Boots Retirement Savings Plan (BRSP)

Contribution Option Form

If you need any help completing this form please call 0115 959 1670 (internal 72 16 70).

This form is not required if you wish to remain in the Auto-Enrolment Section (AE Section).

My details:


  • Until further notice, I wish to take the following action in relation to my payments to the Plan.

    (Please complete ONE box only)

    If you are a Band A employee who selects either 3% or 4%, you will be in the Base Section. This means you could be automatically enrolled into the AE Section in the future. The AE Section does not provide life cover. Please read the factsheet here to fully understand the implications. If you’re not sure what Band you’re in, you can ask your line manager.

    If you select either 5%, 6% or more, you will be in the Standard Section. Please read the factsheet here to fully understand the implications. If you’re not sure what Band you’re in, you can ask your line manager.

Please note this form must be completed and submitted by the 5th of the month that you wish the contribution change to be made. This is due to payroll processing dates. If it is received after the 5th, your request will be processed at the next available payment date.


  • I understand that by participating in SMART (in relation to employee contributions), I am agreeing to a change in my terms and conditions of employment. If I no longer wish to participate in SMART I will submit a SMART Opt Out Form.
  • I understand there are instances when SMART may not provide a financial benefit so participation may not be appropriate. I understand if my earnings fall below the Pay Protection Limit or National Minimum Wage after my SMART adjustment, my contribution will be taken after tax and national insurance has been applied. Basic tax relief will be applied by Legal & General.
  • I understand that my employer will make contributions to the Plan at the ratio applicable to my Band. I understand and accept that in order to maintain the market competitiveness of the Plan, my employer reserves the right at its sole discretion to vary at any time the Band that applies to my grade/job role; the level of employee and/or employer contributions; and/or the level of life assurance benefits provided under the Plan. Appropriate notice will be given of such a change.
  • I confirm that I know which Band applies to my grade/job role and I furthermore confirm that, if I am a Band A employee, I understand the implications of selecting a 3% or 4% contribution rate and that I have read the relevant factsheet.
  • I understand that my membership of the AE Section will cease upon submitting my request (if applicable).
  • I authorise my employer to facilitate my membership of the Plan and to pass on any information about me which might reasonably be required to companies within WBA’s UK employing entities, L&G, payroll and life cover provider.
  • I understand that I may be eligible for life cover whilst I remain in the Base Section or the Standard Section. I have read the relevant factsheet.
  • I have read the data protection statement below.

Please confirm your details before submitting this form.

Data protection:


We take customer privacy very seriously. Unless you tell us not to, Legal & General may use the personal information that you or your employer have provided us with for the purposes of:

  • Dealing with your enquiries and requests for products and services from Legal & General
  • Administering your plan including processing any claims
  • Carrying out market research, statistical analysis and customer profiling.

We will not use your personal information for the purposes of marketing our other products and services or those of third parties.

You should also be aware that given the global nature of Legal & General’s business, it may be necessary to transfer your information to countries outside the European Economic Area in order to administer your plan.

Sharing with others

If necessary we’ll share your information with other companies within the Legal & General group of companies, regulatory bodies, law enforcement agencies, future owners of our business, suppliers engaged by Legal & General to process data on its own behalf and when necessary to a reassurer.

If you make a claim we may share your information with other insurance companies to prevent fraudulent claims. We’ll also check your details with fraud prevention agencies and if false or inaccurate information is provided and fraud is detected then details will be passed to fraud prevention agencies. Law enforcement agencies may also access and use this information. Legal & General and other organisations may also access and use this information to prevent fraud and money laundering, for example, when:

  • Checking details on applications for credit and credit related or other facilities;
  • Managing credit and credit related accounts or facilities;
  • Recovering debt;
  • Checking details on proposals and claims for all types of insurance;
  • Checking details of job applicants and employees.

If you would like to receive details of the relevant fraud prevention agencies then please contact Legal & General at Group Financial Crime, Knox Court, 10 Fitzalan Road, Cardiff, CF24 0TL.