* Required Field

Section 1 - Personal

* *

Policy number *


Section 2 - Changes to your pension contribution

..Mine/Employee £ ...... ..... ......... (complete sections 3 & 5)

..Mine/Employee..£ . .......... .... . ....... (complete sections 3 & 5)

Mine/Employee..£ .... ...... ......... (complete sections 3, 4 & 5).

..... ...

SIPP trustee cash account movements (only applicable to SIPPs)

Please switch £ out of the trustee cash account and invest it as follows :- (complete sections 3, 4 & 5)


Section 3 - How do you want your money invested?


Option 1 - existing funds

..I wish the money to be invested into the funds I already hold and in the same proportion.

Option 2 - select your own funds

..I wish the money to be invested and allocated into the following funds:-

% .... %

% .... %

% .... %

% .... %

% .... %

Please ensure that the total allocation add up to 100%

Option 3 - use one of our portfolios

I wish my money to be invested into the following portfolio:

For the Premier Service (total funds from all contracts £75,000 or more)..........

For the Executive Plus and Executive Services.............


Section 4 - Options on how to invest any additional new money


Section 5 - Your preferred method of payment

Section 6 - Comments

This is also a declaration that you have received no advice from us. Heritage will not provide a Suitability Report or Illustration that would have been provided if you had asked for advice. There will be no charge for this service. However, we do reserve the right to make a charge if the work is more complex or if the frequency of your alterations demands it. We will always inform you of our intention to charge before making any change on your behalf. *

You will receive confirmation of the change from the product provider.

Please type the following numbers into the adjacent box This Is CAPTCHA Image

Form Instruction

  1. In section 1 enter your name and policy details
  2. In section 2 select the radial dial that is most relevant to you
  3. Section 3 is only applicable if you are increasing your pension contribution. Select option 1 if you want the money invested into the same fund(s) you already hold. Select option 2 if you want the money invested into a new fund or mix of funds. Select option 3 if you with the money to be invested into one of our portfolios.
  4. Section 4 is only applicable for lump sum payments where you can opt for the money to be invested all at once or phased into the fund(s) over a period of time to help reduce risk
  5. Let us know in section 5 how you would like to pay any additional contribution
  6. Make use of the comments field in section 6 to clarify and make it absolutely clear how you would like the alterations to take place.

Portfolio Risk Assessment

Premier Service

Executive and Supersaver Service