The Pearson Pension Plan

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Forename* - This is a required field

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National Insurance number* - This is a required field

Employer* - This is a required field

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.

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
  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

Today's date* - This is a required field

Reason for opting-out* - This is a required field Change in circumstancesFinancial reasonsSaving elsewhere

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.