13 HMRC reference number. This is the QROPS reference number allocated to the scheme by HMRC: 14 Full name and address of the QROPS to which you want your AVC Fund to be transferred (if more than one scheme please give second scheme details on separate sheet and indicate in what proportions you would like the transfer payment to be split between the schemes): 15 Name of the country or territory under whose law the QROPS is established and regulated : 16. Is the QROPS receiving the transfer? The QROPS you are transferring to will know if they fall within the definition of an ‘overseas public service scheme’ under regulation 3(1B) or the definition of an ‘international organisation’ under regulation 2(5) of the Pension Schemes (Categories of Country and Requirements for Overseas Pension Schemes and Recognised Overseas Pension Schemes) Regulations 2006 [SI 2006/206]. Please tick the appropriate box: An Occupational Pension Scheme? An Overseas Public Service Scheme? An International Organisation? None of the above? (if you tick box 16(d) please go to question 22) 17. Name of your current employer 18. Your current job title 29. Address of your current employer: Postcode 20. Date your current employment began: 21. Your current payroll tax reference number (if not known – state ‘not known’)
Request for Payment of a Transfer Value from Administrators of a Personal Pension Scheme and Receiving Scheme Discharge Form Instructions to administrators of the new scheme: Please complete Parts A, B and the relevant section in Part C. Then return the completed form to: [Administering authority to enter appropriate info] PART A PLEASE COMPLETE THIS PART IN ALL CASES: Member's Full Name Member's date of birth Member's NI Number Name of Personal Pension Scheme ('the Scheme') Address of Personal Pension Scheme which is to receive the transfer value: Postcode
Request for Payment of Cash Equivalent Transfer Value to a Personal Pension Scheme Please complete this form if you want the value of your Local Government Pension Scheme (LGPS) AVC Pension Credit rights to be transferred to another scheme. Return the completed form to us at: [Administering authority to enter relevant address] Please note that we cannot pay, or instruct our AVC provider to pay, the transfer value until or unless we receive and are satisfied with the Receiving Scheme Discharge Form which [administering authority to enter appropriate wording e.g. you should get your new scheme to complete and return to you so that you can attach it to this form, or we have asked your new scheme to complete and return to the Pensions Section] [The administering authority should also enter information here on any other actions the scheme member needs to take to comply with the administering authority’s working practices when dealing with transfers out] About you and the registered pension to which you elect to transfer your LGPS pension credit AVC Fund 1 Title 2 Surname 3 Forename(s) 4 Date of birth 5 National Insurance Number * 6 Address Postcode 7 Full name & address of the registered personal pension scheme & scheme administrator (if different) to which you want your AVC Fund to be transferred (if more than one scheme please give second scheme details on separate sheet and indicate in what proportions you would like the transfer payment to be split between the schemes) Post code
Then return the completed form to: [Administering authority to enter appropriate info] PART A PLEASE COMPLETE THIS PART IN ALL CASES: Member's Full Name Member's date of birth Member's NI Number Name of Personal Pension Scheme ('the Scheme') Address of Personal Pension Scheme which is to receive the transfer value: Postcode PART B: PLEASE READ THIS CERTIFICATE CAREFULLY AND COMPLETE IT FULLY. THE XXXX PENSION FUND WILL NOT ACCEPT INCOMPLETE OR UNSATISFACTORY FORMS.