Fill - Free fillable ASSET TRANSFER FORM SERVICING Completing this form Who (RL360) PDF form

Who is this form for?

This form is for applicants or plan

owners of lump sum products who

wish to transfer existing assets

into their plan. This should not

be used for any cash transfers.

How does an asset transfer work?

Your existing assets can be

transferred into your plan directly,

subject to them being acceptable

to us. To do this we require your

permission via the Power of

Attorney (incorporated into this

form) to transfer the assets on your

behalf. When we possess all of the

necessary documentation we will

transfer each asset as required.

You

should note that the process can

take a substantial length of time,

in some cases several months or

longer to complete. Whilst we will

initiate your transfer(s) on receipt

of this instruction, we are reliant

on third parties to complete on

the request. We can only transfer

assets where this form and your

application (where applicable) are

correctly completed.

Completing this form

By completing this form you will be

providing and authorising RL360,

through a Power of Attorney, to

transfer the assets listed in Section

2 owned by you. Please complete

in BLOCK capitals throughout.

We can only accept original written

instructions that have been signed

by all of the registered owner(s) of

the assets to be transferred. The

signing must be witnessed by an

independent witness (a spouse is

not considered an independent

witness). If a transfer relates to a

physical share certiﬁcate(s), RL360

will require all original certiﬁcates.

As this form is a legal document

any alterations, corrections and/

or additions must be initialled by

the owner(s) of the assets to be

transferred. Please do not use

correction ﬂuid as this will invalidate

the form.

Where appropriate, any reference to

the singular includes the plural and

reference to the masculine includes

the feminine.

Please make sure that you read the

important notes section.

For more information about

completing this form, please

read our Guidance notes or

contact our customer services

team on +44 (0)1624 681682

or alternatively you can email

asset.transfers@rl360.com.

When you have completed this

form

Please make sure that all

certiﬁcates and/or other

documents (a recent statement

of holdings) of title for the assets

detailed are also included when

returning this form. Wherever

possible these should not be

printouts of online statements as

they rarely provide vital contact

information. We cannot proceed

without these.

Once complete please send it to:

Dealing Team, RL360, International

House, Cooil Road, Douglas, Isle of

Man, IM2 2SP.

ASSET

TRANSFER

FORM

SERVICING

SECTION 1

1. In connection with my application or plan, I, as owner(s) of the assets detailed in the Schedule described in Section 2

Name

Current residential

address (including

postcode)

hereby appoint RL360 Insurance Company Limited (RL360), in its absolute discretion to be my Attorney, to act in my name(s) and

on my behalf by deed or otherwise to do any or all of the things necessary to undertake the transfer of all assets to RL360 or, such

custodian or nominee as RL360 may appoint, for the purposes of holding the asset(s) at a price equal to their relevant value, at the

market bid price obtainable by RL360 at the relevant time. You should complete a separate form for each asset manager.

2. I understand that

(i) the transfer of the assets will normally take place as soon as reasonably practicable following

RL360

’s receipt of this authority

and product application form (where applicable), both of which must be completed correctly and in addition to the relevant

certiﬁcates (where appropriate) and/or other documents of the title to the assets.

(ii) if for any reason whatsoever the plan is not eected, RL360 will deduct any stockbrokers’ commission, duties or other such

expenses incurred in respect of the transfer of the assets from the proceeds of such any transfer of the assets back to me/us.

3. I authorise

RL360

(i) to invest the net proceeds referred to in sub-paragraph 1 above into my plan.

(ii) to insert and/or alter the appropriate amount of my asset as set out in my product application form (where applicable) for the

plan.

4. I hereby warrant that

(i) I am the owner(s) of the assets and have all the necessary powers to dispose of them.

(ii) I have full power to give this authority without requiring the consent of any other person(s).

(iii) none of the assets are subject to any lien, charge, encumbrance or any other third party right, nor is there any legal or other

prohibition on the proposed transfer of any of the assets.

5. I irrevocably undertake

(i)

to account to RL360 without avoidable delay for all dividends, interest or other rights or beneﬁts received or receivable

by me after the transfer of the assets pursuant to this authority and to which the transferee of the relevant assets is

entitled.

(ii) to pay promptly all calls and other payments due in respect of the assets before the date of transfer thereof pursuant to this

authority (except insofar as they were taken account of in the price for the purposes of the relevant transfer).

(iii) to forward to RL360 without avoidable delay all notices and other communications relating to the assets which are received

by me and which will have an eect after the date of transfer thereof pursuant to this authority.

(iv) to execute without avoidable delay following a request from

RL360

, any transfer form(s) or any other transfer document(s)

that may be required in connection with transfer of all or any of the assets.

(v) to reimburse

RL360

to the extent of any loss or expense suered or incurred by

RL360

should any of the certiﬁcates or other

documents of title not accurately reﬂect my holding in any of the assets.

For the purpose of carrying into eect the transfer of all or any of the assets detailed and/or any other matters authorised by

this authority, I hereby irrevocably appoint any two authorised signatories of RL360 to be my attorney. They shall have full

power on my behalf to execute or sign any transfer form(s) or other document(s) which may be required, and to do any other

act or thing as RL360 may deem necessary or expedient to accomplish any such transfer and/or any other matters authorised

by this authority as fully and eectively as if I could do if personally present. I hereby ratify and conﬁrm whatever my said

attorney shall lawfully do or cause to be done by virtue of this appointment.

7. I agree that the law of the Isle of Man shall apply to this authority.

Signed and delivered as a deed

RL360 can only accept original written instructions that have been signed by all of the owner(s) of the assets to be transferred.

Your signature(s) must be witnessed by an independent witness (a spouse is not considered an independent witness).

Owner(s)

Signature

Date (dd/mm/yyyy)

Witness

Name

Address

Occupation

Signature

Date (dd/mm/yyyy)

Contact details

Please note the below details will be used if any queries arise in relation to transferring the assets. This will enable us to liaise

with the counter-party.

Financial adviser contact details

Name

Telephone number

Email address

Counter-party contact information

Name of

counter-party

Name of

individual/team

Telephone number

Email address

SECTION 2 SCHEDULE OF ASSETS

Please provide details of the assets to be transferred as per Section 1. Please make sure that all certiﬁcates and/or other

documents (a recent statement of holdings) of title for the assets detailed are also included when returning this form. Wherever

possible these should not be printouts of online statements as they rarely provide vital contact information. We cannot proceed

without these.

Personal reference number or

account number

Name(s) of registered

owner(s) as they appear

on the certiﬁcate or

document of title

Full description of the asset as shown

on the certiﬁcate or document of title,

including any ISIN or SEDOL code

Number of units

or shares to be

transferred

If there is insucient space above, please continue on a separate sheet of paper. This should be signed and dated by

all owners.

Schedule of assets example

The below table is an example of how this section should be completed.

Personal reference

number or account

number

Name(s) of registered

owner(s) as they appear

on the certiﬁcate or

document of title

Full description of the asset as shown

on the certiﬁcate or document of title,

including any ISIN or SEDOL code

Number of units or shares

to be transferred

COMPUTERSHARE

A/C: C1234567890

MR JOHN DOE

UNILEVER PLC

ISIN: GB000B10RZP78

SEDOL: B10RZP7

1,000 SHARES

FRANKLIN

TEMPLETON

A/C: DOE1234567

MR JOHN DOE

TEMPLETON GROWTH FUND A

ISIN: US8801991048

SEDOL: 2893208

2,500 SHARES

PHYSICAL SHARE

CERTIFICATE

CERTIFICATE NO:

1234567

MR JOHN DOE

BT GROUP PLC

ISIN: GB0030913577

SEDOL: 3091357

4,000 SHARES

Important notes

Whilst we endeavour to use all best eorts to undertake a transfer on your behalf, the period of time it takes to complete is outside

of our control. We can accept no responsibility for any consequences that may arise from a delay.

We cannot be held responsible

for any loss of value in your asset between the period of your transfer request and our receipt of the realised value.

We can only transfer assets that are acceptable to us.

We will apply an administration fee for each asset transferred (details can be found in your product literature).

The transfer of securities may give rise to a tax liability. We will not provide any estimate as to the tax liability which may arise as

the result of a transfer for any of the assets referred to in this form. It is your responsibility to calculate and meet any tax liability

and you are strongly recommended to speak to your ﬁnancial adviser.

Data protection

This form collects your personal data. We require your personal data so we can provide you with services relating to the

performance of your contract. You may ask us to stop processing your data, however this may disrupt the services RL360 can

provide to you or may stop us being able to assist you. To ﬁnd out how long we will keep your data, please refer to our privacy

policy at www.rl360.com/privacy. Any data you provide to RL360 may be shared, if allowed by law, with other companies both

inside and outside of RL360 and to persons who act on your behalf. Data and information about you can be transferred outside

of the Isle of Man and RL360 may be required to provide it to its regulator, its government or anyone else required by law.

RL360 will use your data and information to allow for the administration of your plan, prevent crime, prosecute criminals and for

market research and statistics. RL360 will, at all times, make sure that your data and information is only used in ways that are

allowed by law.

You can receive a copy of the information RL360 holds about you free of charge by writing to our Data Protection Ocer at: RL360,

International House, Cooil Road, Douglas, Isle of Man, IM2 2SP, British Isles, or by emailing dpo@rl360.com. We can reserve the right

to not send you your personal data in some circumstances - if we do we will write to you setting out the reasons why.

Our full privacy and cookie policies can be viewed at www.rl360.com/privacy or can be obtained by requesting a copy from our

Data Protection Ocer.

Hong Kong Personal Data (Privacy) Ordinance

I consent to the use of any personal information collected or held by

RL360

(whether contained in this application or obtained

otherwise and stored electronically or in any other form) and which may be used by

RL360 to

• transfer the information between its oces wherever they are situated; and

• provide me with information about other products and services which you believe may be of interest to me; and

• communicate with me whether directly or indirectly for any other purpose.

RL024d 10/19

RL360 Insurance Company Limited. Registered Oce: International House, Cooil Road, Douglas,

Isle of Man, IM2 2SP, British Isles. Registered in the Isle of Man number 053002C. RL360

Insurance Company Limited is authorised by the Isle of Man Financial Services Authority.

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