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The application process for a one-time Pension refund per the Covid-19 Pension Act Amendment is NOW OPEN.  Click here to apply

Pension Withdrawal Form

Temporary Access to Pension Refund–Application Form

Use this Application Form to apply for approval of a Pension Refund from your occupational pension plan or retirement product under the National Pension Scheme (Occupational Pensions) Act 1998. There are two parts to the application process: the submission of this Form and an ID verification process to be completed separately via a link that will be provided by BF&M.

PLEASE NOTE: (i) You are entitled to receive your refund within 20 days after your Application has been approved. (ii) Your Application Form must be completed in full and accurately, with the required accompanying documentation outlined in this Form, to avoid delays or rejection. (iii) Applicants who are members of a Defined Benefit Plan are not eligible.

Note: You cannot apply for a refund of money using this form if:

  • The money you seek to have refunded is not governed by or under the National Pension Scheme (Occupational Pensions) Act 1998
  • It is after June 30, 2021
  • You have already applied and been approved for a temporary refund previously
  • Part of the money you seek to have refunded represents voluntary contributions (no such approval is required to withdraw any voluntary pension contributions)
  • You have sought pension refunds which, when added to this refund request, amount to more than $12,000 in refunds
  • You have purchased an annuity. In such cases your funds are locked-in and may not be refunded
  • You cannot apply for a pensions refund if you are 65 and older 

1. Member Information

* Denotes that these fields are mandatory

Group Policies Only
First Middle Last
dd/mm/yyyy
SIN
Please use the following format for Residential Address: Street Address/Parish or City/Postal Code/Country
If different from Residential Address
 

2. Payment Instructions

Payment Method *:

Currency *:

*Conversion and other applicable bank charges will be deducted
Amount to request for Withdrawal

* Please note that the maximum amount of withdrawal from your pensions is $12,000.00 or the entirety of your account balance if less than $12,000.00, and that the balance in your account is subject to daily market fluctuations. Please note also that you are making a one-time application for a withdrawal. Once you submit the application form your amount cannot be amended or modified and you cannot submit another application.

 

A. Local bank information (Complete for payment to banks in Bermuda)

* The Account Holder name MUST be in the name of the member (single or joint account). Any conversion or foreign exchange fees are at the cost of the Member. Payments can only be applied to Chequing or Savings Accounts.

 

B. Overseas bank account information (Complete this section for payment to banks outside of Bermuda)

* The Financial Beneficiary name MUST be in the name of the member (single or joint account). The Financial Beneficiary address MUST be linked to the bank account provided. Any conversion or foreign exchange fees are at the cost of the Member. Overseas transactions may be subject to additional bank fees deducted by the receiving bank. Transactions sent to any European Country requires an IBAN number. 

If Required
First/Middle/Last

* Any costs associated with the foreign exchange conversion will be deducted from the amount to be paid.


3. Member Status

*This excludes Hardship Withdrawals.

If you answered “Yes”, provide the date of any application(s), the amount(s) applied for and the name of the plan administrator(s) that provided the refund.

Date of Application Amount of Refund(s) Requested Plan Administrator Name(s)
dd-mmm-yyyy
*Total refund across all pensions cannot exceed $12,000
 

Certification

By signing this form, I certify and understand that:

  • I have declared all applications for refunds that I have made from my BF&M pension(s) or pensions from other providers
  • Including the amount requested by this refund, I will not receive more than $12,000.00 in pension refunds
  • I understand my account balance may go up and down and that I will receive the value of my account at the time of redemption.
  • All of the information supplied in this Application and any documents that accompany this Application are true copies and/or accurate.
  • I give consent to BF&M to process my personal data in accordance with BF&M’s Privacy Policy www.bfm.bm/privacy.
  • I understand that I will receive an email from BF&M with a link to BF&M's online ID verification process, and that I must complete that process for my application to be complete.
  • I authorise BF&M to contact the Pension Commission, any other person, including other pension plan administrators or retirement product administrators to confirm or verify any information provided by or about me in this Application.
  • I authorise the Pension Commission, any person, other pension plan administrator or retirement product administrator to provide information to BF&M with respect to information in this Application.

I submit this Application and fully understand that by checking the “ACCEPT TERMS” box below, I certify and confirm that I understand and agree with the declaration and authorisation of personal information set out above.