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Schedule 1 FORM OF CONSENT TO ARRANGEMENT FOR SECURING BENEFITS

To the trustees/managers* of the……………………………….......................................……‡
Full name of earner/widow/widowerF1/surviving civil partner*
Present address of earner/widow/widower/surviving civil partner*
Benefit to be provided by the proposed policy/contract*:
Name of insurer with whom benefits are to be secured:
I consent to the securing, under an insurance policy taken out/annuity contract entered into* with the insurer named above, of the benefits specified above substitution for benefits which would otherwise have fallen to be provided for or in respect of me under the pension scheme named above.
Signed...................................................................
Date......................................................................
*delete whichever is inapplicable
‡insert name of pension scheme

Annotations

Textual amendments

F1

Words in sch. 1 substituted (5.12.2005) by The Civil Partnership (Contracted-out Occupational and Appropriate Personal Pension Schemes) (Surviving Civil Partners) Order 2005 (S.I. 2005/2050), art. 1(3), Sch. 2 para. 44