop ULU MARK2171
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	Operational Forms	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
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	Operational Forms	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
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	Operational Forms	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
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	Operational Forms	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
Corporate Select Plan – België – Bijlage: lijst van beschikbare Externe Fondsen	This form shows the list of available internal collective funds for the Corporate Select Plan product	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Corporate Select Plan	FOS	New Business Pack	This form shows the list of available internal collective funds for the Corporate Select Plan product Investment literature/Strategies Corporate Select Plan – België – Bijlage: lijst van beschikbare Externe Fondsen ULU CONT4190
Corporate Select Plan – Algemene Voorwaarden	Stand-alone version of General Conditions for the Corporate Select Plan product – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Policy Conditions	Corporate Select Plan	FOS	New Business Pack	Stand-alone version of General Conditions for the Corporate Select Plan product – Belgium (FOS) – Dutch version Policy Conditions Corporate Select Plan – Algemene Voorwaarden ULU CONT4180
Corporate Select Plan	New business application form for the Corporate Select Plan product – Belgium; Capitalisation contract	Belgium (BE)	Utmost Luxembourg S.A	Application Form	Corporate Select Plan	FOS	New Business Pack	New business application form for the Corporate Select Plan product – Belgium; Capitalisation contract Application Form Corporate Select Plan ULU CONT4175
FOR INTERMEDIARIES – Identifiedocument – Versie voor de Tussenpersoon (Vennootschap)	Fact Find for INTERMEDIARIES for the Belgian market (FOS); dedicated to CORPORATE ENTITIES subscribing. To be used in combination with the new business application forms for this market. Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Fact Find	Corporate Select Plan	FOS	New Business Pack	Fact Find for INTERMEDIARIES for the Belgian market (FOS); dedicated to CORPORATE ENTITIES subscribing. To be used in combination with the new business application forms for this market. Dutch version Fact Find FOR INTERMEDIARIES – Identifiedocument – Versie voor de Tussenpersoon (Vennootschap) ULU CONT4161
FOR INTERMEDIARIES – Identificatiedocument – Versie voor de Tussenpersoon / Maatschap/Stichting	Fact Find for INTERMEDIARIES for the Belgian market (FOS); dedicated to FIDUCIARIES subscribing. To be used in combination with the new business application forms for this market. Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Fact Find	Select Client Plan	FOS	New Business Pack	Fact Find for INTERMEDIARIES for the Belgian market (FOS); dedicated to FIDUCIARIES subscribing. To be used in combination with the new business application forms for this market. Dutch version Fact Find FOR INTERMEDIARIES – Identificatiedocument – Versie voor de Tussenpersoon / Maatschap/Stichting ULU CONT3965
FOR INTERMEDIARIES – Identificatiedocument – Versie voor de Tussenpersoon Naturlijke persoon	Fact Find for INTERMEDIARIES for the Belgian market (FOS); dedicated to PHYSICAL PERSONS subscribing. To be used in combination with the new business application forms for this market. Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Fact Find	Select Client Plan	FOS	New Business Pack	Fact Find for INTERMEDIARIES for the Belgian market (FOS); dedicated to PHYSICAL PERSONS subscribing. To be used in combination with the new business application forms for this market. Dutch version Fact Find FOR INTERMEDIARIES – Identificatiedocument – Versie voor de Tussenpersoon Naturlijke persoon ULU CONT3961
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	Operational Forms	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
Bijlage: beleggingsregels en -limieten voor Interne en Externe Fondsen	Table of Luxembourg Investment Rules	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Non Product Specific	FOS		Table of Luxembourg Investment Rules Investment literature/Strategies Bijlage: beleggingsregels en -limieten voor Interne en Externe Fondsen ULU CONT3683
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	Operational Forms	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 – België – Bijlage: lijst van beschikbare Interne Collectieve Fondsen	Internal Collective Funds list – Belgium	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Select Client Plan	FOS		Internal Collective Funds list – Belgium Investment literature/Strategies Select Client Plan – België – Bijlage: lijst van beschikbare Interne Collectieve Fondsen ULU CONT3620-2
Select Client Plan – Bijlage: lijst van beschikbare Externe Fondsen	This form shows the list of available external funds for the Select Client Plan product	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Select Client Plan	FOS	New Business Pack	This form shows the list of available external funds for the Select Client Plan product Investment literature/Strategies Select Client Plan – Bijlage: lijst van beschikbare Externe Fondsen ULU CONT3620
Privacyverklaring	Privacy Notice – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Client Letters/Indemnity/Data Protection	Non Product Specific	FOS		Privacy Notice – Dutch version Client Letters/Indemnity/Data Protection Privacyverklaring ULU CONT3341-WEB
Verklaring betreffende de Bescherming van Persoonsgegevens	Privacy Notice – Dutch version – Belgium (FOS)	Belgium (BE)	Utmost Luxembourg S.A	Client Letters/Indemnity/Data Protection	Non Product Specific	FOS		Privacy Notice – Dutch version – Belgium (FOS) Client Letters/Indemnity/Data Protection Verklaring betreffende de Bescherming van Persoonsgegevens ULU CONT3341
Aanvraag van het Statuut van Professionele Cliënt / Request for Professional Client Status	Request for Professional Client Status	Belgium (BE)	Utmost Luxembourg S.A	Operational Forms	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
Overzicht van bijkomende administratieve vergoedingen	Annex showing the activity-based charging grid	Belgium (BE)	Utmost Luxembourg S.A	Operational Forms	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Overzicht van bijkomende administratieve vergoedingen ULU CONT3167
OVEREENKOMST INZAKE OPENBAARMAKING VAN INFORMATIE	Information Disclosure Agreement	Belgium (BE)	Utmost Luxembourg S.A	Client Letters/Indemnity/Data Protection	Non Product Specific	FOS		Information Disclosure Agreement Client Letters/Indemnity/Data Protection OVEREENKOMST INZAKE OPENBAARMAKING VAN INFORMATIE ULU CONT2860
Bijvoegsel bij de levensverzekeringsovereenkomst – Aanvaarding van de begunstiging	Annex to the application form for beneficiary acceptance	Belgium (BE)	Utmost Luxembourg S.A	Operational Forms	Non Product Specific	FOS		Annex to the application form for beneficiary acceptance Operational Forms Bijvoegsel bij de levensverzekeringsovereenkomst – Aanvaarding van de begunstiging ULU CONT2802
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	Operational Forms	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
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	Operational Forms	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
Verzoek om een hogere investeringscategorie	Use this form to request a upgrade of your investment category	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Non Product Specific	FOS		Use this form to request a upgrade of your investment category Investment literature/Strategies Verzoek om een hogere investeringscategorie ULU CONT2529
Verzoek om een lagere investeringscategorie	Use this form to request a downgrade of your investment category	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Non Product Specific	FOS		Use this form to request a downgrade of your investment category Investment literature/Strategies Verzoek om een lagere investeringscategorie ULU CONT2518
Beleggingsstrategie	Use this form to define your investment strategy (generic version)	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Non Product Specific	FOS		Use this form to define your investment strategy (generic version) Investment literature/Strategies Beleggingsstrategie ULU CONT2275
Taks op de Verzekeringsverrichtingen	Back-end tax annex – Belgium	Belgium (BE)	Utmost Luxembourg S.A	Tax and regulatory Literature/technical sales aids and literature	Non Product Specific	FOS		Back-end tax annex – Belgium Tax and regulatory Literature/technical sales aids and literature Taks op de Verzekeringsverrichtingen ULU CONT2262
Afwijking van het Beleggingsprofiel	Use this form to request a deviation from your investment profile	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Non Product Specific	FOS		Use this form to request a deviation from your investment profile Investment literature/Strategies Afwijking van het Beleggingsprofiel ULU CONT2220
Verslag Medisch Onderzoek	Medical Examination Report – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Underwriting guides/questionnaires/brochures	Non Product Specific	FOS		Medical Examination Report – Belgium (FOS) – Dutch version Underwriting guides/questionnaires/brochures Verslag Medisch Onderzoek ULU CONT2190
Vertrouwelijke Financiële Vragenlijst	Confidential Financial Questionnaire – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Underwriting guides/questionnaires/brochures	Non Product Specific	FOS		Confidential Financial Questionnaire – Belgium (FOS) – Dutch version Underwriting guides/questionnaires/brochures Vertrouwelijke Financiële Vragenlijst ULU CONT2188
Bijkomende Vragenlijst over Bestaande Levensverzekeringsovereenkomsten en Aanvragen	Additional Questionnaire on Preexisting Life Policies and Applications – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Underwriting guides/questionnaires/brochures	Non Product Specific	FOS		Additional Questionnaire on Preexisting Life Policies and Applications – Belgium (FOS) – Dutch version Underwriting guides/questionnaires/brochures Bijkomende Vragenlijst over Bestaande Levensverzekeringsovereenkomsten en Aanvragen ULU CONT2186
Bijkomende Medische Vragenlijst	Additional Medical Questionnaire – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Underwriting guides/questionnaires/brochures	Non Product Specific	FOS		Additional Medical Questionnaire – Belgium (FOS) – Dutch version Underwriting guides/questionnaires/brochures Bijkomende Medische Vragenlijst ULU CONT2184
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	Operational Forms	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
Beleggingsprofiel en geschiktheidsevaluatie	Use this form to complete an investment profile questionnaire and request a deviation from your investment profile	Belgium (BE)	Utmost Luxembourg S.A	Investment literature/Strategies	Non Product Specific	FOS	Addition to your Policy	Use this form to complete an investment profile questionnaire and request a deviation from your investment profile Investment literature/Strategies Beleggingsprofiel en geschiktheidsevaluatie ULU CONT2113
Select Client Plan (Multi-Support) – Algemene Voorwaarden	Stand-alone version of General Conditions for the Select Client Plan product – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Policy Conditions	Select Client Plan	FOS		Stand-alone version of General Conditions for the Select Client Plan product – Belgium (FOS) – Dutch version Policy Conditions Select Client Plan (Multi-Support) – Algemene Voorwaarden ULU CONT1868
Benoeming van Begunstigden	Use this form to nominate beneficiaries	Belgium (BE)	Utmost Luxembourg S.A	Operational Forms	Non Product Specific	FOS		Use this form to nominate beneficiaries Operational Forms Benoeming van Begunstigden ULU CONT1803
Keuze van de Toepasbare Wet / Choice of Law	Use this form to perform a choice of law	Belgium (BE)	Utmost Luxembourg S.A	Operational Forms	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
Select Client Plan	New business application form for the Select Client Plan product – Belgium	Belgium (BE)	Utmost Luxembourg S.A	Application Form	Select Client Plan	FOS	New Business Pack	New business application form for the Select Client Plan product – Belgium Application Form Select Client Plan ULU CONT1729
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	Operational Forms	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
Gespecialiseerde Investeringen	Stand-alone Notice on the risks of acceptance when investing in Specialised Investments – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Client Letters/Indemnity/Data Protection	Non Product Specific	FOS		Stand-alone Notice on the risks of acceptance when investing in Specialised Investments – Belgium (FOS) – Dutch version Client Letters/Indemnity/Data Protection Gespecialiseerde Investeringen ULU CONT1586
Depotbank buiten de EER	Declaration for the Use of a Custodian Bank located outside of the EEA – Belgium (FOS) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A	Client Letters/Indemnity/Data Protection	Non Product Specific	FOS		Declaration for the Use of a Custodian Bank located outside of the EEA – Belgium (FOS) – Dutch version Client Letters/Indemnity/Data Protection Depotbank buiten de EER ULU CONT1441
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	Operational Forms	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
Essentiële-informatiedocument (“Eid”)	This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Key Information Document	Select Client Policy	FOE		This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses. Key Information Document Essentiële-informatiedocument (“Eid”) ULBE_KID_BE_BE_EUR_SCP-BE_NL PR
Essentiële-informatiedocument (“Eid”)	This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Key Information Document	Private Client Portfolio	FOE		This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses. Key Information Document Essentiële-informatiedocument (“Eid”) ULBE_KID_BE_BE_EUR_PCP-BE_NL PR
Essentiële-informatiedocument (“Eid”)	This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses.	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Key Information Document	Corporate Select Plan	FOE		This document contains key information about this investment product. The information, prescribed by law, is intended to clarify the product’s features, risks, costs, potential gains and losses. Key Information Document Essentiële-informatiedocument (“Eid”) ULBE_KID_BE_BE_EUR_CSP-BE_NL PR
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	Operational Forms	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
Arbitrageverzoek	Use this form to request a switch of investments on your policy/contract – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Surrender/Claim/Withdrawal/Switch	Non Product Specific	FOE		Use this form to request a switch of investments on your policy/contract – Belgium (Branch) – Dutch version Surrender/Claim/Withdrawal/Switch Arbitrageverzoek ULBE PCON1433
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	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Operational Forms	Non Product Specific	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
Aanstelling van Tussenpersoon	Use this form to request an appointment or change of broker	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Operational Forms	Non Product Specific	FOE		Use this form to request an appointment or change of broker Operational Forms Aanstelling van Tussenpersoon ULBE PCON1430
Aanvraag tot Regelmatige Terugtrekking (Branch)	Use this form to request a regular withdrawal from your policy/contract – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Surrender/Claim/Withdrawal/Switch	Non Product Specific	FOE		Use this form to request a regular withdrawal from your policy/contract – Belgium (Branch) – Dutch version Surrender/Claim/Withdrawal/Switch Aanvraag tot Regelmatige Terugtrekking (Branch) ULBE PCON1400
Verzoek tot Afkoop (Branch)	Use this form to request the surrender of your policy/contract – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Surrender/Claim/Withdrawal/Switch	Non Product Specific	FOE		Use this form to request the surrender of your policy/contract – Belgium (Branch) – Dutch version Surrender/Claim/Withdrawal/Switch Verzoek tot Afkoop (Branch) ULBE PCON1344
Aanvraag tot Gedeeltelijke Afkoop (Branch)	Use this form to request a withdrawal from your policy/contract – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Surrender/Claim/Withdrawal/Switch	Non Product Specific	FOE		Use this form to request a withdrawal from your policy/contract – Belgium (Branch) – Dutch version Surrender/Claim/Withdrawal/Switch Aanvraag tot Gedeeltelijke Afkoop (Branch) ULBE PCON1342
Formulier voor de storting van een bijkomende Premie (Branch)	Use this form for an addition to your policy/contract – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Top Up/Additional Investment	Select Client Policy	FOE	Addition to your Policy	Use this form for an addition to your policy/contract – Belgium (Branch) – Dutch version Top Up/Additional Investment Formulier voor de storting van een bijkomende Premie (Branch) ULBE PCON1338
Verklaring van Verlies van Polisdocument (Branch)	Form to be used to declare the loss of policy documents – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Client Letters/Indemnity/Data Protection	Non Product Specific	FOE		Form to be used to declare the loss of policy documents – Belgium (Branch) – Dutch version Client Letters/Indemnity/Data Protection Verklaring van Verlies van Polisdocument (Branch) ULBE PCON1336
Select Client Policy / Corporate Select Plan – ODDO Global Private Equity Evergreen Fund – Beheersreglement	Internal Collective Fund for Belgian market	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Investment literature/Strategies	Corporate Select Plan, Select Client Policy	FOE		Internal Collective Fund for Belgian market Investment literature/Strategies Select Client Policy / Corporate Select Plan – ODDO Global Private Equity Evergreen Fund – Beheersreglement ULBE CONT4912
Corporate Select Plan – België – Bijlage: lijst van beschikbare Externe Fondsen	This form shows the list of available external funds for the Corporate Select Plan product	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Investment literature/Strategies	Corporate Select Plan	FOE	New Business Pack	This form shows the list of available external funds for the Corporate Select Plan product Investment literature/Strategies Corporate Select Plan – België – Bijlage: lijst van beschikbare Externe Fondsen ULBE CONT4536
FOR INTERMEDIARIES – Identifiedocument – Versie voor de Tussenpersoon (Vennootschap)	Fact Find for INTERMEDIARIES for the Belgian market (Branch); dedicated to FIDUCIARIES subscribing. To be used in combination with the new business application forms for this market. Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Fact Find	Non Product Specific	FOE	New Business Pack	Fact Find for INTERMEDIARIES for the Belgian market (Branch); dedicated to FIDUCIARIES subscribing. To be used in combination with the new business application forms for this market. Dutch version Fact Find FOR INTERMEDIARIES – Identifiedocument – Versie voor de Tussenpersoon (Vennootschap) ULBE CONT4476
Benoeming van Begunstigden	Use this form to nominate beneficiaries	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Operational Forms	Non Product Specific	FOE		Use this form to nominate beneficiaries Operational Forms Benoeming van Begunstigden ULBE CONT4383
Corporate Select Plan – Algemene Voorwaarden	Stand-alone version of General Conditions for the Corporate Select Plan product – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Policy Conditions	Corporate Select Plan	FOE		Stand-alone version of General Conditions for the Corporate Select Plan product – Belgium (Branch) – Dutch version Policy Conditions Corporate Select Plan – Algemene Voorwaarden ULBE CONT4182
Corporate Select Plan	New business application form for the Corporate Select Plan product – Belgium; Capitalisation contract	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Application Form	Corporate Select Plan	FOE	New Business Pack	New business application form for the Corporate Select Plan product – Belgium; Capitalisation contract Application Form Corporate Select Plan ULBE CONT4177
FOR INTERMEDIARIES – Identificatiedocument – Versie voor de Tussenpersoon – Burgerlijke maatschap	Fact Find for INTERMEDIARIES for the Belgian market (Branch); dedicated to FIDUCIARIES subscribing. To be used in combination with the new business application forms for this market. Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Fact Find	Select Client Policy	FOE	New Business Pack	Fact Find for INTERMEDIARIES for the Belgian market (Branch); dedicated to FIDUCIARIES subscribing. To be used in combination with the new business application forms for this market. Dutch version Fact Find FOR INTERMEDIARIES – Identificatiedocument – Versie voor de Tussenpersoon – Burgerlijke maatschap ULBE CONT3971
FOR INTERMEDIARIES – Identificatiedocument – Versie voor de Tussenpersoon / Naturlijke persoon	Fact Find for INTERMEDIARIES for the Belgian market (Branch); dedicated to PHYSICAL PERSONS subscribing. To be used in combination with the new business application forms for this market. Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Fact Find	Select Client Policy	FOE	New Business Pack	Fact Find for INTERMEDIARIES for the Belgian market (Branch); dedicated to PHYSICAL PERSONS subscribing. To be used in combination with the new business application forms for this market. Dutch version Fact Find FOR INTERMEDIARIES – Identificatiedocument – Versie voor de Tussenpersoon / Naturlijke persoon ULBE CONT3969
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	Operational Forms	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
Bijlage: beleggingsregels en -limieten voor Interne en Externe Fondsen	Table of Luxembourg Investment Rules	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Investment literature/Strategies	Non Product Specific	FOE		Table of Luxembourg Investment Rules Investment literature/Strategies Bijlage: beleggingsregels en -limieten voor Interne en Externe Fondsen ULBE CONT3684
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	Operational Forms	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 – België / Bijlage: lijst van beschikbare Interne Collectieve Fondsen	This form shows the list of available external funds for the Select Client Policy product	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Investment literature/Strategies	Select Client Policy	FOE	New Business Pack	This form shows the list of available external funds for the Select Client Policy product Investment literature/Strategies Select Client Policy – België / Bijlage: lijst van beschikbare Interne Collectieve Fondsen ULBE CONT3621-1
Select Client Policy – Bijlage: lijst van beschikbare Externe Fondsen	This form shows the list of available internal collective funds for the Select Client Policy product	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Investment literature/Strategies	Select Client Policy	FOE	New Business Pack	This form shows the list of available internal collective funds for the Select Client Policy product Investment literature/Strategies Select Client Policy – Bijlage: lijst van beschikbare Externe Fondsen ULBE CONT3621-2
Beleggingsprofiel en geschiktheidsevaluatie	Use this form to complete an investment profile questionnaire and request a deviation from your investment profile	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Investment literature/Strategies	Non Product Specific	FOE	Addition to your Policy	Use this form to complete an investment profile questionnaire and request a deviation from your investment profile Investment literature/Strategies Beleggingsprofiel en geschiktheidsevaluatie ULBE CONT3474
Taks op de Verzekeringsverrichtingen	Back-end tax annex – Belgium	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Tax and regulatory Literature/technical sales aids and literature	Non Product Specific	FOE		Back-end tax annex – Belgium Tax and regulatory Literature/technical sales aids and literature Taks op de Verzekeringsverrichtingen ULBE CONT3403
Verklaring betreffende de Bescherming van Persoonsgegevens	Privacy Notice – French version – Belgian Branch	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Client Letters/Indemnity/Data Protection	Non Product Specific	FOS		Privacy Notice – French version – Belgian Branch Client Letters/Indemnity/Data Protection Verklaring betreffende de Bescherming van Persoonsgegevens ULBE CONT3339
Privacyverklaring	Privacy Notice – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Client Letters/Indemnity/Data Protection	Non Product Specific	FOE		Privacy Notice – Dutch version Client Letters/Indemnity/Data Protection Privacyverklaring ULBE CONT3339-WEB
OVEREENKOMST INZAKE OPENBAARMAKING VAN INFORMATIE	Information Disclosure Agreement	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Client Letters/Indemnity/Data Protection	Non Product Specific	FOE		Information Disclosure Agreement Client Letters/Indemnity/Data Protection OVEREENKOMST INZAKE OPENBAARMAKING VAN INFORMATIE ULBE CONT3286
Afwijking van het Beleggingsprofiel	Use this form to request a deviation from your investment profile	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Investment literature/Strategies	Non Product Specific	FOE		Use this form to request a deviation from your investment profile Investment literature/Strategies Afwijking van het Beleggingsprofiel ULBE CONT3269
Verzoek om een hogere investeringscategorie	Use this form to request a upgrade of your investment category	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Investment literature/Strategies	Non Product Specific	FOE		Use this form to request a upgrade of your investment category Investment literature/Strategies Verzoek om een hogere investeringscategorie ULBE CONT3238
Verzoek om een lagere investeringscategorie	Use this form to request a downgrade of your investment category	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Investment literature/Strategies	Non Product Specific	FOE		Use this form to request a downgrade of your investment category Investment literature/Strategies Verzoek om een lagere investeringscategorie ULBE CONT3236
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	Operational Forms	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
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	Operational Forms	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
Overzicht van bijkomende administratieve vergoedingen	Annex showing the activity-based charging grid	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Operational Forms	Non Product Specific	FOE		Annex showing the activity-based charging grid Operational Forms Overzicht van bijkomende administratieve vergoedingen ULBE CONT3181
Depotbank buiten de EER (Branch)	Declaration for the Use of a Custodian Bank located outside of the EEA – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Client Letters/Indemnity/Data Protection	Non Product Specific	FOE		Declaration for the Use of a Custodian Bank located outside of the EEA – Belgium (Branch) – Dutch version Client Letters/Indemnity/Data Protection Depotbank buiten de EER (Branch) ULBE CONT2947
Verklaring betreffende de Fiscale Verplichtingen – Branch	Stand-alone Tax Compliance Certification form – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Client Letters/Indemnity/Data Protection	Non Product Specific	FOE		Stand-alone Tax Compliance Certification form – Belgium (Branch) – Dutch version Client Letters/Indemnity/Data Protection Verklaring betreffende de Fiscale Verplichtingen – Branch ULBE CONT2831
Vertrouwelijke Financiële Vragenlijst (Branch)	Confidential Financial Questionnaire – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Underwriting guides/questionnaires/brochures	Non Product Specific	FOE		Confidential Financial Questionnaire – Belgium (Branch) – Dutch version Underwriting guides/questionnaires/brochures Vertrouwelijke Financiële Vragenlijst (Branch) ULBE CONT2819
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	Operational Forms	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
Bijkomende Vragenlijst over Bestaande Levensverzekeringsovereenkomsten en Aanvragen (Branch)	Additional Questionnaire on Preexisting Life Policies and Applications – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Underwriting guides/questionnaires/brochures	Non Product Specific	FOE		Additional Questionnaire on Preexisting Life Policies and Applications – Belgium (Branch) – Dutch version Underwriting guides/questionnaires/brochures Bijkomende Vragenlijst over Bestaande Levensverzekeringsovereenkomsten en Aanvragen (Branch) ULBE CONT2817
Verslag Medisch Onderzoek (Branch)	Medical Examination Report – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Underwriting guides/questionnaires/brochures	Non Product Specific	FOE		Medical Examination Report – Belgium (Branch) – Dutch version Underwriting guides/questionnaires/brochures Verslag Medisch Onderzoek (Branch) ULBE CONT2815
Bijkomende Medische Vragenlijst (Branch)	Additional Medical Questionnaire – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Underwriting guides/questionnaires/brochures	Non Product Specific	FOE		Additional Medical Questionnaire – Belgium (Branch) – Dutch version Underwriting guides/questionnaires/brochures Bijkomende Medische Vragenlijst (Branch) ULBE CONT2813
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	Operational Forms	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
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	Operational Forms	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
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	Operational Forms	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	Operational Forms	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
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	Operational Forms	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
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	Operational Forms	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
Beleggingsstrategie (Branch)	Generic investment strategy form for the Belgian market (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Investment literature/Strategies	Non Product Specific	FOE		Generic investment strategy form for the Belgian market (Branch) – Dutch version Investment literature/Strategies Beleggingsstrategie (Branch) ULBE CONT2778
Select Client Policy – Algemene Voorwaarden	Stand-alone version of General Conditions for the Select Client Policy product – Belgium (Branch) – Dutch version	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Policy Conditions	Non Product Specific	FOE		Stand-alone version of General Conditions for the Select Client Policy product – Belgium (Branch) – Dutch version Policy Conditions Select Client Policy – Algemene Voorwaarden ULBE CONT2693
Select Client Policy	New business application form for the Select Client Policy product – Belgium	Belgium (BE)	Utmost Luxembourg S.A. - Belgian Branch	Application Form	Select Client Policy	FOE	New Business Pack	New business application form for the Select Client Policy product – Belgium Application Form Select Client Policy ULBE CONT2689

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