Document Library

To search for documents, you have several options available, and you can select from any or all of the following filters.

If you are aware of the insurer or the market you are dealing with, you can filter this way. Additionally, you can refine your search by product, language, or asset (document) type.

By using these filters, you can streamline your search process and find the specific document you need.

Current Filters

Documents

Title	Description	Insurer	Language	Product	Regime	Process	Excerpt
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)	Non Product Specific	FOS	Addition to your Policy, New Policy	This questionnaire seeks to obtain information and documentation from the adviser to establish the source of wealth of high-risk clients of Utmost International Isle of Man Limited and Utmost PanEurope dac Operational Forms Source of Wealth Questionnaire UWSQ PR \| 20888
Tax Declaration and Self Certification for Entity Investors	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for Entity investors such as, companies, corporate trusts or foundations.	Utmost Wealth Solutions	English (EN)	Non Product Specific	FOS	Making a change to your policy, New Policy	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for Entity investors such as, companies, corporate trusts or foundations. Operational Forms Tax Declaration and Self Certification for Entity Investors UWSQ PR \| 12415
Tax Declaration and Self Certification for Individual Investors	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders, persons authorised to sign on behalf of the policyholder, for example their Power of Attorney or court appointed Deputy, and individuals linked to the trust where Utmost International Trustee Solutions Limited are the appointed trustee.	Utmost Wealth Solutions	English (EN)	Non Product Specific	FOS	Addition to your Policy, Making a change to your policy, New Policy, Surrender or Claim	For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders, persons authorised to sign on behalf of the policyholder, for example their Power of Attorney or court appointed Deputy, and individuals linked to the trust where Utmost International Trustee Solutions Limited are the appointed trustee. Operational Forms Tax Declaration and Self Certification for Individual Investors UWSQ PR \| 12373
French Executive Portfolio – Clause bénéficiaire démembrée avec quasi-usufruit	Please use this form if your client would like to nominate a beneficiary using a clause bénéficiaire démembrée specific to French law	Utmost PanEurope	French (FR)	Non Product Specific	FOS	New Policy	Please use this form if your client would like to nominate a beneficiary using a clause bénéficiaire démembrée specific to French law Operational Forms French Executive Portfolio – Clause bénéficiaire démembrée avec quasi-usufruit UPEQ PR \| 20688
Assignment of Policies Form for Apex France with Utmost PanEurope dac	This form can be used to reassign your Apex France policy to someone else.	Utmost PanEurope	English (EN)	Apex (France)	FOS	New Policy	This form can be used to reassign your Apex France policy to someone else. Operational Forms Assignment of Policies Form for Apex France with Utmost PanEurope dac UPE_WS PR 00122
Change of Beneficiary Form for Apex France with Utmost PanEurope dac	This form can be used to change the beneficiary of your Apex France policy.	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	This form can be used to change the beneficiary of your Apex France policy. Operational Forms Change of Beneficiary Form for Apex France with Utmost PanEurope dac UPE_WS PR 00120
Proof of Life Form for Apex France and PWP with Utmost PanEurope dac	This form can be used to confirm that the Life Assured is alive at the date of signing.	Utmost PanEurope	English (EN)	Apex (France)	FOS	New Policy	This form can be used to confirm that the Life Assured is alive at the date of signing. Operational Forms Proof of Life Form for Apex France and PWP with Utmost PanEurope dac UPE_WS PR 00121
Nomination of Investment Adviser Form for Apex France with Utmost PanEurope dac	This form can be used to nominate an Investment Advisor for your Apex France policy.	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	This form can be used to nominate an Investment Advisor for your Apex France policy. Operational Forms Nomination of Investment Adviser Form for Apex France with Utmost PanEurope dac UPE_WS PR 00119
France Death Benefit Claim form	This form can be used to claim a death benefit for Apex France or PWP France policies	Utmost PanEurope	English (EN)	Apex (France), Private Wealth Portfolio (PWP) France	FOS	Surrender or Claim	This form can be used to claim a death benefit for Apex France or PWP France policies Operational Forms France Death Benefit Claim form UPE_WS PR 00114
Déclaration Fiscale et Auto certification pour les Investisseurs Personnes Morales	Il vous a été demandé de remplir ce formulaire afin que la compagnie concernée puisse déclarer correctement votre contrat dans le cadre des accords d’échange d’informations fiscales, y compris FATCA et CRS.Ce formulaire doit être signé par la personne appropriée comme indiqué ci-dessous :› Pour une entreprise – Une personne qui a le pouvoir de signer, par exemple un dirigeant ou un administrateur d’une entreprise.	Utmost PanEurope	French (FR)	Non Product Specific	FOS	Making a change to your policy, New Policy, Surrender or Claim	Il vous a été demandé de remplir ce formulaire afin que la compagnie concernée puisse déclarer correctement votre contrat dans le cadre des accords d’échange d’informations fiscales, y compris FATCA et CRS.Ce formulaire doit être signé par la personne appropriée comme indiqué ci-dessous :› Pour une entreprise – Une personne qui a le pouvoir de signer, par exemple un dirigeant ou un administrateur d’une entreprise. Operational Forms Déclaration Fiscale et Auto certification pour les Investisseurs Personnes Morales UPE PR 12861
Never Received or Lost Policy Schedule Declaration (EN)	Utmost Pan Europe dac Never Received or Lost Policy Schedule Declaration	Utmost PanEurope	English (EN)	Apex (France), Apex (Portugal), Non Product Specific, Private Wealth Portfolio - Italy, Private Wealth Portfolio - Portugal, Private Wealth Portfolio - Spain, Private Wealth Portfolio - UK, Private Wealth Portfolio (PWP) France, Selection, Target	FOS	Surrender or Claim	Utmost Pan Europe dac Never Received or Lost Policy Schedule Declaration Operational Forms Never Received or Lost Policy Schedule Declaration (EN) UPE PR 12847
Formulaire de Changement de Coordonnées Personnelles	Ce formulaire est destiné aux clients d’Utmost PanEurope dac qui souhaitent nous informer de toute modification de leurs données personnelles, telles que le nom, le spécimen de signature, l’adresse, l’adresse e-mail ou le numéro de téléphone.	Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	Ce formulaire est destiné aux clients d’Utmost PanEurope dac qui souhaitent nous informer de toute modification de leurs données personnelles, telles que le nom, le spécimen de signature, l’adresse, l’adresse e-mail ou le numéro de téléphone. Operational Forms Formulaire de Changement de Coordonnées Personnelles UPE PR 12836
Private Wealth Portfolio France Formulaire De Demande De Versement Complementaire	Formulaire De Demande De Versement Complementaire	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	Formulaire De Demande De Versement Complementaire Operational Forms Private Wealth Portfolio France Formulaire De Demande De Versement Complementaire UPE PR 12822
Formulaire d’arbitrage – Portefeuille en gestion conseillée	Formulaire d’arbitrage – Portefeuille en gestion conseillée Advisory Portfolio Dealing Instruction Form	Utmost PanEurope	English (EN), French (FR)	Private Wealth Portfolio (PWP) France		Making a change to your policy	Formulaire d’arbitrage – Portefeuille en gestion conseillée Advisory Portfolio Dealing Instruction Form Operational Forms Formulaire d’arbitrage – Portefeuille en gestion conseillée UPE PR 12738
Mandat d’accès à l’information	Ce formulaire doit etre complété et signé par le Souscripteur lorsqu’il souhaite recevoir /donner acces aux informations des actifs sous-jacents de son Contrat .	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France		New Policy	Ce formulaire doit etre complété et signé par le Souscripteur lorsqu’il souhaite recevoir /donner acces aux informations des actifs sous-jacents de son Contrat . Operational Forms Mandat d’accès à l’information UPE PR 12740
Client Information and Change of Details Form	This form is intended for most Utmost PanEurope dac customers who wish to inform us of any changes to their personal details, such as name, specimen signature, address, email address or telephone number.	Utmost PanEurope	English (EN)	Non Product Specific	FOS	Making a change to your policy	This form is intended for most Utmost PanEurope dac customers who wish to inform us of any changes to their personal details, such as name, specimen signature, address, email address or telephone number. Operational Forms Client Information and Change of Details Form UPE PR 12682
PWP France – Nomination of Investment Adviser	PWP France – Nomination of Investment Adviser	Utmost PanEurope	English (EN)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	PWP France – Nomination of Investment Adviser Operational Forms PWP France – Nomination of Investment Adviser UPE PR 12675
Clause bénéficiaire démembrée avec quasi-usufruit	Ce formulaire est fourni strictement en qualité de projet pour examen par les conseillers juridiques du Souscripteur et devra etre adapté aux contextes et objectifs du Souscripteur qui sollicite une telle clause.	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	Ce formulaire est fourni strictement en qualité de projet pour examen par les conseillers juridiques du Souscripteur et devra etre adapté aux contextes et objectifs du Souscripteur qui sollicite une telle clause. Operational Forms Clause bénéficiaire démembrée avec quasi-usufruit UPE PR 12463
Gestion discrétionnaire – Transfert de titres	Ce formulaire doit être complété et signé par l’assuré et le gestionnaire de fonds discrétionnaire lorsqu’une prime additionnelle doit être versée par transfert de titres (prime en nature).	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, New Policy	Ce formulaire doit être complété et signé par l’assuré et le gestionnaire de fonds discrétionnaire lorsqu’une prime additionnelle doit être versée par transfert de titres (prime en nature). Operational Forms Gestion discrétionnaire – Transfert de titres UPE PR 12442
Demande de versement de capital décès	Ce formulaire devra etre complété et signé par le demandeur/ bénéficiaire afin qu’Utmost PanEurope dac (« Utmost PanEurope ») puisse verser le capital décés.	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Surrender or Claim	Ce formulaire devra etre complété et signé par le demandeur/ bénéficiaire afin qu’Utmost PanEurope dac (« Utmost PanEurope ») puisse verser le capital décés. Operational Forms Demande de versement de capital décès UPE PR 12418
Déclaration de perte de la documentation contractuelle et demande de duplicata	Ce formulaire devra etre complété et signé par tous les Souscripteurs en cas de perte de la documentation contractuelle recue et demande de duplicata.	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, Surrender or Claim	Ce formulaire devra etre complété et signé par tous les Souscripteurs en cas de perte de la documentation contractuelle recue et demande de duplicata. Operational Forms Déclaration de perte de la documentation contractuelle et demande de duplicata UPE PR 12417
Spécimen de signature	Ce formulaire est a completer et signer par le Souscripteur en cas de changement de nom ou sur demande de l’Assureur, ainsi que par l’exécuteur testamantaire.	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	Ce formulaire est a completer et signer par le Souscripteur en cas de changement de nom ou sur demande de l’Assureur, ainsi que par l’exécuteur testamantaire. Operational Forms Spécimen de signature UPE PR 12416
Demande de changement de clause bénéficiaire	Ce formulaire est a completer et signer par le Souscripteur pour demande de changement de clause bénéficiaire.	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	Ce formulaire est a completer et signer par le Souscripteur pour demande de changement de clause bénéficiaire. Operational Forms Demande de changement de clause bénéficiaire UPE PR 12415
Désignation d’un ‘Intermédiaire en Assurance	Ce formulaite est a remplir et signer par le Souscripteur et le nouvel Intermédiaire en Assurance qu’il souhaite désigner pour son Contrat.	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, New Policy	Ce formulaite est a remplir et signer par le Souscripteur et le nouvel Intermédiaire en Assurance qu’il souhaite désigner pour son Contrat. Operational Forms Désignation d’un ‘Intermédiaire en Assurance UPE PR 12413
Private Wealth Portfolio France formulaire de rachat partiel ou total	Ce formulaire doit etre complété et signé par le Souscripteur lorsqu’il souhaite demander un rachat partiel our total de son contrat .	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Surrender or Claim	Ce formulaire doit etre complété et signé par le Souscripteur lorsqu’il souhaite demander un rachat partiel our total de son contrat . Operational Forms Private Wealth Portfolio France formulaire de rachat partiel ou total UPE PR 00233
Déclaration Fiscale et Auto-certification pour les Investisseurs Individuels	Il vous a été demandé de remplir ce formulaire afin que la compagnie concernée puisse déclarer correctement votre contrat dans le cadre des accords d’échange d’informations fiscales, y compris FATCA et CRS. Ce formulaire doit être complété par:• Le titulaire de la police (parfois appelé titulaire du régime ou titulaire du compte)• Les personnes autorisées à signer au nom de l’Assuré, par exemple leur mandataire ou leur adjoint désigné par le tribunal, lorsque nous détenons les documents appropriés qui peuvent justifier l’intervention d’une personne autorisée.	Utmost PanEurope	French (FR)	Non Product Specific	FOS	Making a change to your policy, New Policy, Surrender or Claim	Il vous a été demandé de remplir ce formulaire afin que la compagnie concernée puisse déclarer correctement votre contrat dans le cadre des accords d’échange d’informations fiscales, y compris FATCA et CRS. Ce formulaire doit être complété par:• Le titulaire de la police (parfois appelé titulaire du régime ou titulaire du compte)• Les personnes autorisées à signer au nom de l’Assuré, par exemple leur mandataire ou leur adjoint désigné par le tribunal, lorsque nous détenons les documents appropriés qui peuvent justifier l’intervention d’une personne autorisée. Operational Forms Déclaration Fiscale et Auto-certification pour les Investisseurs Individuels UPE PR 00232
Personne Politiquement Exposée	Document permettant d’identifier toute personne associée au contrat qui pourrait être considérée comme une personne politiquement exposée (PPE).	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, New Policy, Surrender or Claim	Document permettant d’identifier toute personne associée au contrat qui pourrait être considérée comme une personne politiquement exposée (PPE). Operational Forms Personne Politiquement Exposée UPE PR 00230
Attestation D’Existence – PWP France	Attestation D’Existence	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, Surrender or Claim	Attestation D’Existence Operational Forms Attestation D’Existence – PWP France UPE PR 00229
Formulaire de changement de nom et/ou d’adresse	Ce formulaire est a completer et signer par le Souscripteur en cas de changement de nom et/ou d’adresse postale.	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy	Ce formulaire est a completer et signer par le Souscripteur en cas de changement de nom et/ou d’adresse postale. Operational Forms Formulaire de changement de nom et/ou d’adresse UPE PR 00227
Apex France Nomination of Discretionary Fund Manager, Platform or Custodian	This form can be used to nominate a Discretionary Fund Manager, Platform or Custodian to assist you with your Apex France policy	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	This form can be used to nominate a Discretionary Fund Manager, Platform or Custodian to assist you with your Apex France policy Operational Forms Apex France Nomination of Discretionary Fund Manager, Platform or Custodian UPE PR 00204
Apex France Guide for Additional Single Premium	Please use this application form to add additional single premium to Apex France.	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	Please use this application form to add additional single premium to Apex France. Operational Forms Apex France Guide for Additional Single Premium UPE PR 00163
DÉSIGNATION D’UN CONSEILLER EN INVESTISSEMENT ET D’UN DÉPOSITAIRE	Ce formulaire permet au souscripteur de nommer ou changer un conseiller en investissement et/ou un dépositiaire pour son contrat d’assurance-vie.	Utmost PanEurope	French (FR)	Private Wealth Portfolio (PWP) France	FOS	Making a change to your policy, New Policy	Ce formulaire permet au souscripteur de nommer ou changer un conseiller en investissement et/ou un dépositiaire pour son contrat d’assurance-vie. Operational Forms DÉSIGNATION D’UN CONSEILLER EN INVESTISSEMENT ET D’UN DÉPOSITAIRE UPE PR 00159
APEX France – Portfolio Undertaking Form	This form must be completed where an Additional Single Premium is to be paid via the transfer of assets (Premium in kind) from an existing Discretionary Fund Manager (DFM) account.	Utmost PanEurope	English (EN)	Apex (France)	FOS	New Policy	This form must be completed where an Additional Single Premium is to be paid via the transfer of assets (Premium in kind) from an existing Discretionary Fund Manager (DFM) account. Operational Forms APEX France – Portfolio Undertaking Form UPE PR 00145
Apex France – Dealing account overdraft clearance instruction form	This form can be used to request an overdraft clearance for your Apex France Dealing Account.	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	This form can be used to request an overdraft clearance for your Apex France Dealing Account. Operational Forms Apex France – Dealing account overdraft clearance instruction form UPE PR 00141
Apex France – Dealing instruction	This form should be used to buy and/or sell External Assets linked to your Policy. It cannot be used to buy or sell assets held by a Discretionary Fund Manager or those held on a Platform.	Utmost PanEurope	English (EN)	Apex (France)	FOS	Making a change to your policy	This form should be used to buy and/or sell External Assets linked to your Policy. It cannot be used to buy or sell assets held by a Discretionary Fund Manager or those held on a Platform. Operational Forms Apex France – Dealing instruction UPE PR 00130
Change of Communications Means and Use of Electronic Signatures form	Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures	Utmost Luxembourg S.A	English (EN)	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 Change of Communications Means and Use of Electronic Signatures form ULU PR 00102
DÉCLARATION DE PERTE DE DOCUMENTS	Formulaire de déclaration de perte de documents – Version française à utiliser avec Utmost Luxembourg S.A. France	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Formulaire de déclaration de perte de documents – Version française à utiliser avec Utmost Luxembourg S.A. France Operational Forms DÉCLARATION DE PERTE DE DOCUMENTS ULU PR 00091
Modification des caractéristiques principales d’une Unité de Compte constituée par un Fonds d’Assurance Spécialisé existant	Use this form to request a change to one or more key characteristics of a Specialised Assurance Fund; such as Change of Fund Manager and Custodian Bank	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to request a change to one or more key characteristics of a Specialised Assurance Fund; such as Change of Fund Manager and Custodian Bank Operational Forms Modification des caractéristiques principales d’une Unité de Compte constituée par un Fonds d’Assurance Spécialisé existant ULU PCON1566
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)	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 Formulaire de changement de moyen de communication et utilisation des signatures électroniques ULU PCON1524
Demande de Changement de Gestionnaire et Stratégie d’Investissement	Use this form to request a change of Investment Manager and Investment Strategy – France	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to request a change of Investment Manager and Investment Strategy – France Operational Forms Demande de Changement de Gestionnaire et Stratégie d’Investissement ULU PCON1069
Formulaire Changement de Banque Dépositaire	Use this form to request a change of Custodian Bank	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to request a change of Custodian Bank Operational Forms Formulaire Changement de Banque Dépositaire ULU PCON1060
Mandat de vérification d’instructions et de réception/ transmission d’ordres pour le Fonds d’Assurance Spécialisé	Power of Attorney for the verification of the instructions for the Specialised Assurance Fund – France	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS	New Policy	Power of Attorney for the verification of the instructions for the Specialised Assurance Fund – France Operational Forms Mandat de vérification d’instructions et de réception/ transmission d’ordres pour le Fonds d’Assurance Spécialisé ULU CONT4875
Mandat de réception d’instructions pour un Fonds d’Assurance Spécialisé	Power of Attorney for the reception of the instructions for the Specialised Assurance Fund – France	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS	New Policy	Power of Attorney for the reception of the instructions for the Specialised Assurance Fund – France Operational Forms Mandat de réception d’instructions pour un Fonds d’Assurance Spécialisé ULU CONT4874
Nouvelle Unité de Compte constituée par un Fonds d’Assurance Spécialisé	Annex to add additional Specialised Assurance Funds to the contract/policy	Utmost Luxembourg S.A	French (FR)	Private Client Portfolio	FOS	New Policy	Annex to add additional Specialised Assurance Funds to the contract/policy Operational Forms Nouvelle Unité de Compte constituée par un Fonds d’Assurance Spécialisé ULU CONT4860
Nouvelle Unité de Compte constituée par un Fonds Interne Dédié	Annex to add additional Internal Dedicated Funds to the contract/policy	Utmost Luxembourg S.A	French (FR)	Private Client Portfolio	FOS	New Policy	Annex to add additional Internal Dedicated Funds to the contract/policy Operational Forms Nouvelle Unité de Compte constituée par un Fonds Interne Dédié ULU CONT4854
Echange Automatique de Renseignements Formulaire d’Autocertification	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.	Utmost Luxembourg S.A	French (FR)	Liberté, Liberté Capitalisation	FOS	New Policy	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons. Operational Forms Echange Automatique de Renseignements Formulaire d’Autocertification ULU CONT4271
Echange Automatique de Renseignements Formulaire d’Autocertification	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications.	Utmost Luxembourg S.A	French (FR)	Liberté, Liberté Capitalisation	FOS	New Policy	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications. Operational Forms Echange Automatique de Renseignements Formulaire d’Autocertification ULU CONT4259
Echange Automatique de Renseignements Formulaire d’Autocertification	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.	Utmost Luxembourg S.A	French (FR)	Liberté, Liberté Capitalisation	FOS	New Policy	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders. Operational Forms Echange Automatique de Renseignements Formulaire d’Autocertification ULU CONT4247
Avenant au contrat de capitalisation	“Prise de date” annex to the Liberté Capitalisation product – France	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS	New Policy	“Prise de date” annex to the Liberté Capitalisation product – France Operational Forms Avenant au contrat de capitalisation ULU CONT3910
Avenant au contrat d’assurance-vie	“Prise de date” annex to the Liberté product – France	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS	New Policy	“Prise de date” annex to the Liberté product – France Operational Forms Avenant au contrat d’assurance-vie ULU CONT3909
Unité de Compte du Contrat constituée par un Fonds Interne Dédié lié à plusieurs Contrats	Annex to add additional Internal Dedicated Funds to a multi-contract/policy on the Liberté Capitalisation product – France	Utmost Luxembourg S.A	French (FR)	Liberté Capitalisation	FOS	Addition to your Policy	Annex to add additional Internal Dedicated Funds to a multi-contract/policy on the Liberté Capitalisation product – France Operational Forms Unité de Compte du Contrat constituée par un Fonds Interne Dédié lié à plusieurs Contrats ULU CONT3775
Unité de Compte du Contrat constituée par un Fonds Interne Dédié lié à plusieurs Contrats	Annex to add additional Internal Dedicated Funds to a multi-contract/policy on the Liberté product – France	Utmost Luxembourg S.A	French (FR)	Liberté	FOS	Addition to your Policy	Annex to add additional Internal Dedicated Funds to a multi-contract/policy on the Liberté product – France Operational Forms Unité de Compte du Contrat constituée par un Fonds Interne Dédié lié à plusieurs Contrats ULU CONT3769
Choice of Law form	Choice of law for the French market (Englishh version)	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Choice of law for the French market (Englishh version) Operational Forms Choice of Law form ULU CONT3572
Détails des Frais de transaction	Annex showing the activity-based charging grid	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Annex showing the activity-based charging grid Operational Forms Détails des Frais de transaction ULU CONT3169
Declaration de statut de « Non-U.S. Person » (Multi-Support)	Use this form to declare a status of “Non-U.S. Person”	Utmost Luxembourg S.A	French (FR)	Non Product Specific	FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Declaration de statut de « Non-U.S. Person » (Multi-Support) ULU CONT2755
Choix de la Loi Applicable / Choice of Law – Capitalisation Contract	Use this form to perform a choice of law	Utmost Luxembourg S.A	English (EN), French (FR)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Choix de la Loi Applicable / Choice of Law – Capitalisation Contract ULU CONT2602
Automatic Exchange of Information – Self-Certification for Controlling Persons	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons. Operational Forms Automatic Exchange of Information – Self-Certification for Controlling Persons ULU CONT2599
Automatic Exchange of Information – Self-Certification for Entities	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications.	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications. Operational Forms Automatic Exchange of Information – Self-Certification for Entities ULU CONT2596
Automatic Exchange of Information – Self-Certification for Individuals	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.	Utmost Luxembourg S.A	English (EN)	Non Product Specific	FOS		Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders. Operational Forms Automatic Exchange of Information – Self-Certification for Individuals ULU CONT2593
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)	Non Product Specific	FOS		Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons. Operational Forms FATCA Self-Certification ULU CONT2170-5
FATCA 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)	Liberté, Liberté Capitalisation	FOS	New Policy	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons. Operational Forms FATCA Auto-Certification ULU CONT2170-2
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)	Non Product Specific	FOS		Use this form to declare a status of “Non-U.S. Person” Operational Forms Déclaration de Statut de « Non-U.S. Person » ULU CONT2040
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)	Non Product Specific	FOS		Use this form to perform a choice of law Operational Forms Choix de la Loi Applicable / Choice of Law ULU CONT1794
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)	Non Product Specific	FOS		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Confirmation des coordonnées du Client utilisées pour la signature électronique des documents ULU CONNECT1057

Customer Support

Utmost Wealth Solutions

Popular support Pages

Previously visited Support Pages

Online Service Login

Utmost Wealth Solutions

Popular logins

Previously used logins

Document Library

Utmost Wealth Solutions

Document Library