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Title	Description	Insurer	Product	Process	Excerpt
Modification des caractéristiques principales d’un Fonds Interne Dédié existant	Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank	Utmost Luxembourg S.A	Non Product Specific		Use this form to request a change to one or more key characteristics of an Internal Dedicated Fund; such as Change of Fund Manager and Custodian Bank Operational Forms Modification des caractéristiques principales d’un Fonds Interne Dédié existant ULU PCON1556
Formulaire de changement de moyen de communication et utilisation des signatures électroniques	Use this form to request a change of communication means; change of address; change of correspondence address and consent to the use of electronic signatures	Utmost Luxembourg S.A	Non Product Specific		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
Désignation d’Intermédiaire	Use this form to request an appointment or change of broker	Utmost Luxembourg S.A	Non Product Specific		Use this form to request an appointment or change of broker Operational Forms Désignation d’Intermédiaire ULU PCON1323
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes détenant le contrôle	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	Non Product Specific	New Policy	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for controlling persons. Operational Forms Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes détenant le contrôle ULU CONT4262
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les entités	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	Non Product Specific	New Policy	Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for corporate applications. Operational Forms Echange Automatique de Renseignements – Formulaire d’Autocertification pour les entités ULU CONT4250
Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes physiques	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	Non Product Specific		Please complete this form in order that we can accurately report your policy under the relevant tax information exchange agreements, including Foreign Account Tax Compliance Act (FATCA) and the Common Reporting Standard (CRS) regulations. This form should be used for individual policyholders. Operational Forms Echange Automatique de Renseignements – Formulaire d’Autocertification pour les personnes physiques ULU CONT4241
Déclaration des associés d’une société civile en tant que Preneur d’Assurance	Declaration of the partners of a civil partnership as policyholder	Utmost Luxembourg S.A	Select Client Plan	New Policy	Declaration of the partners of a civil partnership as policyholder Operational Forms Déclaration des associés d’une société civile en tant que Preneur d’Assurance ULU CONT4191
Select Client Plan – Caractéristiques principales du (family shared) Fonds interne dédié	Annex to add additional Family Shared Internal Dedicated Funds to the contract/policy	Utmost Luxembourg S.A	Select Client Plan	New Policy	Annex to add additional Family Shared Internal Dedicated Funds to the contract/policy Operational Forms Select Client Plan – Caractéristiques principales du (family shared) Fonds interne dédié ULU CONT3788
Select Client Plan (Multi-Support) – Fonds Interne Dédié additionnel	Annex to add additional Internal Dedicated Funds to the contract/policy	Utmost Luxembourg S.A	Select Client Plan	New Policy	Annex to add additional Internal Dedicated Funds to the contract/policy Operational Forms Select Client Plan (Multi-Support) – Fonds Interne Dédié additionnel ULU CONT3633
Demande de Statut de Client Professionnel / Request for Professional Client Status	Request for Professional Client Status	Utmost Luxembourg S.A	Non Product Specific		Request for Professional Client Status Operational Forms Demande de Statut de Client Professionnel / Request for Professional Client Status ULU CONT3207
Aperçu des frais administratifs additionnels	Annex showing the activity-based charging grid	Utmost Luxembourg S.A	Non Product Specific		Annex showing the activity-based charging grid Operational Forms Aperçu des frais administratifs additionnels ULU CONT3168
Avenant au contrat d’assurance-vie – Acceptation du bénéfice	Annex to the application form for beneficiary acceptance	Utmost Luxembourg S.A	Non Product Specific		Annex to the application form for beneficiary acceptance Operational Forms Avenant au contrat d’assurance-vie – Acceptation du bénéfice ULU CONT2803
Avenant au contrat d’assurance-vie – Dissolution de cession de droits	Annex to the application form for signing the dissolution of the transfer of insurance rights	Utmost Luxembourg S.A	Non Product Specific		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
Avenant au contrat d’assurance-vie – Convention de Cession Post Mortem des droits découlant du Contrat	Annex to the application form for signing a post-mortem transfer agreement of the rights arising from the contract/policy	Utmost Luxembourg S.A	Non Product Specific		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
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	Non Product Specific		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
Désignation des Bénéficiaires	Use this form to nominate beneficiaries	Utmost Luxembourg S.A	Non Product Specific		Use this form to nominate beneficiaries Operational Forms Désignation des Bénéficiaires ULU CONT1802
Choix de la Loi Applicable / Choice of Law	Use this form to perform a choice of law	Utmost Luxembourg S.A	Non Product Specific		Use this form to perform a choice of law Operational Forms Choix de la Loi Applicable / Choice of Law ULU CONT1790
Déclaration de Statut de « Non-U.S. Person »	Use this form to declare a status of “Non-U.S. Person”	Utmost Luxembourg S.A	Non Product Specific		Use this form to declare a status of “Non-U.S. Person” Operational Forms Déclaration de Statut de « Non-U.S. Person » ULU CONT1632
Confirmation des coordonnées du Client utilisées pour la signature électronique des documents	Confirmation of Client contact details used for the Electronic Signing of documents	Utmost Luxembourg S.A	Non Product Specific		Confirmation of Client contact details used for the Electronic Signing of documents Operational Forms Confirmation des coordonnées du Client utilisées pour la signature électronique des documents ULU CONNECT1048

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