Who is this for? This form is for members of the Auto-Enrolment (AE) and Money Purchase 2003 (MP03) sections of the Pearson Pension Plan who wish to make a single one-off AVC payment. When you submit the form, it will be sent to Pearson People Services (PPS) to be actioned. You will receive an email confirming the submission shortly after you submit the form. 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? * Denotes required fields Before deciding to make an AVC payment, we recommend that you check your Annual Allowance and Lifetime Allowance limits. These limits determine if there may be an additional tax charge payable. You can find further information about the Annual Allowance and the Lifetime Allowance on the My Contributions - This link opens in a new browser window page and on the HMRC website www.gov.uk/tax-on-your-private-pension/annual-allowance - This link opens in a new browser window. Please note that you are unable to make a single contribution that will exceed your gross monthly pay. Single payment* - This is a required field Investment selection Unless you have previously self selected the funds that your AVCs are invested in, your contributions will be automatically invested in the Drawdown lifecycle option. If you do not wish to remain in the Drawdown lifecycle option, you can select alternative funds by logging onto Aviva’s secure online portal, MyWorkplace - This link opens in a new browser window, once your payment has been received by Aviva. Your declaration Please tick the boxes below to confirm that you understand and acknowledge the statements. I hereby confirm that the information provided in this form is correct. I also authorise the deduction of the appropriate AVC from my pensionable pay. 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 Pearson People Services (PPS). Please contact them directly if you have any queries. Back to Home
