Who is this for? This form is for the members of the Final Pay Section and the Money Purchase 2003 (MP03) Section who would like to opt out of the Plan. This form should not be completed by members of the Auto Enrolment (AE) Section. Important If you are opting out of the Plan and wanting to rejoin at a later date, you will need to complete a health declaration in connection with an application to rejoin the MP03 Section of the Plan. If you are opting out to transfer your benefits to another approved arrangement, you will need to complete the transfer before applying to rejoin the MP03 Section. Your details * Denotes required fields Your name Title*MrMrsMissMsDrProfTitle* - This is a required field Forename(s)* - This is a required field Surname* - This is a required field Address Select countryUnited KingdomAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaÅland IslandsBhutanBolivia (Plurinational State of)Bonaire, Sint Eustatius & SabaBosnia & HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Democratic Republic of)CongoCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island & McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic)Korea (Republic of)KuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension & Tristan da CunhaSaint Kitts & NevisSaint LuciaSaint Martin (French part)Saint Pierre & MiquelonSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard & Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan (Province of China)TajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVenezuela (Bolivarian Republic of)Viet NamVirgin Islands (British)Virgin Islands (U.S.)Wallis & FutunaWestern SaharaYemenZambiaZimbabweCountry* - This is a required field Start typing your address Look up address Address line 1* - This is a required field Address line 2 Town County/State/Province/Region Postcode/Zip code Date of birth* Day* of birth - This is a required fieldDD01020304050607080910111213141516171819202122232425262728293031 Month* of birth - This is a required fieldMM010203040506070809101112 Year* of birth - This is a required fieldYYYY20082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920191919181917191619151914 Other information National Insurance number* - This is a required field For example QQ123456C Email address* - This is a required field What would you like to do? Reason for opting-out * Denotes required fields Reason for opting-out* - This is a required fieldSelect reason*Change in circumstancesFinancial reasonsSaving elsewhereTransferring to another approved pension arrangement I understand that by doing so: My Plan contributions will cease To the extent I was eligible for Company contributions, I will no longer benefit from these contributions to the Plan My death-in-service benefits will no longer include any pension for my spouse/civil partner/nominated dependant or dependent children My death-in-service benefits will no longer include full life cover. It will be reduced to twice my pensionable salary I will no longer be eligible for an enhanced ill-health pension from the Plan I may be automatically enrolled back into the Plan at a later date (usually every three years) if I meet certain criteria and I will be given further information and the opportunity to opt-out again at that time I may have a lower income when I retire If I change job, my new employer will normally put me back into pension saving straight away This notice only opts me out of pension saving with the employer named above. A separate notice must be filled out and given to any other employer I work for if I wish to opt out of that pension saving as well I am aware that my employer cannot ask me or force me to opt out and if I am asked or forced to opt out I can tell the Pensions Regulator see www.thepensionsregulator.gov.uk I will need to complete a health declaration in connection with an application to rejoin the MP03 Section If I am transferring my pension to another approved arrangement, I will need to complete the transfer before an application to rejoin the MP03 Section is allowed I can confirm that I have read, understood and agree with all the above statements. Your declaration Please tick the boxes below to confirm that you understand and acknowledge the statements. I wish to opt-out of active membership of The Pearson Pension Plan (the Plan) with effect from the last day of the next available calendar month which is within payroll deadlines. Data protection The Trustee, as the controller under the applicable data protection legislation in the UK, uses certain personal information about you to (amongst other reasons) communicate with you and administer your benefits in the Plan. Your information is shared with the Plan’s administrators, other providers of services to us, and public bodies such as HM Revenue & Customs. For more detailed information on how we use and disclose your information, the protections we apply, the legal bases we rely on and your data protection rights, please see our privacy notice at www.pearson-pensions.com/privacy-notice/ - This link opens in a new browser window. If you would like a copy of our privacy notice to be sent to you, please contact the pensions helpline. I confirm I understand that the data I provide will be used as outlined in the data protection statement. Today's Date: Date: 21-11-2024 Thank you You will receive a confirmation email shortly. Your form will be processed by the pensions team. Please contact them directly if you have any queries. Back to Home
