Section 1 - Personal

* Required Field

Personal details of the person who is taking the pension benefits

* *

* Occupation*

Personal details of the spouse/civil partner

* *

* Occupation*

Section 2 - Contact Details

* *

Section 3 - Lifestyle

Do you smoke? .. - ...

Do you drink alcohol? - ..

Are you suffering from any condition that requires medical treatment and or medication? .

If you have answered No, skip to Section 4, if Yes, please answer the following sections:

Any medication for condition 1?

Any medication for condition 2?

Any medication for condition 3?


Section 4 - Exisiting Pension Arrangements

Do you have a personal pension? No ....... Yes

If Yes, please complete the following sections:


..Approx. value (£) . ...Still contribute?


..Approx. value (£) . ...Still contribute?


..Approx. value (£) . ...Still contribute?

Do you have a company pension? No ...... Yes.

...Approx. value (£) ........

If Yes, do you still contribute? ....

...Approx. value (£) ........

If Yes, do you still contribute? ....

...Approx. value (£) ........

If Yes, do you still contribute? ....

Additional information you would like to provide:

Section 5 - Tell us what style of pension income you would like

How much tax free cash would you like? 25%

If less than 25%, let us know how much in £'s or %age ...

Would you like to include your spouse/civil partner in receiving income payments after you death?

- joint life ..... - single life

If Yes, how much would you like them to receive?

Note: The higher the surviving partners income, the less yours will be.

Would you like your pension income to be guaranteed for a minimum period?

Note: The guarantee period will ensure that if death occurs within this period, income payments will continue to be paid until the guaranteed period expires. otherwise, if you outive this period, the income payments will stop on your death or if you have opted for a joint life plan, your surviving partners death.

If Yes, which guarantee period would you like? .... .....

How frequently would you like the income paid? .. ....

Would you like your income payments to increase annually?

If Yes, by how much?

Note: The higher the indexation, the less your pension will be from outset and it can take over 10 years to get to the same level of income paid with no indexation.

If your combined pension funds are greater than £25,000, would you like us to consider an Open Market Option?

Note: This is when we research all of the different insurance companies to see who pays the highest income, and if we find one, it involves your current pension provider paying the tax free cash and the balance transferred to to new provider. please click here for the differences in ' Annuity Purchase with same Life Office' and 'Annuity Open Market Option' charges.

Section 5 - Risk profile

Please read the description and afterwards click on the most appropriate radial button to confirm your choice. The lowest risk is 1 and gradually increases in risk to 10. If, after looking at the table below, you are unsure about what your risk profile is you can complete our Risk and Reward Questionnaire in addition to this questionnaire which will enable us to calculate your risk tolerance and advise you accordingly.


Section 6 - Options on how to invest your money (lump sums only)




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Click on the above brochure to learn more about Flexible Drawdown

Click on the above brochure to learn more about Annuities

Click on the above brochure to learn more about Retirement Planning

Advisory process

Step 1 - Complete the Retirment Questionnaire and submit to us

Step 2 - Once we receive the emailed Questionnaire, we will evaluate it and with any additional information we may ask of you, contact you via email what we believe is the best investment(s) for you.

If you prefer to download and submit a paper copy, click here.