# The Occupational Pension Schemes (Discharge of Liability) Regulations 1997, Schedule 1: FORM OF CONSENT TO ARRANGEMENT FOR SECURING BENEFITS


To the trustees/managers* of the……………………………….......................................……‡
Full name of earner/widow/widower/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

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Source: https://www.legislation.gov.uk/uksi/1997/784/schedule/1 (the official version)
Page: https://openlegislation.uk/occupational-pension-schemes-discharge-of-liability-regulations-1997/schedule-1
Contains public sector information licensed under the Open Government Licence v3.0. Source: legislation.gov.uk, The National Archives.