Auto Enrolment Opt Out Consent

Employee Name:

Employer Name:

National Insurance Number or Date of Birth:

I confirm that I have personally submitted this notice, that I am fully aware of the implications of opting out of auto-enrolment, and I wish to opt out of my employer's pension scheme.

Yes

No

Signed:

Date:

Email address:

Enter the number above

Please note - if you opt out within 30 days of being enrolled onto the scheme, then you will be refunded any contributions made since the date of enrolment.