Please complete this form in BLOCK CAPITALS throughout.
Individual plan owners must complete Additional Payment form - ref. RS02.
Corporate Trustee plan owners must complete Additional Payment form - ref. RS03.
You can download these forms from our website www.rl360.com.
Once you have completed and signed the form, you should send it along with all requested additional information to:
or alternatively post it to:
New Business Team
Isle of Man
Speciﬁed US Person
Speciﬁed US Person means a US citizen or tax resident individual who has a US residential/correspondence address or who
either holds a US Passport, a US Green Card or who was born in the US and has not yet renounced their US citizenship. More
information on US FATCA can be found at: www.irs.gov/Businesses/Corporations/Foreign-Account-Tax-Compliance-Act-FATCA
If you choose Yes to being a Speciﬁed US Person, you will need to provide us with your US Taxpayer Identiﬁcation Number (TIN)
or US Social Security Number (SSN).
If you choose No but you have a US residential/correspondence address, hold a US Passport, a US Green Card or you were born
in the US, you will need to provide us with documentary evidence that you are in the process of or have renounced your US
Citizenship. RL360 can accept a certiﬁed copy of your DS-4083 form (also known as CLN – Certiﬁcate of Loss of Nationality)
and/or a certiﬁed copy of your passport in which you are obtaining new citizenship.
Automatic Exchange of Information - Entity Self Certiﬁcation
Automatic Exchange of Information (AEOI) is the United States Foreign Account Tax Compliance Act (FATCA) and the
Organisation of Economic Cooperation and Development (OECD) Common Reporting Standards (CRS). Under these tax
regulations and intergovernmental agreements entered into by the Isle of Man, we are required to collect information which may
be exchanged by the Isle of Man Government with other jurisdictions. In order for us to comply with these requirements, you will
need to complete the appropriate AEOI Self-Certiﬁcation Forms in addition to this application form.
Details of who is considered to be a controlling person under AEOI can be found in our AEOI Deﬁnitions document which can be
found here https://www.rl360.com/generic/downloads/tech032.pdf
The AEOI Entity and Individual Self-Certiﬁcation Forms can be found here: www.rl360.com/row/downloads/forms.htm
FORM FOR COMPANY
REGULAR SAVINGS PLAN