Expression of Wish Form - DOC by 9a3XQT


									Expression of Wish Form

To the Trustee of the Plumbing and Mechanical Services (UK) Industry Pension

Full Name of Member __________________________________________

                                          Death Benefits
In the event of my death, I would like the Trustee to consider making payment of any lump sum death
benefits due in proportions shown below:

         Full Name of Beneficiary                       Relationship              Percentage

    1.   ____________________________________________________________________

    2.   ____________________________________________________________________

    3.   ____________________________________________________________________

    4.   ____________________________________________________________________


I understand that this indication of my wishes will be used as a guide to the Trustee when they exercise
their discretion under the governing rules of the Pension Scheme. This form cancels any Expression of
Wish / Nomination of Dependant given prior to the date below.

Signed: _______________________________________                     Date: ___________________

National Insurance Number: ______________________

Notes to Member
Most employees nominate their spouse or partner as their main beneficiary. If you want to clarify how
you wish the lump sum to be allocated in the event of joint deaths of you and the main beneficiary –
e.g. to your children or other members of your family - please write your comments overleaf.

If your personal circumstances change you may wish to complete a new Expression of Wish
form. You will find a printable version of the form in the Pension Scheme (Death Benefits) page
of our website - or, alternatively you can contact our Benefits
Department directly on 0131 556 0600 to send you a copy of the form.

            Registered Office: Bellevue House, 22 Hopetoun Street, Edinburgh EH7 4GH
           Telephone: 0131-556 0600, Fax 0131-556 8343, Email:
                    Robert D. Burgon, BA (Hons), MLitt, FPMI, Hon. FCIPHE, FIPA,
Additional Comments

    Signed : ___________________________________   Date : _____________

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