Application to make contributions to The Bath Private Pension Plan
Use this form if you wish to join the Bath Private Pension Plan and make contributions.
The Bath Private Pension Plan is a Registered Pension Scheme which is governed by Rules (as amended from time to time). Cabot Trustees Limited is the Trustee and operator of the Plan.
IMPORTANT
All material facts must be disclosed. These are facts that would be regarded as likely to influence the assessment and acceptance of an application. If you are in any doubt about whether a fact is material it should be disclosed since non-disclosure or misrepresentation of a material fact may result in adjustment or constitute grounds for voiding the plan.
Please complete all sections of this form in BLOCK CAPITALS and TICK relevant boxes. (Please answer all questions to avoid delays in effecting your plan).
Please return the completed application form to your financial adviser.
The administrator is:
Cabot Trustees Limited
Suite 1D
Crescent Centre
Temple Back
Bristol
BS1 6EZ
Important – if you have enhanced protection, any contribution that you make will remove this protection. Contact your financial adviser for advice.
Personal details
If you are a legal guardian completing this application on behalf of a child under 18, the details given should relate to the child.
Mr/Mrs/Miss/Ms
Surname
Forenames
______
______
______
______
______Post Code ______
Permanent Residential
Address
Date of BirthExpected retirement age
Nationality
Marital status
Spouse’s nameSpouse’s date of birth
Contact telephone number
National Insurance No
Employment status
Please tick the most appropriate box below – only one box must be ticked.
EmployedOccupation
Self employedOccupation
Pensioner
Unemployed
In full time education
Child under 16 years old
Caring for a person aged 16 or over
Caring for one or more children under 16 years old
Other, please specify
Contributions
Please indicate the level of contribution that you or your employer intend to make
Personal contributionEmployer contribution
Single contributionnet of taxgross
Monthly contributionnet of taxgross
Expected day of the month that regular contributions will be paid
Basic rate tax relief will be added to the contribution that you have elected to make, but not to the employer contribution. It takes between 6 weeks and 11 weeks to receive the tax relief from the Inland Revenue.
Source of personal contributions– only complete this section if you are making personal contributions (or someone else is paying on your behalf). This does not apply to employer contributions.
Please tick one or more boxes to indicate the source of member contributions:
Income from employment or self employment
From investments or savings
Inheritance
Property sale
Divorce settlement
Other, please specify
Data Protection: What we collect and use your information for
We take your privacy seriously and we will only ever collect and use information which is personal to you where it is necessary, fair and lawful to do so. We will collect and use your information only where:
- you have given us your permission.
- it is necessary to provide the service you have requested e.g. we will require some personal information including your name, address, date of birth, bank account details
- it is necessary for us to meet our legal or regulatory obligations e.g. to send you Annual Statements, tell you about changes to Terms and Conditions or for the detection and prevention of fraud
- it is in the legitimate interests of Companies e.g.to deliver appropriate information and guidance so you are aware of the options that will help you get the best outcome from your scheme or investment; where we need to process your information to better understand you and your needs so we can send you more relevant communications about your scheme.
- it’s in the legitimate interests of a third party e.g. sharing information with your employer’s adviser for the governance of a pension scheme of which you are a member
If you do not wish us to collect and use your personal information in these ways, it may mean that we will be unable to provide you with our services.
For the purposes of the data protection legislation:
I consent to Cabot Trustees Limited collecting data, relating to me and to my pension arrangements, from any source and processing that data.
I consent to Cabot corresponding with my financial adviser or any other adviser that I appoint. (Note: Cabot will not disclose information to third parties except as authorised by you or required by law).
I agree to my personal information being used by the Provider, Cabot Trustees Limited, and any other bank or financial institution that provides services to my SIPP, to make a search with a credit reference agency who will supply information, including information from the Electoral Register, for the purposes of verifying my identity and address.
The Cabot Trustees Limited Privacy Policy can be downloaded in full from
If your identity cannot be verified by electronic means, we may ask you for additional information. If we suspect fraud, we will inform the fraud prevention agencies.
Declaration
I apply to join the Bath Private Pension Plan and agree to be bound by its rules, which I have had the opportunity to read. I confirm that I am aware that the assets of the Scheme are held by the Trustee subject to those rules and that my entitlement under the Scheme shall be as laid down in those rules.
I declare that:
I am a Relevant UK Individual, defined as someone who, in the current tax year,
a)has Relevant UK Earningschargeable to income tax
b)is resident in the United Kingdom at some time in the tax year
c)has general earnings from overseas Crown employment subject to UK tax (or whose spouse has such earnings).
(Relevant UK Earnings are defined in Section 189(2) of Finance Act 2004)
The contributions paid in any tax year by and in respect of me to the Plan and to any other Registered Pension Schemes where I am entitled to relief under S188 of the Finance Act 2004 will not exceed the higher of the Basic Amount (£3,600) and 100% of my Relevant UK Earnings for that tax year
I will tell Cabot Trustees Limited if I cease to be eligible for relief under S188 of the Finance Act 2004 by the 5th April of the year in which I ceased to be eligible or within 30 days after the event if that is later.
Cabot Trustees Limited may approach the providers of any other Registered Pension Schemes to which I am or have contributed to obtain any information Cabot Trustees Limited feels necessary to administer my Plan.
To the best of my knowledge and belief, the particulars and declarations given in this application are correct and complete. I have not withheld any matter or circumstance affecting my eligibility for the contract and I agree that this declaration and any other declaration made by me in connection with this application shall be the basis of the contract between me and the Provider
The answers given in the application which are not in my handwriting have been inserted at my request and that I have read the answers and confirm that the application has been completed correctly.
I have received and understood the Key Features, Terms of Business, Cancellation Rights and Fee Menu documents.
I hereby request Cabot Trustees Limited to appoint the nominated investment manager but fully understand and agree:
-that I am solely responsible for all decisions relating to the purchase, retention and sale of the investments in respect of my arrangements under the Plan.
-to hold Cabot Trustees Limited fully indemnified against any claim in respect of such decisions.
It is a serious offence to make false statements; the penalties are severe and could lead to prosecution.
In return for the services provided by Cabot Trustees Limited, I agree to pay the charges as set out in the charging structure, as amended from time to time. I authorise Cabot Trustees Limited to realise investments attributable to me in order to pay an annual charge and or transaction charges in respect of any third party charges for investment transactions, to the extent that such charges have not been otherwise paid within 14 days of falling due.
I agree to the deduction of amounts in respect of any scheme sanction charge or other tax charge or fine or penalty which may the levied by HMRC, from the funds held for me under the Scheme. If amounts involved exceed those funds, I agree to meet the excess personally.
Signature ______Date______
A copy of the rules governing the scheme and a copy of this completed application are available on request from Cabot Trustees Limited.