This form should be filled in by your customer if they want to apply for a Relevant Life Plan. It can either be returned to Royal London as a paper application form or returned to the Adviser to use with our online service.

Important information about this form

• Ensure your customer has received a copy of Relevant Life Plan: Key Facts (44KF0922) before they fill out this form
• We may request medical information as part of the application, or up to six months after the plan has started, to confirm the information given
• Before we can do this, we will ask for permission under the Access to Medical Reports Act 1988
• If any of the people covered don’t give permission, or any statement is inaccurate and this affects our assessment of the application, we will then have the right to reconsider or withdraw terms and the plan may be cancelled
• Please answer all questions accurately and honestly and to the best of your knowledge and belief
• If there’s a delay between the application date and the plan starting, please use the Declaration of Health form (P9B0006) to let us know if there is a change to any of the answers that you or the covered person have given
• If the plan is not in force twelve months after the date this form is signed, we may request a new application form
• We may have to verify the identity of certain individuals connected to a policy. We do this electronically to make things easier
• If your customer would prefer us not to do this electronically, please call us on 0345 6094 500 so we can talk through what needs to be sent to us.