Contributions Form – The Surrey and Berkshire NewspapersLifestyle Plan

If you are unsure at any stage, please contact the Pensions Department on 020 3353 2000

1. Please fill in YOUR DETAILS (CAPITAL LETTERS)

SURNAME…………………………………………….. INITIALS…………………… DATE OF BIRTH…………………..

2. Pleasesetan EFFECTIVE DATE for the change in your contributions, after reading the following IMPORTANT NOTE
IMPORTANT NOTE: If you participate in PaySmart and want to reduce your ordinary contributions (or AVCs or ECs) at any time other than 1st April each year then, as per HMRC regulations, you can only do so if one of the following fundamental changes in personal circumstances applies to you:- (please tick relevant box)
within first 3 months of employment Change in working hours  reduced earnings due to prolonged sick leave
pregnancy you/partner marriage divorce
death of partner redundancy of self/partner significantly reduced earnings of partner
beginning or returning from maternity/adoption leave Keep within Annual Allowance or Lifetime Allowance
If you reduce your contributions under PaySmart and set a date other than first of April, by signing below you confirm that one of the above changes in circumstances applies to you (our auditors may request proof at any time).
EFFECTIVE DATE  / FIRST DAY OF (MONTH) (YEAR)
3. To CHANGE Your Current Rate Of Ordinary Contributions
Please tick one of the boxes

5%*The Company will pay between 8% and 12%
2.5%*The Company will pay between 4% and 6%
0%*The Company will pay 2.5%
* % of Pensionable Earnings
Note that your life cover and Income Protection cover will be lower if you choose to be a non-contributor. If you move from paying 0% to paying 2.5% or 5%, the increase in life cover and Income Protection cover would be subject to medical underwriting.

WARNING: A limit of £50,000, per tax year, total pension contributions (employee plus company) are eligible for tax relief. It is your personal responsibility to monitor future contributions and consider changes as and when you deem appropriate.

4. To START, STOP or CHANGE Additional Voluntary Contributions (AVCs) or Extra Contributions (ECs)

AVCs as % of pensionable earnings
(MAXIMUM 10%) / OR / Fixed Amount AVCs £
per month
Variable AVCs on any non-pensionable earnings
(MAXIMUM 15%) / To STOP paying AVCs please tick here

If you choose maximum AVCs, you could also consider paying Extra Contributions (ECs).

ECs as% of pensionable earnings
(MAXIMUM 85%) / OR / Fixed Amount ECs £
per month
/ To STOP paying ECs please tick here
5. Please SIGN, DATE AND RETURN your Contributions Form
I request and authorise the Company to commence or stop deductions from my pay (via PaySmart where appropriate) as detailed above.
SIGNED…………………………………………………………………DATE…………………………………
NOTE: When completed return this form to your payroll administrator
Payroll administrator signature………………………………………………………

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The security of your personal information: All the information you provide will be held by the Trustees or by the scheme administrators who act on their behalf to arrange and administer your entitlements (and entitlements in respect of you) from the scheme. The information is kept secure and is only disclosed to third parties to the extent needed to enable the Trustees and their advisers to run the Scheme and comply with any legal or other requirements imposed on the Trustees. It may be necessary from time to time to disclose your personal data to people and organisations outside the European Economic Area and which are not covered by equivalent data protection legislation; in these circumstances the Trustees will take whatever steps they feel are necessary to ensure that your data remains secure.