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Use this form to request a regular withdrawal from your policy/contract – Belgium (FOS) – French version
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Surrender/Claim/Withdrawal/Switch |
FOS |
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Use this form to request a regular withdrawal from your policy/contract – Belgium (FOS) – French version
Surrender/Claim/Withdrawal/Switch
Rachat Partiel Programmé
ULU PCON1078
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Use this form to request a withdrawal from your policy/contract – Belgium (FOS) – French version
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Surrender/Claim/Withdrawal/Switch |
FOS |
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Use this form to request a withdrawal from your policy/contract – Belgium (FOS) – French version
Surrender/Claim/Withdrawal/Switch
Demande de Rachat Partiel
ULU PCON1033
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Use this form to request a switch of investments on your policy/contract – Belgium (FOS) – Dutch version
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Surrender/Claim/Withdrawal/Switch |
FOS |
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Use this form to request a switch of investments on your policy/contract – Belgium (FOS) – Dutch version
Surrender/Claim/Withdrawal/Switch
Demande d’Arbitrage
ULU PCON1030
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Please use this Information Disclosure Agreement for sharing client information with the National Bank of Belgium
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Client Letters/Indemnity/Data Protection |
FOS |
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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 (FR)
ULU PR 00098
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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
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Operational Forms |
FOS |
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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
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Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures
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Operational Forms |
FOS |
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Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures
Operational Forms
Formulaire de changement de moyen de communication et utilisation des signatures électroniques
ULU PCON1521
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Use this form to request an appointment or change of broker
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Operational Forms |
FOS |
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Use this form to request an appointment or change of broker
Operational Forms
Désignation d’Intermédiaire
ULU PCON1323
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Form to be used to declare the loss of policy documents – Belgium (FOS) – French version
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Client Letters/Indemnity/Data Protection |
FOS |
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Form to be used to declare the loss of policy documents – Belgium (FOS) – French version
Client Letters/Indemnity/Data Protection
Déclaration de Perte de Documents
ULU PCON1089
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Use this form to initiate a death claim – Belgium (French version)
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Surrender/Claim/Withdrawal/Switch |
FOS |
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Use this form to initiate a death claim – Belgium (French version)
Surrender/Claim/Withdrawal/Switch
Dénouement par Décès
ULU PCON1065
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Use this form to request the surrender of your policy/contract – Belgium (FOS) – French version
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Surrender/Claim/Withdrawal/Switch |
FOS |
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Use this form to request the surrender of your policy/contract – Belgium (FOS) – French version
Surrender/Claim/Withdrawal/Switch
Demande de Rachat Total
ULU PCON1045
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This user guide helps to navigate through the Connect Platform and explain functionality – French version
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Guides and Supporting Documents |
FOE FOS |
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This user guide helps to navigate through the Connect Platform and explain functionality – French version
Guides and Supporting Documents
Connect – Aperçu (Guide d’utilisation pour les clients)
ULU MARK2351
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This is a Connect User Guide for digital subscription – French version
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Guides and Supporting Documents |
FOE FOS |
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This is a Connect User Guide for digital subscription – French version
Guides and Supporting Documents
Guide d’utilisation Connect Souscription Digitale – Belgique
ULU MARK2302
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Connect User Guide – Total Redemption (French)
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Guides and Supporting Documents |
FOE FOS |
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Connect User Guide – Total Redemption (French)
Guides and Supporting Documents
Connect User Guide – Total Redemption (French)
ULU MARK2174
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Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
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Operational Forms |
FOS |
New Policy |
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes détenant le contrôle
ULU CONT4262
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Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications.
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Operational Forms |
FOS |
New Policy |
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les entités
ULU CONT4250
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Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
|
Operational Forms |
FOS |
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Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes physiques
ULU CONT4241
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Table of Luxembourg Investment Rules
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Investment literature/Strategies |
FOS |
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Table of Luxembourg Investment Rules
Investment literature/Strategies
Règles d’investissement pour fonds internes – Belgique
ULU CONT3681
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Privacy Notice – French version – Belgium (FOS)
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Client Letters/Indemnity/Data Protection |
FOS |
|
Privacy Notice – French version – Belgium (FOS)
Client Letters/Indemnity/Data Protection
Déclaration concernant la Protection des Données à Caractère
ULU CONT3340
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Privacy Notice – French version
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Client Letters/Indemnity/Data Protection |
FOS |
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Privacy Notice – French version
Client Letters/Indemnity/Data Protection
Avis de confidentialité
ULU CONT3340-WEB
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Request for Professional Client Status
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Operational Forms |
FOS |
|
Request for Professional Client Status
Operational Forms
Demande de Statut de Client Professionnel / Request for Professional Client Status
ULU CONT3207
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Annex showing the activity-based charging grid
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Operational Forms |
FOS |
|
Annex showing the activity-based charging grid
Operational Forms
Aperçu des frais administratifs additionnels
ULU CONT3168
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Information Disclosure Agreement
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Client Letters/Indemnity/Data Protection |
FOS |
|
Information Disclosure Agreement
Client Letters/Indemnity/Data Protection
ACCORD DE COMMUNICATION D’INFORMATION
ULU CONT2861
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Annex to the application form for beneficiary acceptance
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Operational Forms |
FOS |
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Annex to the application form for beneficiary acceptance
Operational Forms
Avenant au contrat d’assurance-vie – Acceptation du bénéfice
ULU CONT2803
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|
Annex to the application form for signing the dissolution of the transfer of insurance rights
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Operational Forms |
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
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|
Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy
|
Operational Forms |
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
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Use this form to request a upgrade of your investment category
|
Investment literature/Strategies |
FOS |
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Use this form to request a upgrade of your investment category
Investment literature/Strategies
Demande de classement dans une catégorie d’investissement supérieure
ULU CONT2526
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Use this form to request a downgrade of your investment category
|
Investment literature/Strategies |
FOS |
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Use this form to request a downgrade of your investment category
Investment literature/Strategies
Demande de classement dans une catégorie d’investissement inférieure
ULU CONT2515
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Use this form to define your investment strategy (generic version)
|
Investment literature/Strategies |
FOS |
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Use this form to define your investment strategy (generic version)
Investment literature/Strategies
Stratégie d’Investissement
ULU CONT2276
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|
Back-end tax annex – Belgium
|
Tax and regulatory Literature/technical sales aids and literature |
FOS |
|
Back-end tax annex – Belgium
Tax and regulatory Literature/technical sales aids and literature
Taxe sur les Opérations d’Assurance
ULU CONT2263
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Use this form to request a deviation from your investment profile
|
Investment literature/Strategies |
FOS |
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Use this form to request a deviation from your investment profile
Investment literature/Strategies
Déviation du Profil d’investissement
ULU CONT2221
|
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Medical Examination Report – Belgium (FOS) – French version
|
Underwriting guides/questionnaires/brochures |
FOS |
|
Medical Examination Report – Belgium (FOS) – French version
Underwriting guides/questionnaires/brochures
Rapport d’Examen Medical
ULU CONT2189
|
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Confidential Financial Questionnaire – Belgium (FOS) – French version
|
Underwriting guides/questionnaires/brochures |
FOS |
|
Confidential Financial Questionnaire – Belgium (FOS) – French version
Underwriting guides/questionnaires/brochures
Questionnaire Financier Confidentiel
ULU CONT2187
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|
Additional Questionnaire on Preexisting Life Policies and Applications – Belgium (FOS) – French version
|
Underwriting guides/questionnaires/brochures |
FOS |
|
Additional Questionnaire on Preexisting Life Policies and Applications – Belgium (FOS) – French version
Underwriting guides/questionnaires/brochures
Questionnaire Complementaire Contrats d’Assurance Vie et Demandes Existantes
ULU CONT2185
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Additional Medical Questionnaire – Belgium (FOS) – French version
|
Underwriting guides/questionnaires/brochures |
FOS |
|
Additional Medical Questionnaire – Belgium (FOS) – French version
Underwriting guides/questionnaires/brochures
Questionnaire Medical Complementaire
ULU CONT2183
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Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
|
Operational Forms |
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
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Use this form to complete an investment profile questionnaire and request a deviation from your investment profile
|
Investment literature/Strategies |
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
Profil d’investissement et évaluation de l’adéquation
ULU CONT2114
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Use this form to nominate beneficiaries
|
Operational Forms |
FOS |
|
Use this form to nominate beneficiaries
Operational Forms
Désignation des Bénéficiaires
ULU CONT1802
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|
Use this form to perform a choice of law
|
Operational Forms |
FOS |
|
Use this form to perform a choice of law
Operational Forms
Choix de la Loi Applicable / Choice of Law
ULU CONT1790
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|
Use this form to declare a status of “Non-U.S. Person”
|
Operational Forms |
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
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Stand-alone Notice on the risks of acceptance when investing in Specialised Investments – Belgium (FOS) – French version
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Client Letters/Indemnity/Data Protection |
FOS |
|
Stand-alone Notice on the risks of acceptance when investing in Specialised Investments – Belgium (FOS) – French version
Client Letters/Indemnity/Data Protection
Investissements Spécialisés
ULU CONT1590
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Declaration for the Use of a Custodian Bank located outside of the EEA – France – Liberté product
|
Client Letters/Indemnity/Data Protection |
FOS |
|
Declaration for the Use of a Custodian Bank located outside of the EEA – France – Liberté product
Client Letters/Indemnity/Data Protection
Déclaration pour l’utilisation d’une banque dépositaire hors de l’EEE
ULU CONT1434-2
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Confirmation of Client contact details used for the Electronic Signing of documents
|
Operational Forms |
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
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