@sipp — SIPP Application Form

Select Your SIPP Type

Choose the type of Self-Invested Personal Pension that best suits your needs.

Application For

Full SIPP

All investment options

Collective SIPP

Collective arrangements

Solo SIPP

One investment

Solo SIPP+

Two investments

Solo SIPP+

Three investments

Fee	Amount
Set Up
Advised	£337
Non-Advised	£676
Annual
Advised	£838
Non-Advised	£838
Other
Transfer in of Pension Funds	Free
Contributions	Free
Standard Investment / Disinvestment	Free

Fee	Amount
Set Up
Advised	£204
Non-Advised	£271
Annual
Advised	£528
Non-Advised	£528
Other
Transfer in of Pension Funds	Free
Contributions	Free
Standard Investment / Disinvestment	Free

Fee	Amount
Set Up
Advised	£0¹ / £135²
Non-Advised	£204
Annual
Advised	£253
Non-Advised	£369
Other
Transfer in of Pension Funds	Free
Contributions	Free
Standard Investment / Disinvestment	Free

Fee	Amount
Set Up
Advised	£135
Non-Advised	£204
Annual
Advised	£369
Non-Advised	£439
Other
Transfer in of Pension Funds	Free
Contributions	Free
Standard Investment / Disinvestment	Free

Fee	Amount
Set Up
Advised	£135
Non-Advised	£204
Annual
Advised	£439
Non-Advised	£505
Other
Transfer in of Pension Funds	Free
Contributions	Free
Standard Investment / Disinvestment	Free

This application is for you to become a member of the @sipp SIPP scheme.

You should read the Key Features document, Rules of the scheme, Terms and Conditions, Fee Schedule and Permitted Investments Schedule prior to completing this application.

We also strongly recommend that you seek financial advice in relation to the content of this application. If you are in any doubt about any of the questions in this application please seek advice from your financial adviser.

Where you wish to receive immediate benefits please also complete a Benefit Payment form. Where you are transferring benefits in payment and wish to continue receiving payment please also complete an Alteration to Income Form.

Personal Information

If you are a legal guardian completing this on behalf of a child under age 18, the details given should relate to the child. The legal guardian should complete their details on the Legal Guardian Consent form available at www.atsipp.co.uk.

Identity

Title *

Surname *

Forename(s) *

Date of Birth *

Gender

Male

Female

Nationality *

Marital Status

Email Address *

Mobile

Permanent Residential Address

Address Line 1 *

Address Line 2

Town / City *

Postcode *

Have you lived at this address for less than three years?

Yes

No

Pension Details

National Insurance Number *

Expected Retirement Age * (from age 55)

Have you made a decision to opt out or not join your employer's pension scheme in favour of establishing this SIPP?

Yes

No

Have you registered for protection against the Lifetime Allowance?

Yes

No

Employment Status

Please indicate, which of the following is most applicable by ticking one box only.

Employed

Self-Employed

Unemployed Pensioner

Child (under 16)

Other

Our firm has to comply with the Anti-Money Laundering Regulations, which requires us to verify the identity of all clients. In order to meet these requirements we subscribe to an electronic verification service. On the rare occasion that we are unable to confirm your identity this way, you may be required to produce documents such as your passport, driving licence and utility bills.

Contributions

Personal contributions are paid net of basic rate income tax. We claim back the tax relief from HM Revenue & Customs and add it to your fund. Please note that this can take up to eleven weeks. Any employer contributions must be paid gross.

Pension Contributions

Would you like to set up pension contributions as part of this application?

Yes

No

Transfer In Application

Please complete this form if you wish to transfer cash and/or assets from another registered pension scheme to @sipp. If you are transferring more than one plan please use a separate Transfer In form for each transfer.

Pension Transfer

Would you like to transfer over an existing pension scheme as part of this application?

Yes

No

Investment Details

Please provide details of your proposed SIPP investments. A Permitted Investments list is available at www.atsipp.co.uk

Investment Details

Please provide details of your proposed investment(s)

Please enclose the relevant investment applications forms and completed Property Questionnaire, as applicable.

Expression of Wish

This is an expression of my wishes. I understand that @sipp will pay due consideration to my wishes but will have absolute discretion as to the beneficiaries and benefits paid to each.

Beneficiaries

Would you like to complete beneficiary details as part of this application? *

Yes

No

Alternative Beneficiaries

Please only complete this section if you wish to name alternative beneficiaries where all of the beneficiaries you name either:

• die before you; or
• do not wish to receive benefits from your plan (for example, for tax planning purposes).

Would you like to add alternative beneficiaries? *

Yes

No

Financial Adviser

Please give details of your financial adviser.

Financial Adviser

Is there a financial adviser associated with this application?

Yes

No

Declaration & Review

Please review your application and sign the declarations below.

General Declaration

I acknowledge and accept and agree to be bound by the applicable Terms & Conditions, Fee Schedule and Permitted Investments Schedule applying to the @sipp SIPP product I have chosen.
I agree to be bound by the trust deed and rules of the scheme which may be amended from time to time.
To the best of my knowledge and belief, the particulars given on the application form are correct and complete.
I wish to nominate the named person(s) in Part 6 "Expression of Wish – Disposal of Death Benefits" to be considered to receive any benefit payment payable under the scheme on my death. I accept that this Expression of Wish is not a binding contract but allows @sipp to consider to whom the death benefits should be paid.
I hereby consent to @sipp obtaining relevant details from the administrator/trustees or insurance company or other registered pension scheme provider, arrangement or contract of which I am or have been a member and authorise the giving of any such details to @sipp.
I understand that any transfer(s) made into my scheme may only be applied to provide benefits at the time I take retirement benefits or on my death.
I will not require, nor attempt to require, the withdrawal of funds held to provide benefits for me under the scheme, or the income on those funds, other than in accordance with the rules of the Scheme.
If appropriate @sipp has my authority to check with HM Revenue & Customs the detail of any certificate which I supply which enhances my lifetime allowance or lump sum entitlement.
I acknowledge and accept the terms of this Agreement and I understand that the services provided under it do not extend to financial advice under the terms of the Financial Services and Markets Act 2000.

Contributions Declaration

I declare I am under the age of 75.
I declare that the total contributions to any registered pension schemes in respect of which I am entitled to relief under section 188 of the Finance Act 2004 will not exceed the higher of: (a) The basic amount, or (b) My UK relevant earnings within the meaning of section 189 of the Finance Act 2004 in any tax year.
I declare, where my total gross contributions exceed the Annual Allowance in the current tax year, that I have sufficient unused annual allowances to carry forward from the three previous tax years.
I declare that: (a) in relation to (i) the particulars specified in Part 3 are to the best of my knowledge and belief, correct and complete; and (ii) the second bulleted contributions declaration above is to the best of my knowledge and belief, correct. (b) no later than either the date which is 30 days after the occurrence of the event or 5th April in the tax year of assessment, I will give notice to you if an event occurs, as a result of which I am no longer entitled to tax relief for contributions pursuant to section 188 of the Finance Act 2004.
I undertake to inform the Scheme Administrator in writing (within 30 days) if: (a) I cease to be a UK resident; (b) There is any change in my name or permanent residential status or employment status; (c) I contribute on aggregate more than 100% of my earnings to this and any other pension scheme in any tax year; (d) I cease to have UK relevant earnings; (e) I intend making contributions that are not to benefit from tax relief, for example 'excess' contributions.
I understand that by signing this application form I am declaring that I am aware of my annual allowance (including any carry forward) and request that @sipp reclaims tax on my contributions unless I instruct otherwise.

IMPORTANTThe information on this application is used in dealings with HM Revenue & Customs for tax relief purposes. It is a serious offence to make false statements with penalties being severe. False statements could lead to prosecution.

Cancellation Rights

I acknowledge under current rules I have the right to cancel my SIPP application within 30 days of receiving my SIPP cancellation notice.
I acknowledge that on receipt of any funds @sipp will invest these and pay any adviser charges to my financial adviser according to my instructions.
I acknowledge and accept that I might not get back the amount originally invested, if I exercise my right to cancel my SIPP application.
I acknowledge and accept that once the SIPP is established the SIPP set up fee is due and will not be refunded, and that @sipp will not reclaim any fees already paid to your financial adviser.
I acknowledge and accept that the amount I will receive will be the realisation value of the investment(s) less any applicable charges.

Transfer In Declaration

1. Request to Transfer

I authorise, instruct and apply to the current provider to transfer sums and assets from the plan(s) as listed in PART 4 of this application directly to @sipp and to provide any instructions and/or discharge required by any relevant third party to do so.
I accept that in order to comply with regulatory obligations @sipp and the current provider named in this application may need to verify my identity and residential address and may use credit reference agency searches and ask for my documents to verify my identity and address.
I authorise @sipp, the current provider, any contributing employer and any financial adviser named in this application to obtain from each other, and release to each other any information that may be required to enable the transfer of sums and assets to @sipp.
Until this application is accepted and complete, @sipp's responsibility is limited to the return of the total payment(s) to the current provider(s).
Where the payment is made to @sipp as instructed, this means that I shall no longer be entitled to receive pension benefits from the whole of the plan(s) listed in PART 4 of this application where the whole of the plan(s) is transferring, or that part of the plan(s) represented by payment if only part of the plan(s) is transferring.
I have read any information provided or made available to me by the current provider in connection with this transfer and have considered if there are any benefits or options I may lose as a result of the transfer.
I have read guidance from the Financial Conduct Authority or the Pensions Regulator on the risks and warning signs of pensions scams before making this application.
I confirm that I have provided only true and accurate information in applying for this transfer. I understand that @sipp and the current provider cannot accept responsibility, and are not liable, for any losses resulting from untrue, incorrect or misleading information that I provide, or from any failure on my part to comply with any part of this application.

2. Transfers into the Scheme

I request that @sipp accepts the transfer of the funds from the current provider detailed listed in PART 4 of this application. I hereby request that @sipp apply such transfer payment so to not constitute a separate arrangement for the purposes of Part 4 of the Finance Act 2004, where possible, unless I and @sipp expressly agree otherwise.

3. Cancellation Rights (Transfer)

I acknowledge I have the right to cancel my transfer within 30 calendar days of @sipp accepting my transfer request.
I acknowledge that on receipt of the transfer of funds @sipp will invest these according to my instructions.
I acknowledge and accept I might not get back the amount originally invested if I exercise my right to cancel the transfer.
I acknowledge and accept the amount I will receive will be the realisation value of the investment less any applicable charges.

Data Protection

The information you provide to @sipp on this application form and during the course of your @sipp membership will be held by @sipp as data controllers in accordance with all relevant data protection legislation and our Privacy Information Notice, a copy of which can be obtained from our website.

I confirm that:

I have read and understood @sipp's Privacy Information Notice.
I consent to @sipp (and any data processor or other data controllers they may use) processing data relating to me as set out in the Privacy Information Notice. I also consent to such data being transferred to third parties in connection with the administration and operation of the SIPP as set out in the Privacy Information Notice.
Where I provide @sipp with information about another person, that they have appointed me to act for them, that they consent to the processing of their personal information and I have informed them of @sipp's contact details and the purposes for which their personal information will be processed and the disclosures that may be made (both of which are set out in the Privacy Information Notice).

Signature

Please complete your details below. When this PDF is sent via DocuSign or another e-signature platform, the recipient should sign in the designated boxes below.

Full Name *

Date *

Member Signature

✍ Signature

Sign here

📅 Date Signed

Date here

Full name:

Financial Adviser Signature

✍ Signature

Sign here

📅 Date Signed

Date here

Adviser name:

📋 For E-Signature Platforms Upload the downloaded PDF to DocuSign, Adobe Sign or your preferred platform and place signature tags in the dashed boxes above for each signatory.

Notes

Notes Area (e.g. previous address if less than 3 years at current address)