Request for Payment of Cash Equivalent Transfer Value to a Personal Pension Scheme Please complete this form if you want the value of your Local Government Pension Scheme (LGPS) AVC Pension Credit rights to be transferred to another scheme. Return the completed form to us at: [Administering authority to enter relevant address] Please note that we cannot pay, or instruct our AVC provider to pay, the transfer value until or unless we receive and are satisfied with the Receiving Scheme Discharge Form which [administering authority to enter appropriate wording e.g. you should get your new scheme to complete and return to you so that you can attach it to this form, or we have asked your new scheme to complete and return to the Pensions Section] [The administering authority should also enter information here on any other actions the scheme member needs to take to comply with the administering working practices when authority’s dealing with transfers out] About you and the registered pension to which you elect to transfer your LGPS pension credit AVC Fund 1 Title 2 Surname 3 Forename(s) 4 Date of birth 5 National Insurance Number * 6 Address Postcode 7 Full name & address of the registered personal pension scheme & scheme administrator (if different) to which you want your AVC Fund to be transferred (if more than one scheme please give second scheme details on separate sheet and indicate in what Post code proportions you would like the transfer payment to be split between the schemes)
Request for Payment of Cash Equivalent Transfer Value to a Personal Pension Scheme Please complete this form if you want the value of your Local Government Pension Scheme (LGPS) AVC Pension Credit rights to be transferred to another scheme. Return the completed form to us at: [Administering authority to enter relevant address] Please note that we cannot pay, or instruct our AVC provider to pay, the transfer value until or unless we receive and are satisfied with the Receiving Scheme Discharge Form which [administering authority to enter appropriate wording e.g. you should get your new scheme to complete and return to you so that you can attach it to this form, or we have asked your new scheme to complete and return to the Pensions Section] [The administering authority should also enter information here on any other actions the scheme member needs to take to comply with the administering authority’s working practices when dealing with transfers out] About you and the registered pension to which you elect to transfer your LGPS pension credit AVC Fund 1 Title 2 Surname 3 Forename(s) 4 Date of birth 5 National Insurance Number * 6 Address Postcode 7 Full name & address of the registered personal pension scheme & scheme administrator (if different) to which you want your AVC Fund to be transferred (if more than one scheme please give second scheme details on separate sheet and indicate in what proportions you would like the transfer payment to be split between the schemes) Post code
FCTDv7.0t.docx