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The Royal Bank of Scotland Group Pension Fund

Death Benefit

Partner/ Dependant Pension Nomination Form

1. Member’s details

Name (in full)

Date of birth

National Insurance Employee reference

number number

2. Your information

Under the Rules of the Group Fund, if you die, a pension may be payable to your spouse or a dependant. If you are married (and normally resident with your spouse) at the time of your death, your spouse will automatically receive a pension. You do not need to complete this form if this situation currently applies to you. If you are not married then this pension may be payable to a partner providing you have been living together for at least six months and your partner is financially dependant or interdependent on you. A financial dependant is a person who relies on your financial support to maintain their standard of living.

In addition, if you are a member of the NatWest or Coutts schedule and you are not married or you do not have a partner, the pension may be payable to any person who is financially dependant on you.

The information you provide in this form will be retained by Group Pension Services on behalf of the Trustee and used for the purpose of administering pension benefits. It may be shared with third parties that administer pension benefits on behalf of the Trustee. By completing this form, you are providing your consent to your information being used in this manner.

3. Nominated Partner/ Dependant details

In the event of my death, I wish to nominate the following person to receive any pension benefits

Name (in full)

Home address line 1

Home address line 2

Home address line 3

Home address line 4 OR

overseas country

Postcode

Relationship

4. Confirmation

I understand that the payment of this pension is at the discretion of the Trustee. The Trustee will need to ensure that the conditions described above are met at the time of death before any payments can be made.

Member’s signature

Date

Please return this form to:

Group Pension Services, Group Human Resources

The Royal Bank of Scotland Group, PO Box 1390, Croydon, CR9 5WP

(For internal mail only add Depot Code 190)