Investment Bond Form Test — Railway Enginemen's

Member's Details

Are you already a Railway Enginemens member?YesNo
Title:MrMrsMs
Surname:
Forenames:
Postcode:
Address:
How long have you lived at this address:
Previous full postal address(es) if resident at the above address for less than 3 years:
Phone:Either a landline or mobile.
Email:
DOB:We use your date of birth to calculate your guaranteed sum assured.
National Insurance Number:

Continue to Appointment of Nominee
Appointment of Nominee

Please record here the name and address of the person who you wish to receive the benefit of your Bond in the event of your death.

A nomination is rendered void by the subsequent marriage of the nominator. Payments in excess of £5,000 will be made to your estate in accordance with statute.

Surname:
Forenames:
Postcode:
Address:
Relationship to You:

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Continue to Your Investment Amount
Your Investment Amount

Please make your cheque payable to Railway Enginemen's Assurance Society Limited and enclose with this application form. Write your national insurance number on the back of your cheque.

Or, if you wish to pay your investment directly into our bank account, please contact us and we will provide you with our bank account details.

Choose the amount you would like to invest (minimum £500; maximum £50,000):

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Continue to Demands and Needs
Demands and Needs

Railway Engineman's Assurance Society is required by law to seek confirmation that the Investment Bond product is a product which meets your financial demands and needs and is appropriate for you to invest in on a non-advised basis. Please complete the Statement of Demands and Needs questions on the document, 'Is the Investment Bond the right product for me?' and return that document along with your Application Pack.

Please complete the following confirmation:

I confirm that I have completed the Statement of Demands and Needs and returned this document along with my Investment Bond Application Pack.

Signed:
Date:

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Continue to Appropriateness
Appropriateness

Railway Enginemen's Assurance Society is required by law to seek confirmation that the Investment Bond product is a product which is appropriate for you to invest in on a non-advised basis. Please complete the Appropriateness Test on the document, 'Is the Investment Bond the right product for me?' and return that document along with your Application Pack.

Please complete the following confirmation:

I confirm that I have completed the Appropriateness Test and returned this document along with my Investment Bond Application Pack.

Signed:
Date:

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Continue to Confirmation of Non-Advised Application
Confirmation of Non-Advised Application

We treat all members and customers who invest with us as retail clients. This provides you with the highest level of protection under the financial services regulations. As we do not give advice, this sale will be classed as a non-advised sale. Should you be under any doubt as to whether this product is suitable for you, we recommend that you seek the advice of an Independent Financial Advisor (IFA). If you do not have a financial advisor, you can find details of a local financial advisor by telephoning IFA Promotion on 020 7833 3131 or via www.unbiased.co.uk. Using the services of a financial advisor may incur charges; please confirm with the individual advisor.

I confirm that I have neither asked for nor received a personal recommendation from the Society or any of its representatives, concerning the suitability of the Investment Bond.

Signed:
Date:

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Continue to Data Protection and Marketing Preferences
Data Protection and Marketing Preferences

In order to process your application and administer your Investment Bond, we need to obtain certain information from you and maintain it on our computer systems and manual records. If you have applied for a policy through one of our Area Representatives, we will share your policy information with them unless you instruct us otherwise.

We may also need to disclose your information to third parties. These may include our regulators and our professional advisors for auditing, compliance and other purposes. We strongly advise that you read our Privacy Policy, which you can find on our website, or you can ask us for a copy.

We would like to contact you from time to time by post, e-mail and telephone to bring to your attention additional products which we think may be of interest to you. We will never use sensitive personal information (such as information relating to your health) to assist us in the marketing of products to you.

If you agree to being contacted by us in this way, please tick the relevant boxes (You have the right to withdraw this consent at any time):PostEmailPhone

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Continue to Proof of Identity and Address
Proof of Identity and Address

When applying for an Investment Bond with the Society you will need to supply a document to prove your identity and a different document to prove your address. Photocopies of these documents are accepted.

To prove your identify, you would need to provide one of the following:

• Passport

• Driving licence

To prove your address, you would need to provide one the following:

• Driving licence

• Bank statement

• Credit card statement

• Utility bill

• Council tax bill

• HMRC tax notification document

Upload Document for Proof of Identity:
Upload Document for Proof of Address:

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Continue to Source of Funds
Source of Funds

What is the source of the investment? Please tick the box (es) that apply:Maturing proceeds from Railway Engineman's policyAccumulated savings from salarySale of propertyEquity ReleaseSale or maturing of previous investmentsDivorce SettlementPension lump sum
Other (please specify):

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Continue to Declaration
Declaration

I hereby apply to Railway Enginemen's Assurance Society Limited for an Investment Bond.
YesNo
I declare that I am 18 years of age or older.
YesNo
I declare that I am resident in the United Kingdom for tax purposes.
YesNo
I declare that I am a United Kingdom national person.
YesNo
I understand that, in accordance with money laundering legislation and regulations, the Society will undertake identity verification checks by electronic means, and I authorise such checks.
YesNo
I declare that to the best of my knowledge and belief the information provided in this application is true and complete. I understand that such information, together with this declaration, shall be the basis of the contract between me and the Society and that any policy issued on the basis of this application shall be subject to the terms and conditions of the Investment Bond.
YesNo
I agree to inform Railway Enginemen's Assurance Society promptly in writing of any changes to my details.
YesNo
I agree to the Investment Bond terms and conditions.
YesNo

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Member's Details

Appointment of Nominee

Your Investment Amount

Demands and Needs

Appropriateness

Confirmation of Non-Advised Application

Data Protection and Marketing Preferences

Proof of Identity and Address

Source of Funds

Declaration