Certification by Receiving Scheme Manager in Respect of an AVC Transfer to a Qualifying Recognised Overseas Pension Scheme (QROPS) DETAILS OF THE SCHEME MEMBER TRANSFERRING PENSION RIGHTS FROM THE AVC ARRANGEMENT UNDER THE LOCAL GOVERNMENT PENSION SCHEME (LGPS): Surname Forename(s) Principal residential address National Insurance Number date of birth DETAILS OF THE QROPS TO WHICH the TRANSFER Payment IS TO BE MADE : Full name of the QROPS: Name of country or territory under whose law the QROPS is established and regulated: QROPS reference number (this is the QROPS reference number, allocated to the scheme by HMRC, when the notification that it met the requirements to be a recognised overseas pension scheme was acknowledged): Full name, official address, Name business telephone number Address and, where available, electronic mail address of the manager of the QROPS: Tel E-mail Reference (if any):
Certification by Receiving Scheme Manager in Respect of an AVC Transfer to a Qualifying Recognised Overseas Pension Scheme (QROPS) DETAILS OF THE SCHEME MEMBER TRANSFERRING PENSION RIGHTS FROM THE AVC ARRANGEMENT UNDER THE LOCAL GOVERNMENT PENSION SCHEME (LGPS): Surname Forename(s) Principal residential address National Insurance Number date of birth DETAILS OF THE QROPS TO WHICH the TRANSFER Payment IS TO BE MADE : Full name of the QROPS: Name of country or territory under whose law the QROPS is established and regulated: QROPS reference number (this is the QROPS reference number, allocated to the scheme by HMRC, when the notification that it met the requirements to be a recognised overseas pension scheme was acknowledged): Full name, official address, business telephone number and, where available, electronic mail address of the manager of the QROPS: Name Address Tel E-mail Reference (if any):
FCTDv5.0c.docx