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Investment Bond and Portfolio Investment Bond Fund Switch request

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(1)

Name(s) of planholder

Plan number

Before completing this form, you should read the notes below and overleaf as they give general information about the fund switch facility. You can get further information from the Plan Terms and Conditions. If you need any help or more details, please contact your adviser or telephone Customer Services on 01793 514514.

Notes

1. Valuations

When we receive this correctly completed form in Swindon, we will follow your fund switch instructions using the selling price of the relevant units. The valuation date used will depend on the type of bond you hold and the time we receive your completed form. Please see the table below for details:

2. a) If your bond has a plan number suffi x AF, AG, AH, AJ: You may link these bonds to only one fund at any time. b) If your bond has a plan number suffi x DJ: You may link this bond to up to 12 funds at any one time.

3. This request must be signed by all planholders (ie all trustees and assignees, except for Trust T7 where only the settlor should sign).

Portfolio Investment Bond and DJ Investment Bond

We offer a range of portfolios, each aligned to a particular risk profi le, which you may switch into as your attitude to risk and circumstances change. If your request is more complex please use the section at the top of page 2.

Have you received advice from your adviser in connection with this fund switch? Yes No

Investment Bond and

Portfolio Investment Bond

Fund Switch request

Fund choice

Your attitude to risk Managed Portfolios Multimanager Portfolios

Please tick one of the Recommended funds for attitude to risk Recommended funds for attitude to risk

following choices. (% in whole numbers) (% in whole numbers)

Cautious Defensive AL %

Moderately cautious Defensive Equity & Bond AL % Defensive Equity & Bond AL %

Balanced Equity & Bond AL % Equity & Bond AL %

Moderately adventurous Global Equity & Bond AL % Global Equity & Bond AL %

Bond Type Valuation date* Form must be received by

Suffi x AF, AG, AH, AJ Day after receipt 10.30 am

Suffi x DJ Day after receipt 10.30 am

Portfolio investment bond Day of receipt 10.00 am

* Units will be valued on the day specifi ed if a correctly completed form is received by the relevant time shown. Any forms received after this time will be treated as being received on the next working day.

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Other fund switch instructions for all Bonds

Please specify the fund(s) to be cancelled and the new fund(s) to be selected and the relevant proportion of each (% in whole numbers) from the choice of funds detailed below.

Existing fund name % of existing fund to be switched New fund name

Authority

I/We request and authorise Zurich Assurance Ltd to carry out the above instructions.

Date Planholder Date Planholder Date Trustee/assignee Date Trustee/assignee

Please ensure that the form is signed appropriately before returning it to:

Zurich Assurance Ltd, Customer Services, UK Life Centre, Station Road, Swindon, SN1 1EL If advice has been sought and the fund selection does not match the attitude to risk, please give reasons.

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Funds available

The table below indicates the investment funds available depending on the version of Bond you hold. The letters (eg. DJ) identifies the plan version and form the suffix to your plan number.

Funds managed by Threadneedle DJ issued before DJ issued after AF, AG, Portfolio 26 August 1997 26 August 1997 AH, AJ Investment

including top-ups Bond

American Equity AL 3 3

American AL 3 3 3

American Managed AL 3 3

American Property AL 3 3

American Select AL 3 3 3

American Smaller Companies AL 3 3 3

Asia AL 3 3 3

Balanced Managed AL 3

Cautious Managed AL 3

Defensive AL 3 3 3

Defensive Equity and Bond AL 3 3 3

Equity and Bond AL 3 3 3

Equity AL 3 3

European AL 3 3 3

European Growth AL 3 3

European Select AL 3 3 3

European Smaller Companies AL 3 3 3

Far East Equity AL 3 3

Far East and Japan AL 3 3 3

Fixed Interest Deposit AL 3 3

Gilt Edged AL 3 3 3 3

Global Bond AL 3 3 3

Global Equity AL 3 3 3

Global Equity and Bond AL 3 3 3

Global Select AL 3 3 3

High Income AL 3 3

Japan AL 3 3 3

Japan Smaller Companies AL 3 3 3

Latin America AL 3 3 3 Managed AL 3 3 3 3 Managed Income AL 3 3 3 Overseas Earnings AL 3 3 Property AL 3 3 3 3 Protected Profits AL 3

(4)

The fund availability shown above is correct at the time of printing.

Funds available (continued)

Funds managed by Threadneedle DJ issued before DJ issued after AF, AG, Portfolio 26 August 1997 26 August 1997 AH, AJ Investment

including top-ups Bond

UK Corporate Bond AL 3 3 3

UK Equity Income AL 3 3 3

UK AL 3 3 3

UK Growth and Income AL 3 3 3

UK Money Securities AL 3 3 3

UK Monthly Income AL 3 3 3

UK Select AL 3 3 3

UK Smaller Companies AL 3 3 3

Funds managed by other fund managers

AXA Framlington Equity Income AL 3

BGI Corporate Bond AL 3

BGI UK Equity AL 3

BlackRock Balanced Portfolio AL 3

Close UK Escalator Plus AL 3

Fidelity American Special Situations AL 3

Fidelity Managed AL 3 3 3

First State Asia Pacific Leaders AL 3

Gartmore European Selected Opportunities AL 3

Henderson Industries of the Future AL 3 3 3

Henderson Preference and Bond AL 3

HSBC Active Index AL 3 3 3

HSBC Gilt and Fixed Interest AL 3

HSBC UK Growth and Income AL 3

Invesco Bond AL 3

Invesco Perpetual Corporate Bond AL 3

Invesco Perpetual Income AL 3

Invesco Perpetual Managed AL 3 3 3

JPM Select Managed AL 3 3 3

JPM Global AL 3

JPM Global (ex UK) Bond AL 3

JPM Corporate Bond AL 3

JPM UK Dynamic AL 3

Merrill Lynch Managed AL 3 3

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Funds available (continued)

Funds managed by other fund managers DJ issued before DJ issued after AF, AG, Portfolio 26 August 1997 26 August 1997 AH, AJ Investment

including top-ups Bond

Multimanager Equity and Bond AL 3 3 3

Multimanager Global Equity AL 3 3 3

Multimanager Global Equity and Bond AL 3 3 3

Newton Managed AL 3 3 3

Schroder Gilt and Fixed Interest AL 3

Schroder Managed Balanced AL 3 3 3

Schroder Tokyo AL 3

Schroder UK Smaller Companies AL 3

Please let us know if you would like a copy of this

in large print or braille, or on audiotape or CD.

For details of the fund charges, please refer to your key features document or contact us.

Zurich Assurance Ltd

Registered in England and Wales under company number 02456671. Registered Office: UK Life Centre, Station Road, Swindon SN1 1EL. Telephone: 01793 514514.

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