1
Who is this form for?
This form is for applicants or plan owners of any of the following RL360 products:
• Regular Savings Plan
• Regular Savings Plan Malaysia
• Quantum (issued after April 2010)
• Quantum Malaysia
• Paragon
Completing this form
Please complete in BLOCK capitals throughout.
By completing this form you will be authorising RL360 to take a fee from your plan that will be paid to:
(financial adviser company and address)
RL360 adviser number:
We can only accept written instructions that have been signed by all applicants, plan owners, trustees or
authorised signatories.
When you have completed this form, please send it to: RL360, International House, Cooil Road, Douglas, Isle of
Man, IM2 2SP.
Important notes
1. As this instruction will result in a deduction from your plan to meet the fee you are agreeing to pay, you should
note that this deduction may form part of any deferred tax allowance for your country of residence. You should
consult your tax adviser to determine whether this could aect you.
2. RL360 cannot be held responsible for any future tax liability that may accrue to the adviser as a result of a failure
to levy tax where it later transpires that it should have been charged. The adviser is responsible for deciding
whether or not the service they are providing is subject to any additional taxes.
3. The fee will be added to your plan from the date when we receive the completed form. Commencement will be
subject to product rules, details of which can be found on the page 2.
4. The value of any increase or lump sum payments made to the original plan will be treated as part of its value
when the fees are calculated.
5. This agreement shall be subject to, and interpreted in, accordance with the laws of the Isle of Man.
6. I confirm that I will inform RL360 in writing should I wish to terminate payment of this fee.
AUTHORISATION TO PAY
A FINANCIAL ADVISER FEE
SERVICING
