Pensions Enquiry Form

In order that we can accurately assess your requirements, please answer all questions as completely as you can. Thank you.
Full name
Email address
Telephone (day)
Pension fund value (must be £10,000 or greater after Tax free cash taken)
Do you want to take Maximum Tax Free Cash		Yes No
Single or Joint Life Annuity		Single Joint
Your date of birth
Spouse's date of birth (if Joint Annuity chosen)
Guaranteed period		None 5 years
Pension Escalation		3% RPI
Occupation (full details please, we will need to know what you actually do)
Do you smoke tobacco? If yes, give type & amount
Do you drink alcohol? if yes, how many units per week
Weight (in indoor clothing)
Height (without shoes)
Medical condition - please give full details including date first diagnosed, treatment and severity
Anything else we should know now (this will include any changes in the answers above during the last five years, and any family history of the same or related medical conditions)
How did you hear about us