|
|
Use this form to nominate beneficiaries
|
Utmost Luxembourg S.A |
Operational Forms |
Dutch (NL) |
FOS |
|
Use this form to nominate beneficiaries
Operational Forms
Benoeming van Begunstigden
ULU CONT1803
|
|
|
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 |
Operational Forms |
Dutch (NL) |
FOS |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
Operational Forms
Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor uiteindelijk belanghebbenden (AEoI)
ULU CONT4264
|
|
|
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 |
Operational Forms |
French (FR) |
FOS |
New Policy |
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes détenant le contrôle (AEoI)
ULU CONT4262
|
|
|
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 |
Operational Forms |
Dutch (NL) |
FOS |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications.
Operational Forms
Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor entiteiten (AEoI)
ULU CONT4252
|
|
|
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 |
Operational Forms |
French (FR) |
FOS |
New Policy |
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les entités (AEoI)
ULU CONT4250
|
|
|
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 |
Operational Forms |
Dutch (NL) |
FOS |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
Operational Forms
Automatische Uitwisseling van Inlichtingen – Zelfcertificering voor natuurlijke personen (AEoI)
ULU CONT4243
|
|
|
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 |
Operational Forms |
French (FR) |
FOS |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes physiques (AEoI)
ULU CONT4241
|
|
|
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 |
Operational Forms |
English (EN) |
FOS |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
Operational Forms
Automatic Exchange of Information – Self-Certification for Individuals (AEoI)
ULU CONT2593
|
|
|
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 |
Operational Forms |
English (EN) |
FOS |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications.
Operational Forms
Automatic Exchange of Information – Self-Certification for Entities (AEoI)
ULU CONT2596
|
|
|
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 |
Operational Forms |
English (EN) |
FOS |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
Operational Forms
Automatic Exchange of Information – Self-Certification for Controlling Persons (AEoI)
ULU CONT2599
|
|
|
Back-end tax annex – Belgium
|
Utmost Luxembourg S.A |
Tax and regulatory Literature/technical sales aids and literature |
English (EN) |
FOS |
|
Back-end tax annex – Belgium
Tax and regulatory Literature/technical sales aids and literature
Tax on Insurance Transactions
ULU CONT2466
|
|
|
Back-end tax annex – Belgium
|
Utmost Luxembourg S.A |
Tax and regulatory Literature/technical sales aids and literature |
French (FR) |
FOS |
|
Back-end tax annex – Belgium
Tax and regulatory Literature/technical sales aids and literature
Taxe sur les Opérations d’Assurance
ULU CONT2263
|
|
|
Back-end tax annex – Belgium
|
Utmost Luxembourg S.A |
Tax and regulatory Literature/technical sales aids and literature |
Dutch (NL) |
FOS |
|
Back-end tax annex – Belgium
Tax and regulatory Literature/technical sales aids and literature
Taks op de Verzekeringsverrichtingen
ULU CONT2262
|
|
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications.
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les entités (Branch) (AEoI)
ULBE CONT2795
|
|
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes détenant le contrôle (Branch) (AEoI)
ULBE CONT2796
|
|
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications.
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications.
Operational Forms
Automatische Uitwisseling van Inlichtingen Zelfcertificering (AEoI)
ULBE CONT2792
|
|
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
Operational Forms
Automatische Uitwisseling van Inlichtingen Zelfcertificering (AEoI)
ULBE CONT2793
|
|
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
Operational Forms
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes physiques (Branch) (AEoI)
ULBE CONT2794
|
|
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
Operational Forms
Automatische Uitwisseling van Inlichtingen Zelfcertificering (AEoI)
ULBE CONT2791
|
|
|
Operational Forms Formulaire de Choix Option « Opt-Out » (FR) ULBE PR 00008
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
Addition to your Policy, Making a change to your policy |
Operational Forms
Formulaire de Choix Option « Opt-Out » (FR)
ULBE PR 00008
|
|
|
Privacy Notice – English version
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
English (EN) |
FOS |
|
Privacy Notice – English version
Client Letters/Indemnity/Data Protection
Privacy Notice
ULU CONT3337-WEB
|
|
|
Privacy Notice – French version
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
French (FR) |
FOS |
|
Privacy Notice – French version
Client Letters/Indemnity/Data Protection
Avis de confidentialité
ULU CONT3340-WEB
|
|
|
Privacy Notice – Dutch version
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
FOS |
|
Privacy Notice – Dutch version
Client Letters/Indemnity/Data Protection
Privacyverklaring
ULU CONT3341-WEB
|
|
|
Annex showing the activity-based charging grid
|
Utmost Luxembourg S.A |
Commission Documents/Fees & Charges Literature and Illustrations |
Dutch (NL) |
FOS |
|
Annex showing the activity-based charging grid
Commission Documents/Fees & Charges Literature and Illustrations
Overzicht van bijkomende administratieve vergoedingen
ULU CONT3167
|
|
|
Annex showing the activity-based charging grid
|
Utmost Luxembourg S.A |
Commission Documents/Fees & Charges Literature and Illustrations |
French (FR) |
FOS |
|
Annex showing the activity-based charging grid
Commission Documents/Fees & Charges Literature and Illustrations
Aperçu des frais administratifs additionnels
ULU CONT3168
|
|
|
Operational Forms Keuzeformulier Voor de ‘Opt-Out’-Optie ULBE PR 00007
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
Addition to your Policy, Making a change to your policy |
Operational Forms
Keuzeformulier Voor de ‘Opt-Out’-Optie
ULBE PR 00007
|
|
|
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 |
Operational Forms |
English (EN) |
FOS |
Addition to your Policy, New Policy |
This questionnaire seeks to obtain information and documentation from the adviser to establish the source of wealth of high-risk clients of Utmost International Isle of Man Limited and Utmost PanEurope dac
Operational Forms
Source of Wealth Questionnaire
UWSQ PR | 20888
|
|
|
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 trusts where all the trustees are all individuals. It should be completed by one trustee on behalf of the trust.
|
Utmost Wealth Solutions |
Tax and regulatory Literature/technical sales aids and literature |
English (EN) |
FOS |
Making a change to your policy, New Policy |
For Use with Utmost Worldwide, Utmost PanEurope and Utmost International Isle of Man products. You have been asked to complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for trusts where all the trustees are all individuals. It should be completed by one trustee on behalf of the trust.
Tax and regulatory Literature/technical sales aids and literature
Tax Declaration and Self-Certification for Trusts
UTSQ PR | 20885
|
|
|
This form should be used for policies subject to the laws of Belgium, Cyprus, Spain or Sweden. Complete this form if you are the policyholder and request for the mutual stipulations wording to be applied to your policy and also wish to nominate the beneficiary(ies) listed in the appointment of beneficiary(ies) for your policy.
|
Utmost PanEurope |
Operational Forms |
English (EN) |
FOS |
Making a change to your policy |
This form should be used for policies subject to the laws of Belgium, Cyprus, Spain or Sweden. Complete this form if you are the policyholder and request for the mutual stipulations wording to be applied to your policy and also wish to nominate the beneficiary(ies) listed in the appointment of beneficiary(ies) for your policy.
Operational Forms
Mutual Stipulations and Nomination Form Irish jointly Owned Products
UPEQ PR | 21042
|
|
|
This Connect User Guide shows how to request a regular withdrawal – in Dutch
|
Utmost Luxembourg S.A |
Product Guides/Brochures/Snapshots and Training Materials |
Dutch (NL) |
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
|
|
|
Please use this Information Disclosure Agreement for sharing client information with the National Bank of Belgium
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
French (FR) |
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 (FR)
ULU PR 00098
|
|
|
Please use this Information Disclosure Agreement for sharing client information with the National Bank of Belgium
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
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
|
|
|
Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank
|
Utmost Luxembourg S.A |
Operational Forms |
Dutch (NL) |
FOS |
|
Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank
Operational Forms
Wijziging van de voornaamste kenmerken van een bestaand Intern Toegewezen Fonds
ULU PCON1557
|
|
|
Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank
|
Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
FOS |
|
Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank
Operational Forms
Modification des caractéristiques principales d’un Fonds Interne Dédié existant
ULU PCON1556
|
|
|
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 |
Operational Forms |
French (FR) |
FOS |
|
Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures
Operational Forms
Formulaire de changement de moyen de communication et utilisation des signatures électroniques
ULU PCON1521
|
|
|
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 |
Operational Forms |
Dutch (NL) |
FOS |
|
Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures
Operational Forms
Wijziging van het communicatiemiddel voor correspondentie en het gebruik van elektronische handtekeningen
ULU PCON1520
|
|
|
Use this form to request an appointment or change of broker
|
Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
FOS |
|
Use this form to request an appointment or change of broker
Operational Forms
Désignation d’Intermédiaire
ULU PCON1323
|
|
|
Use this form to request an appointment or change of broker
|
Utmost Luxembourg S.A |
Operational Forms |
Dutch (NL) |
FOS |
|
Use this form to request an appointment or change of broker
Operational Forms
Aanstelling van Tussenpersoon
ULU PCON1322
|
|
|
Form to be used to declare the loss of policy documents – Belgium (FOS) – French version
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
French (FR) |
FOS |
|
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
|
|
|
Form to be used to declare the loss of policy documents – Belgium (FOS) – Dutch version
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
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
|
|
|
Use this form to request a regular withdrawal from your policy/contract – Belgium (FOS) – French version
|
Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
French (FR) |
FOS |
|
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
|
|
|
Use this form to request a regular withdrawal from your policy/contract – Belgium (FOS) – Dutch version
|
Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
Dutch (NL) |
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
|
|
|
Use this form to initiate a death claim – Belgium (French version)
|
Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
French (FR) |
FOS |
|
Use this form to initiate a death claim – Belgium (French version)
Surrender/Claim/Withdrawal/Switch
Dénouement par Décès
ULU PCON1065
|
|
|
Use this form to request the surrender of your policy/contract – Belgium (FOS) – French version
|
Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
French (FR) |
FOS |
|
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
|
|
|
Use this form to request a switch of investments on your policy/contract – Belgium (FOS) – French version
|
Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
Dutch (NL) |
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
|
|
|
Use this form to request a withdrawal from your policy/contract – Belgium (FOS) – French version
|
Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
French (FR) |
FOS |
|
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
|
|
|
Use this form to request a switch of investments on your policy/contract – Belgium (FOS) – Dutch version
|
Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
French (FR) |
FOS |
|
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
|
|
|
Use this form to request the surrender of your policy/contract – Belgium (FOS) – Dutch version
|
Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
Dutch (NL) |
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
|
|
|
Use this form to request a withdrawal from your policy/contract – Belgium (FOS) – Dutch version
|
Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
Dutch (NL) |
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
|
|
|
Use this form to initiate a death claim – Belgium (Dutch version)
|
Utmost Luxembourg S.A |
Surrender/Claim/Withdrawal/Switch |
Dutch (NL) |
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)
|
Utmost Luxembourg S.A |
Guides and Supporting Documents |
Dutch (NL) |
FOE FOS |
|
Connect Overview – Customer Guide (Dutch)
Guides and Supporting Documents
Connect Overview – Customer Guide (Dutch)
ULU MARK2352
|
|
|
This user guide helps to navigate through the Connect Platform and explain functionality – French version
|
Utmost Luxembourg S.A |
Guides and Supporting Documents |
French (FR) |
FOE FOS |
|
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
|
|
|
This is a Connect User Guide for digital subscription – Dutch version
|
Utmost Luxembourg S.A |
Guides and Supporting Documents |
Dutch (NL) |
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
|
|
|
This is a Connect User Guide for digital subscription – French version
|
Utmost Luxembourg S.A |
Guides and Supporting Documents |
French (FR) |
FOE FOS |
|
This is a Connect User Guide for digital subscription – French version
Guides and Supporting Documents
Guide d’utilisation Connect Souscription Digitale – Belgique
ULU MARK2302
|
|
|
Connect User Guide – Total Redemption (French)
|
Utmost Luxembourg S.A |
Guides and Supporting Documents |
French (FR) |
FOE FOS |
|
Connect User Guide – Total Redemption (French)
Guides and Supporting Documents
Connect User Guide – Total Redemption (French)
ULU MARK2174
|
|
|
Connect User Manual – Full Redemption (Dutch)
|
Utmost Luxembourg S.A |
Guides and Supporting Documents |
Dutch (NL) |
FOE FOS |
|
Connect User Manual – Full Redemption (Dutch)
Guides and Supporting Documents
Connect Gebruikershandleiding – Volledige Afkoop
ULU MARK2171
|
|
|
Table of Luxembourg Investment Rules
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
Dutch (NL) |
FOS |
|
Table of Luxembourg Investment Rules
Investment literature/Strategies
Bijlage: beleggingsregels en -limieten voor Interne en Externe Fondsen
ULU CONT3683
|
|
|
Table of Luxembourg Investment Rules
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
French (FR) |
FOS |
|
Table of Luxembourg Investment Rules
Investment literature/Strategies
Règles d’investissement pour fonds internes – Belgique
ULU CONT3681
|
|
|
Privacy Notice – Dutch version – Belgium (FOS)
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
FOS |
|
Privacy Notice – Dutch version – Belgium (FOS)
Client Letters/Indemnity/Data Protection
Verklaring betreffende de Bescherming van Persoonsgegevens
ULU CONT3341
|
|
|
Privacy Notice – French version – Belgium (FOS)
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
French (FR) |
FOS |
|
Privacy Notice – French version – Belgium (FOS)
Client Letters/Indemnity/Data Protection
Déclaration concernant la Protection des Données à Caractère
ULU CONT3340
|
|
|
Request for Professional Client Status
|
Utmost Luxembourg S.A |
Operational Forms |
Dutch (NL), English (EN) |
FOS |
|
Request for Professional Client Status
Operational Forms
Aanvraag van het Statuut van Professionele Cliënt / Request for Professional Client Status
ULU CONT3210
|
|
|
Request for Professional Client Status
|
Utmost Luxembourg S.A |
Operational Forms |
English (EN), French (FR) |
FOS |
|
Request for Professional Client Status
Operational Forms
Demande de Statut de Client Professionnel / Request for Professional Client Status
ULU CONT3207
|
|
|
Information Disclosure Agreement
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
FOS |
|
Information Disclosure Agreement
Client Letters/Indemnity/Data Protection
OVEREENKOMST INZAKE OPENBAARMAKING VAN INFORMATIE
ULU CONT2860
|
|
|
Information Disclosure Agreement
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
French (FR) |
FOS |
|
Information Disclosure Agreement
Client Letters/Indemnity/Data Protection
ACCORD DE COMMUNICATION D’INFORMATION
ULU CONT2861
|
|
|
Annex to the application form for beneficiary acceptance
|
Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
FOS |
|
Annex to the application form for beneficiary acceptance
Operational Forms
Avenant au contrat d’assurance-vie – Acceptation du bénéfice
ULU CONT2803
|
|
|
Annex to the application form for beneficiary acceptance
|
Utmost Luxembourg S.A |
Operational Forms |
Dutch (NL) |
FOS |
|
Annex to the application form for beneficiary acceptance
Operational Forms
Bijvoegsel bij de levensverzekeringsovereenkomst – Aanvaarding van de begunstiging
ULU CONT2802
|
|
|
Annex to the application form for signing the dissolution of the transfer of insurance rights
|
Utmost Luxembourg S.A |
Operational Forms |
Dutch (NL) |
FOS |
|
Annex to the application form for signing the dissolution of the transfer of insurance rights
Operational Forms
Bijvoegsel bij de levensverzekeringsovereenkomst – Ontbinding van de overdracht van verzekeringsrechten
ULU CONT2798
|
|
|
Annex to the application form for signing the dissolution of the transfer of insurance rights
|
Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
FOS |
|
Annex to the application form for signing the dissolution of the transfer of insurance rights
Operational Forms
Avenant au contrat d’assurance-vie – Dissolution de cession de droits
ULU CONT2799
|
|
|
Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy
|
Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
FOS |
|
Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy
Operational Forms
Avenant au contrat d’assurance-vie – Convention de Cession Post Mortem des droits découlant du Contrat
ULU CONT2629
|
|
|
Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy
|
Utmost Luxembourg S.A |
Operational Forms |
Dutch (NL) |
FOS |
|
Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy
Operational Forms
Bijvoegsel bij de levensverzekeringsovereenkomst – Overeenkomst van Overdracht Post Mortem van de uit de Overeenkomst voortvloeiende rechten
ULU CONT2628
|
|
|
Use this form to request a upgrade of your investment category
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
Dutch (NL) |
FOS |
|
Use this form to request a upgrade of your investment category
Investment literature/Strategies
Verzoek om een hogere investeringscategorie
ULU CONT2529
|
|
|
Use this form to request a upgrade of your investment category
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
French (FR) |
FOS |
|
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
|
|
|
Use this form to request a downgrade of your investment category
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
Dutch (NL) |
FOS |
|
Use this form to request a downgrade of your investment category
Investment literature/Strategies
Verzoek om een lagere investeringscategorie
ULU CONT2518
|
|
|
Use this form to request a downgrade of your investment category
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
French (FR) |
FOS |
|
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
|
|
|
Use this form to define your investment strategy (generic version)
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
French (FR) |
FOS |
|
Use this form to define your investment strategy (generic version)
Investment literature/Strategies
Stratégie d’Investissement
ULU CONT2276
|
|
|
Use this form to define your investment strategy (generic version)
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
Dutch (NL) |
FOS |
|
Use this form to define your investment strategy (generic version)
Investment literature/Strategies
Beleggingsstrategie
ULU CONT2275
|
|
|
Use this form to request a deviation from your investment profile
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
French (FR) |
FOS |
|
Use this form to request a deviation from your investment profile
Investment literature/Strategies
Déviation du Profil d’investissement
ULU CONT2221
|
|
|
Use this form to request a deviation from your investment profile
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
Dutch (NL) |
FOS |
|
Use this form to request a deviation from your investment profile
Investment literature/Strategies
Afwijking van het Beleggingsprofiel
ULU CONT2220
|
|
|
Medical Examination Report – Belgium (FOS) – French version
|
Utmost Luxembourg S.A |
Underwriting guides/questionnaires/brochures |
French (FR) |
FOS |
|
Medical Examination Report – Belgium (FOS) – French version
Underwriting guides/questionnaires/brochures
Rapport d’Examen Medical
ULU CONT2189
|
|
|
Medical Examination Report – Belgium (FOS) – Dutch version
|
Utmost Luxembourg S.A |
Underwriting guides/questionnaires/brochures |
Dutch (NL) |
FOS |
|
Medical Examination Report – Belgium (FOS) – Dutch version
Underwriting guides/questionnaires/brochures
Verslag Medisch Onderzoek
ULU CONT2190
|
|
|
Confidential Financial Questionnaire – Belgium (FOS) – Dutch version
|
Utmost Luxembourg S.A |
Underwriting guides/questionnaires/brochures |
Dutch (NL) |
FOS |
|
Confidential Financial Questionnaire – Belgium (FOS) – Dutch version
Underwriting guides/questionnaires/brochures
Vertrouwelijke Financiële Vragenlijst
ULU CONT2188
|
|
|
Confidential Financial Questionnaire – Belgium (FOS) – French version
|
Utmost Luxembourg S.A |
Underwriting guides/questionnaires/brochures |
French (FR) |
FOS |
|
Confidential Financial Questionnaire – Belgium (FOS) – French version
Underwriting guides/questionnaires/brochures
Questionnaire Financier Confidentiel
ULU CONT2187
|
|
|
Additional Questionnaire on Preexisting Life Policies and Applications – Belgium (FOS) – Dutch version
|
Utmost Luxembourg S.A |
Underwriting guides/questionnaires/brochures |
Dutch (NL) |
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
|
|
|
Additional Medical Questionnaire – Belgium (FOS) – Dutch version
|
Utmost Luxembourg S.A |
Underwriting guides/questionnaires/brochures |
Dutch (NL) |
FOS |
|
Additional Medical Questionnaire – Belgium (FOS) – Dutch version
Underwriting guides/questionnaires/brochures
Bijkomende Medische Vragenlijst
ULU CONT2184
|
|
|
Additional Questionnaire on Preexisting Life Policies and Applications – Belgium (FOS) – French version
|
Utmost Luxembourg S.A |
Underwriting guides/questionnaires/brochures |
French (FR) |
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
|
|
|
Additional Medical Questionnaire – Belgium (FOS) – French version
|
Utmost Luxembourg S.A |
Underwriting guides/questionnaires/brochures |
French (FR) |
FOS |
|
Additional Medical Questionnaire – Belgium (FOS) – French version
Underwriting guides/questionnaires/brochures
Questionnaire Medical Complementaire
ULU CONT2183
|
|
|
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 |
Operational Forms |
Dutch (NL) |
FOS |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
Operational Forms
FATCA Zelfcertificering
ULU CONT2170-8
|
|
|
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 |
Operational Forms |
English (EN) |
FOS |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
Operational Forms
FATCA Self-Certification
ULU CONT2170-5
|
|
|
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 |
Operational Forms |
French (FR) |
FOS |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons.
Operational Forms
FATCA Auto-Certification
ULU CONT2170
|
|
|
Use this form to complete an investment profile questionnaire and request a deviation from your investment profile
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
French (FR) |
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
|
|
|
Use this form to complete an investment profile questionnaire and request a deviation from your investment profile
|
Utmost Luxembourg S.A |
Investment literature/Strategies |
Dutch (NL) |
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
|
|
|
Use this form to nominate beneficiaries
|
Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
FOS |
|
Use this form to nominate beneficiaries
Operational Forms
Désignation des Bénéficiaires
ULU CONT1802
|
|
|
Use this form to perform a choice of law
|
Utmost Luxembourg S.A |
Operational Forms |
Dutch (NL), English (EN) |
FOS |
|
Use this form to perform a choice of law
Operational Forms
Keuze van de Toepasbare Wet / Choice of Law
ULU CONT1791
|
|
|
Use this form to perform a choice of law
|
Utmost Luxembourg S.A |
Operational Forms |
English (EN), French (FR) |
FOS |
|
Use this form to perform a choice of law
Operational Forms
Choix de la Loi Applicable / Choice of Law
ULU CONT1790
|
|
|
Use this form to declare a status of “Non-U.S. Person”
|
Utmost Luxembourg S.A |
Operational Forms |
Dutch (NL) |
FOS |
|
Use this form to declare a status of “Non-U.S. Person”
Operational Forms
Verklaring omtrent „Non-U.S. Person”-status
ULU CONT1634
|
|
|
Use this form to declare a status of “Non-U.S. Person”
|
Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
FOS |
|
Use this form to declare a status of “Non-U.S. Person”
Operational Forms
Déclaration de Statut de « Non-U.S. Person »
ULU CONT1632
|
|
|
Stand-alone Notice on the risks of acceptance when investing in Specialised Investments – Belgium (FOS) – French version
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
French (FR) |
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
|
|
|
Stand-alone Notice on the risks of acceptance when investing in Specialised Investments – Belgium (FOS) – Dutch version
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
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
|
|
|
Declaration for the Use of a Custodian Bank located outside of the EEA – Belgium (FOS) – Dutch version
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
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
|
|
|
Declaration for the Use of a Custodian Bank located outside of the EEA – France – Liberté product
|
Utmost Luxembourg S.A |
Client Letters/Indemnity/Data Protection |
French (FR) |
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
|
|
|
Confirmation of Client contact details used for the Electronic Signing of documents
|
Utmost Luxembourg S.A |
Operational Forms |
Dutch (NL) |
FOE FOS |
|
Confirmation of Client contact details used for the Electronic Signing of documents
Operational Forms
Bevestiging van contactgegevens van de Cliënt die worden gebruikt voor de elektronische ondertekening van documenten
ULU CONNECT1049
|
|
|
Confirmation of Client contact details used for the Electronic Signing of documents
|
Utmost Luxembourg S.A |
Operational Forms |
French (FR) |
FOE FOS |
|
Confirmation of Client contact details used for the Electronic Signing of documents
Operational Forms
Confirmation des coordonnées du Client utilisées pour la signature électronique des documents
ULU CONNECT1048
|
|
|
Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
|
Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank
Operational Forms
Wijziging van de voornaamste kenmerken van een bestaand Intern Toegewezen Fonds
ULBE PCON1561
|
|
|
Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
|
Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank
Operational Forms
Modification des caractéristiques principales d’un Fonds Interne Dédié existant
ULBE PCON1560
|
|
|
Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
|
Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures
Operational Forms
Formulaire de changement de moyen de communication et utilisation des signatures électroniques
ULBE PCON1530
|
|
|
Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
|
Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures
Operational Forms
Wijziging van het communicatiemiddel voor correspondentie en het gebruik van elektronische handtekeningen
ULBE PCON1529
|
|
|
Use this form to request a switch of investments on your policy/contract – Belgium (Branch) – French version
|
Utmost Luxembourg S.A. - Belgian Branch |
Surrender/Claim/Withdrawal/Switch |
French (FR) |
FOE |
|
Use this form to request a switch of investments on your policy/contract – Belgium (Branch) – French version
Surrender/Claim/Withdrawal/Switch
Demande d’Arbitrage
ULBE PCON1432
|
|
|
Use this form to request a switch of investments on your policy/contract – Belgium (Branch) – Dutch version
|
Utmost Luxembourg S.A. - Belgian Branch |
Surrender/Claim/Withdrawal/Switch |
Dutch (NL) |
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
|
|
|
Use this form to request an appointment or change of broker
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
|
Use this form to request an appointment or change of broker
Operational Forms
Aanstelling van Tussenpersoon
ULBE PCON1430
|
|
|
Use this form to request an appointment or change of broker
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
|
Use this form to request an appointment or change of broker
Operational Forms
Désignation d’Intermédiaire
ULBE PCON1429
|
|
|
Use this form to request a regular withdrawal from your policy/contract – Belgium (Branch) – Dutch version
|
Utmost Luxembourg S.A. - Belgian Branch |
Surrender/Claim/Withdrawal/Switch |
Dutch (NL) |
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
|
|
|
Use this form to request a regular withdrawal from your policy/contract – Belgium (Branch) – French version
|
Utmost Luxembourg S.A. - Belgian Branch |
Surrender/Claim/Withdrawal/Switch |
French (FR) |
FOE |
|
Use this form to request a regular withdrawal from your policy/contract – Belgium (Branch) – French version
Surrender/Claim/Withdrawal/Switch
Rachat Partiel Programmé (Branch)
ULBE PCON1401
|
|
|
Use this form to request the surrender of your policy/contract – Belgium (Branch) – French version
|
Utmost Luxembourg S.A. - Belgian Branch |
Surrender/Claim/Withdrawal/Switch |
French (FR) |
FOE |
|
Use this form to request the surrender of your policy/contract – Belgium (Branch) – French version
Surrender/Claim/Withdrawal/Switch
Demande de Rachat Total (Branch)
ULBE PCON1345
|
|
|
Use this form to request the surrender of your policy/contract – Belgium (Branch) – Dutch version
|
Utmost Luxembourg S.A. - Belgian Branch |
Surrender/Claim/Withdrawal/Switch |
Dutch (NL) |
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
|
|
|
Use this form to request a withdrawal from your policy/contract – Belgium (Branch) – French version
|
Utmost Luxembourg S.A. - Belgian Branch |
Surrender/Claim/Withdrawal/Switch |
French (FR) |
FOE |
|
Use this form to request a withdrawal from your policy/contract – Belgium (Branch) – French version
Surrender/Claim/Withdrawal/Switch
Demande de Rachat Partiel (Branch)
ULBE PCON1343
|
|
|
Use this form to request a withdrawal from your policy/contract – Belgium (Branch) – Dutch version
|
Utmost Luxembourg S.A. - Belgian Branch |
Surrender/Claim/Withdrawal/Switch |
Dutch (NL) |
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
|
|
|
Form to be used to declare the loss of policy documents – Belgium (Branch) – French version
|
Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
French (FR) |
FOE |
|
Form to be used to declare the loss of policy documents – Belgium (Branch) – French version
Client Letters/Indemnity/Data Protection
Déclaration de Perte de Documents (Branch)
ULBE PCON1337
|
|
|
Form to be used to declare the loss of policy documents – Belgium (Branch) – Dutch version
|
Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
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
|
|
|
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
|
Utmost Luxembourg S.A. - Belgian Branch |
Fact Find |
Dutch (NL) |
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
|
|
|
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. French version
|
Utmost Luxembourg S.A. - Belgian Branch |
Fact Find |
French (FR) |
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. French version
Fact Find
FOR INTERMEDIARIES – Document d’entrée enrelation / Version pour l’Intermédiaire – Société
ULBE CONT4475
|
|
|
Use this form to nominate beneficiaries
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
|
Use this form to nominate beneficiaries
Operational Forms
Benoeming van Begunstigden
ULBE CONT4383
|
|
|
Use this form to nominate beneficiaries
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
|
Use this form to nominate beneficiaries
Operational Forms
Désignation des Bénéficiaires
ULBE CONT4382
|
|
|
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. French version
|
Utmost Luxembourg S.A. - Belgian Branch |
Fact Find |
French (FR) |
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. French version
Fact Find
FOR INTERMEDIARIES – Document d’entrée en relation – Version pour l’Intermédiaire / Personne physique
ULBE CONT3968
|
|
|
Table of Luxembourg Investment Rules
|
Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
Dutch (NL) |
FOE |
|
Table of Luxembourg Investment Rules
Investment literature/Strategies
Bijlage: beleggingsregels en -limieten voor Interne en Externe Fondsen
ULBE CONT3684
|
|
|
Table of Luxembourg Investment Rules
|
Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
French (FR) |
FOE |
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Table of Luxembourg Investment Rules
Investment literature/Strategies
Annexe: règles et limites d’investissement pour les Fonds Internes et Externes
ULBE CONT3682
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Use this form to complete an investment profile questionnaire and request a deviation from your investment profile
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Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
French (FR) |
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
Profil d’investissement et évaluation de l’adéquation
ULBE CONT3475
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Back-end tax annex – Belgium
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Utmost Luxembourg S.A. - Belgian Branch |
Tax and regulatory Literature/technical sales aids and literature |
Dutch (NL) |
FOE |
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Back-end tax annex – Belgium
Tax and regulatory Literature/technical sales aids and literature
Taks op de Verzekeringsverrichtingen
ULBE CONT3403
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Use this form to complete an investment profile questionnaire and request a deviation from your investment profile
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Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
Dutch (NL) |
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
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Back-end tax annex – Belgium
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Utmost Luxembourg S.A. - Belgian Branch |
Tax and regulatory Literature/technical sales aids and literature |
French (FR) |
FOE |
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Back-end tax annex – Belgium
Tax and regulatory Literature/technical sales aids and literature
Taxe sur les Opérations d’Assurance
ULBE CONT3402
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Privacy Notice – Dutch version
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Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
FOE |
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Privacy Notice – Dutch version
Client Letters/Indemnity/Data Protection
Privacyverklaring
ULBE CONT3339-WEB
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Privacy Notice – French version – Belgian Branch
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Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
FOS |
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Privacy Notice – French version – Belgian Branch
Client Letters/Indemnity/Data Protection
Verklaring betreffende de Bescherming van Persoonsgegevens
ULBE CONT3339
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Privacy Notice – French version
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Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
French (FR) |
FOE |
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Privacy Notice – French version
Client Letters/Indemnity/Data Protection
Avis de confidentialité
ULBE CONT3338-WEB
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Privacy Notice – Dutch version – Belgian Branch
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Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
French (FR) |
FOS |
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Privacy Notice – Dutch version – Belgian Branch
Client Letters/Indemnity/Data Protection
Déclaration concernant la Protection des Données à Caractère
ULBE CONT3338
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Information Disclosure Agreement
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Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
French (FR) |
FOE |
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Information Disclosure Agreement
Client Letters/Indemnity/Data Protection
ACCORD DE COMMUNICATION D’INFORMATION
ULBE CONT3287
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Information Disclosure Agreement
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Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
FOE |
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Information Disclosure Agreement
Client Letters/Indemnity/Data Protection
OVEREENKOMST INZAKE OPENBAARMAKING VAN INFORMATIE
ULBE CONT3286
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Use this form to request a deviation from your investment profile
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Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
French (FR) |
FOE |
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Use this form to request a deviation from your investment profile
Investment literature/Strategies
Déviation du Profil d’investissement
ULBE CONT3270
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Use this form to request a deviation from your investment profile
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Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
Dutch (NL) |
FOE |
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Use this form to request a deviation from your investment profile
Investment literature/Strategies
Afwijking van het Beleggingsprofiel
ULBE CONT3269
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Use this form to request a upgrade of your investment category
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Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
Dutch (NL) |
FOE |
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Use this form to request a upgrade of your investment category
Investment literature/Strategies
Verzoek om een hogere investeringscategorie
ULBE CONT3238
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Use this form to request a downgrade of your investment category
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Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
Dutch (NL) |
FOE |
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Use this form to request a downgrade of your investment category
Investment literature/Strategies
Verzoek om een lagere investeringscategorie
ULBE CONT3236
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Use this form to request a upgrade of your investment category
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Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
French (FR) |
FOE |
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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
ULBE CONT3237
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Use this form to request a downgrade of your investment category
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Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
French (FR) |
FOE |
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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
ULBE CONT3235
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Request for Professional Client Status
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Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
English (EN), French (FR) |
FOE |
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Request for Professional Client Status
Operational Forms
Demande de Statut de Client Professionnel / Request for Professional Client Status (Branch)
ULBE CONT3209
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Request for Professional Client Status
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Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL), English (EN) |
FOE |
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Request for Professional Client Status
Operational Forms
Aanvraag van het Statuut van Professionele Cliënt / Request for Professional Client Status (Branch)
ULBE CONT3208
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Use this form to perform a choice of law
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Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
English (EN), French (FR) |
FOE |
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Use this form to perform a choice of law
Operational Forms
Choix de la Loi Applicable / Choice of Law (Branch)
ULBE CONT3195
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Use this form to perform a choice of law
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Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL), English (EN) |
FOE |
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Use this form to perform a choice of law
Operational Forms
Keuze van de Toepasbare Wet / Choice of Law
ULBE CONT3196
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Annex showing the activity-based charging grid
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Utmost Luxembourg S.A. - Belgian Branch |
Commission Documents/Fees & Charges Literature and Illustrations |
French (FR) |
FOE |
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Annex showing the activity-based charging grid
Commission Documents/Fees & Charges Literature and Illustrations
Aperçu des frais administratifs additionnels
ULBE CONT3182
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Annex showing the activity-based charging grid
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Utmost Luxembourg S.A. - Belgian Branch |
Commission Documents/Fees & Charges Literature and Illustrations |
Dutch (NL) |
FOE |
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Annex showing the activity-based charging grid
Commission Documents/Fees & Charges Literature and Illustrations
Overzicht van bijkomende administratieve vergoedingen
ULBE CONT3181
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Declaration for the Use of a Custodian Bank located outside of the EEA – Belgium (Branch) – Dutch version
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Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
FOE |
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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
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Declaration for the Use of a Custodian Bank located outside of the EEA – Belgium (Branch) – French version
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Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
French (FR) |
FOE |
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Declaration for the Use of a Custodian Bank located outside of the EEA – Belgium (Branch) – French version
Client Letters/Indemnity/Data Protection
Banque Dépositaire hors de l’EEE (Branch)
ULBE CONT2948
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Stand-alone Tax Compliance Certification form – Belgium (Branch) – Dutch version
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Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
Dutch (NL) |
FOE |
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Stand-alone Tax Compliance Certification form – Belgium (Branch) – Dutch version
Client Letters/Indemnity/Data Protection
Verklaring betreffende de Fiscale Verplichtingen – Branch
ULBE CONT2831
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Stand-alone Tax Compliance Certification form – Belgium (Branch) – French version
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Utmost Luxembourg S.A. - Belgian Branch |
Client Letters/Indemnity/Data Protection |
French (FR) |
FOE |
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Stand-alone Tax Compliance Certification form – Belgium (Branch) – French version
Client Letters/Indemnity/Data Protection
Déclaration relative aux Obligations Fiscales – Branch
ULBE CONT2830
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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.
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Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
English (EN) |
FOE |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
Operational Forms
FATCA Self-Certification
ULBE CONT2826
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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.
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
Operational Forms
FATCA Zelfcertificering
ULBE CONT2824
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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.
|
Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
|
Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders.
Operational Forms
FATCA Auto-certification
ULBE CONT2825
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Confidential Financial Questionnaire – Belgium (Branch) – Dutch version
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Utmost Luxembourg S.A. - Belgian Branch |
Underwriting guides/questionnaires/brochures |
Dutch (NL) |
FOE |
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Confidential Financial Questionnaire – Belgium (Branch) – Dutch version
Underwriting guides/questionnaires/brochures
Vertrouwelijke Financiële Vragenlijst (Branch)
ULBE CONT2819
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Confidential Financial Questionnaire – Belgium (Branch) – French version
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Utmost Luxembourg S.A. - Belgian Branch |
Underwriting guides/questionnaires/brochures |
French (FR) |
FOE |
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Confidential Financial Questionnaire – Belgium (Branch) – French version
Underwriting guides/questionnaires/brochures
Questionnaire financier confidentiel (Branch)
ULBE CONT2818
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Additional Questionnaire on Preexisting Life Policies and Applications – Belgium (Branch) – Dutch version
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Utmost Luxembourg S.A. - Belgian Branch |
Underwriting guides/questionnaires/brochures |
Dutch (NL) |
FOE |
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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
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Medical Examination Report – Belgium (Branch) – Dutch version
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Utmost Luxembourg S.A. - Belgian Branch |
Underwriting guides/questionnaires/brochures |
Dutch (NL) |
FOE |
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Medical Examination Report – Belgium (Branch) – Dutch version
Underwriting guides/questionnaires/brochures
Verslag Medisch Onderzoek (Branch)
ULBE CONT2815
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Additional Questionnaire on Preexisting Life Policies and Applications – Belgium (Branch) – French version
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Utmost Luxembourg S.A. - Belgian Branch |
Underwriting guides/questionnaires/brochures |
French (FR) |
FOE |
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Additional Questionnaire on Preexisting Life Policies and Applications – Belgium (Branch) – French version
Underwriting guides/questionnaires/brochures
Questionnaire complémentaire Contrats d’assurance-vie et Demandes existantes (Branch)
ULBE CONT2816
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Medical Examination Report – Belgium (Branch) – French version
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Utmost Luxembourg S.A. - Belgian Branch |
Underwriting guides/questionnaires/brochures |
French (FR) |
FOE |
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Medical Examination Report – Belgium (Branch) – French version
Underwriting guides/questionnaires/brochures
Rapport d’Examen médical (Branch)
ULBE CONT2814
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Additional Medical Questionnaire – Belgium (Branch) – Dutch version
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Utmost Luxembourg S.A. - Belgian Branch |
Underwriting guides/questionnaires/brochures |
Dutch (NL) |
FOE |
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Additional Medical Questionnaire – Belgium (Branch) – Dutch version
Underwriting guides/questionnaires/brochures
Bijkomende Medische Vragenlijst (Branch)
ULBE CONT2813
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Additional Medical Questionnaire – Belgium (Branch) – French version
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Utmost Luxembourg S.A. - Belgian Branch |
Underwriting guides/questionnaires/brochures |
French (FR) |
FOE |
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Additional Medical Questionnaire – Belgium (Branch) – French version
Underwriting guides/questionnaires/brochures
Questionnaire médical complémentaire (Branch)
ULBE CONT2812
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Annex to the application form for beneficiary acceptance
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Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
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Annex to the application form for beneficiary acceptance
Operational Forms
Avenant au contrat d’assurance-vie – Acceptation du bénéfice (Branch)
ULBE CONT2805
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Annex to the application form for signing the dissolution of the transfer of insurance rights
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Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
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Annex to the application form for signing the dissolution of the transfer of insurance rights
Operational Forms
Avenant au contrat d’assurance-vie – Dissolution de cession de droits (Branch)
ULBE CONT2801
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Annex to the application form for beneficiary acceptance
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Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
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Annex to the application form for beneficiary acceptance
Operational Forms
Bijvoegsel bij de levensverzekeringsovereenkomst – Aanvaarding van de begunstiging (Branch)
ULBE CONT2804
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Annex to the application form for signing the dissolution of the transfer of insurance rights
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Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
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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
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Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy
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Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
French (FR) |
FOE |
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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
Avenant au contrat d’assurance-vie – Convention de Cession Post Mortem des droits découlant du Contrat (Branch)
ULBE CONT2789
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Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy
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Utmost Luxembourg S.A. - Belgian Branch |
Operational Forms |
Dutch (NL) |
FOE |
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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
Bijvoegsel bij de levensverzekeringsovereenkomst – Overeenkomst van Overdracht Post Mortem van de uit de Overeenkomst voortvloeiende rechten (Branch)
ULBE CONT2788
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Generic investment strategy form for the Belgian market (Branch) – French version
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Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
French (FR) |
FOE |
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Generic investment strategy form for the Belgian market (Branch) – French version
Investment literature/Strategies
Stratégie d’Investissement (Branch)
ULBE CONT2779
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Generic investment strategy form for the Belgian market (Branch) – Dutch version
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Utmost Luxembourg S.A. - Belgian Branch |
Investment literature/Strategies |
Dutch (NL) |
FOE |
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Generic investment strategy form for the Belgian market (Branch) – Dutch version
Investment literature/Strategies
Beleggingsstrategie (Branch)
ULBE CONT2778
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Stand-alone version of General Conditions for the Select Client Policy product – Belgium (Branch) – Dutch version
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Utmost Luxembourg S.A. - Belgian Branch |
Policy Conditions |
Dutch (NL) |
FOE |
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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
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Stand-alone version of General Conditions for the Select Client Policy product – Belgium (Branch) – French version
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Utmost Luxembourg S.A. - Belgian Branch |
Policy Conditions |
French (FR) |
FOE |
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Stand-alone version of General Conditions for the Select Client Policy product – Belgium (Branch) – French version
Policy Conditions
Select Client Policy – Conditions Générales
ULBE CONT2694
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