Please complete these instructions in BLACK INK using CAPITAL LETTERS (except for your address) and 3 boxes where provided.

Transcription

1 Staff Superannuation Plan a sub-plan of IOOF Employer Super 1 July 2015 Withdrawal Form This form serves as your instruction to us on how to deal with your benefit. We recommend that you consult your licensed financial adviser to assist you in your decision making. Note: Former Temporary Australian Residents Departing Australia Superannuation Payment members will need to complete a Departing Australia Superannuation Payment (DASP) form. To obtain a copy of this form, visit our website ( or contact our client services team on Please complete these instructions in BLACK INK using CAPITAL LETTERS (except for your address) and 3 boxes where provided. Step 1: Member details Member type Employer Personal Member number Title (Dr/Mr/Mrs/Ms/Miss) Surname Given name(s) Residential address Suburb State Postcode Mailing address (if different from above) Suburb State Postcode Phone Phone (home) (work) Mobile Date of birth Tax file number 1 Gender Male Female 1 Under the Superannuation Industry (Supervision) Act 1993, you are not obliged to disclose your Tax File Number (TFN), however if you do not provide your TFN before exiting the fund, any TFN contributions income tax that has been deducted from your account will not be claimed back on your behalf. Refer to the Withdrawal Instructions for more information. Please read the information on collection of TFNs in the Product Disclosure Statement before providing your TFN. Step 2: Residency details Are you an Australian citizen, permanent resident or a New Zealand citizen? Yes No If you ticked No and are or have ever been the holder of a temporary resident visa, please speak to your financial adviser or contact our client services team on

2 Step 3: Withdrawal instructions Full withdrawal Transfer my total benefit to the rollover fund in Step 6 of this form Pay my total benefit to me in cash (subject to the below conditions of release) Withdraw my non-preserved benefit and transfer my preserved benefit to my nominated rollover fund in Step 6 of this form Partial payment type Cash Rollover (complete Step 6) Withdraw my unrestricted non-preserved benefit only Withdraw my restricted non-preserved benefit only Amount Net Gross (Unless indicated the amount shown will be net of tax) For members of the pension division Please treat this benefit as an additional pension payment, not a lump sum payment Please note: All benefits paid in addition to your regular pension payments will be treated as a lump sum withdrawal unless you specify that it be treated as a pension payment. Step 4: Financial institution details Lump sum (cash) withdrawal Name of financial institution Account name BSB Account number Note: If direct credit details are not supplied, or unclear, the payment will be paid to you by cheque and sent to the above mailing address. Funds cannot be credited to a third party bank account. Step 5: Conditions of release You may access your member benefit if you meet one of the criteria detailed below. I have reached preservation age* and have permanently retired and intend never to become engaged in gainful employment for more than 10 hours per week I am aged 60 and less than 65 and have ceased a gainful employment arrangement since turning age 60 I am aged 65 or over My benefit is unrestricted non-preserved I wish to withdraw money from my restricted non-preserved benefit (I have attached a letter from my previous employer confirming the date I ceased employment and that the employer contributed to IOOF Employer Super on my behalf whilst I was employed) I have ceased employment with my last employer and my total benefit was less than 200 at the time of termination (for employer division only) Compassionate grounds as approved by the Department of Human Services (DHS) and I have attached the original DHS approval or certified copy I am permanently incapacitated (conditions apply). Please contact our client services team for further information. * Please refer to the Bendigo and Adelaide Bank Staff Superannuation Plan General Reference Guide (SSB.13) for your preservation age. 2

3 Step 6: Rollover fund details * Indicates mandatory field. If you do not complete all of the mandatory fields, there may be a delay in processing your request. Fund name* ABN* Unique Superannuation Identifier (USI) Account/member number* Member client identifier (if different from Account/member number) Address Suburb State Postcode Phone Cheque made payable to (SMSF only) Step 7: Claiming a tax deduction for non-concessional (personal) contributions Only complete this Step if you are eligible and wish to claim a personal tax deduction in the current and/or previous financial years. If you wish to claim for both financial years you will need to complete and attach a separate form for each financial year. Eligible persons are generally those who have made non-concessional (personal) after-tax contributions to their superannuation and are self-employed, substantially self-employed or not eligible to receive superannuation support from an employer during the financial year. Substantially self-employed persons are those whose assessable income, exempt income and reportable fringe benefits from employment as an employee (as shown on their group certificate) is less than 10 per cent of their total assessable income plus reportable fringe benefits. Unsupported individuals are those who have retired, are under age 65 and have not received any superannuation support from another person during the financial year. I intend to claim a personal tax deduction under section of the Income Tax Assessment Act 1997 Yes No Note: If you answered Yes to the above, please complete Section A and Section B or C (whichever is applicable). Notice of intent to claim or vary a deduction for personal super contributions Section A. Personal contribution details Financial year ended 3 0 / 0 6 / 2 0 My personal contributions to this fund covered by this notice Is this notice varying an earlier notice? Yes No The amount of these personal contributions I will be claiming as a tax deduction Please note: Failure to notify us of your intention to claim a tax deduction will result in you being unable to do so once you have exited the fund or if taking a partial payment may limit the amount you can claim in the future. 3

4 Declaration Complete and sign one of the following statements that applies to you. Section B. Intention to claim a tax deduction Use this declaration if you have not previously lodged a notice for these contributions I am lodging this form before the earlier of the following dates: the day that I lodge my income tax return for the year stated in section 7A, and the end of the income year after the year stated in section 7A. At the time of completing this notice: I intend to claim the personal contributions stated in section 7A as a tax deduction I am a member of the IOOF Employer Super fund IOOF Employer Super still holds these contributions this super fund has not begun to pay a superannuation income stream based in whole or part on these contributions I have not included these contributions in an earlier notice. The information given on this notice is correct and complete. Member name Member signature OR Section C. Variation of previous deduction notice Date Use this declaration if you have already lodged a notice with this fund for these contributions and you wish to reduce the amount stated in that notice. I intend to claim the personal contributions stated in section 7A as a tax deduction. I wish to vary my previous notice for these contributions by reducing the amount I advised in my previous notice. I confirm that either: I have not yet lodged my income tax return for the relevant year and this variation notice is being lodged on or before 30 June in the financial year following the year the contribution was made, or The ATO has disallowed my claim for a deduction for the relevant year and this notice reduces the amount stated in my previous valid notice by the amount that has been disallowed. The information given on this notice is correct and complete. Member name Member signature Step 8: Additional withdrawal payment instructions Date Specific investment withdrawal instructions Investment fund name Amount OR Allocation (%) 4

5 Step 9: Proof of identity You will need to provide documentation with your withdrawal request to prove you are the person to whom the superannuation entitlements belong. You need to provide a certified copy of a document(s) that clearly shows your full name, your signature, date of birth and residential address. To meet these requirements you must provide either a certified copy of A or B as below: EITHER OR A ONE of the following documents only: current driver s licence issued under state or territory law passport B birth certificate or birth extract citizenship certificate issued by the Commonwealth pension card issued by Centrelink that entitles the person to financial benefits AND letter from Centrelink regarding a government assistance payment notice issued by Commonwealth, state or territory government or local council within the past 12 months that contains your name and residential address (eg Tax Office Notice of Assessment or rates notice from local council). Please refer to the Proof of identity requirements section for further explanation. Step 10: Member declaration Important note: The Trustee collects the information in this form for the purpose of updating the information it holds about you. The information provided in this form will be used in accordance with the Privacy Policy at By signing this request form I am making the following statements: I declare I have fully read this form and the information completed is true and correct. I am aware I may ask my super provider for information about any fees or charges that may apply or any other information about the effect this transfer may have on my benefits, and do not require any further information. If the fund I am transferring my benefit to is a Self Managed Superannuation Fund (SMSF), I confirm that I am a trustee or director of a corporate trustee of the SMSF. I discharge IOOF Employer Super of all further liability with respect to the benefits once paid to the fund I am transferring to. I understand that all investment options will be converted to cash prior to transferring out of the fund. I consent that where I have chosen an investment with a long withdrawal period (illiquid investments) or there are delays receiving proceeds from selling my investments, any withdrawal or transfer request may be delayed for more than 30 days. I request and consent to the transfer/withdrawal of super, as described above, and I authorise the super provider of each fund to give effect to this transfer. Member signature Please forward all correspondence and enquiries to Post Bendigo and Adelaide Bank Staff Super, GPO Box 529, Hobart TAS staff.super@bendigobank.com.au Telephone Fax Web Date 5

6 Proof of identity requirements You will need to provide documentation with this benefit payment request to prove you are the person to whom the superannuation entitlements belong. EITHER A ONE of the following documents only: current driver s licence issued under State or Territory law passport OR B birth certificate or birth extract citizenship certificate issued by the Commonwealth pension card issued by Centrelink that entitles the person to financial benefits AND letter from Centrelink regarding a government assistance payment notice issued by Commonwealth, State or Territory government or local council within the past 12 months that contains your name and residential address (such as Tax Office Notice of Assessment or rates notice from local council). Have you changed your name or are you signing on behalf of another person? If you have changed your name or are signing on behalf of the applicant, you will need to provide a certified linking document. A linking document is a document that proves a relationship exists between two (or more) names. The following table contains information about suitable linking documents. Purpose Change of name Signed on behalf of the applicant Suitable linking documents Marriage certificate, deed poll or change of name certificate from the Births, Deaths and Marriages Registration Office Guardianship papers or Power of Attorney Certification of personal documents All copied pages of ORIGINAL proof of identification documents (including any linking documents) need to be certified as true copies by any individual approved to do so (see below). The person who is authorised to certify documents must sight the original and the copy and make sure both documents are identical, then make sure all pages have been certified as true copies by writing or stamping certified true copy followed by their signature, printed name, qualification (such as Justice of the Peace, Australia Post employee) and date. The following can certify copies of the originals as true and correct copies: Chiropractor Dentist Legal practitioner Medical practitioner Nurse Optometrist Patent attorney Pharmacist Physiotherapist Psychologist Trade marks attorney Veterinary surgeon Other persons: Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public Australian Consular Officer or Australia Diplomatic Officer (within the meaning of the Consular Fee Act 1955) Bailiff Bank officer with two or more continuous years of service Building society officer with two or more years of continuous service Chief executive officer of a Commonwealth court Clerk of a court Commissioner for Affidavits Commissioner for Declarations Credit union officer with two or more years of continuous service Employee of the Australian Trade Commission who is: in a country or place outside Australia; and authorised under paragraph 3(c) of the Consular Fees Act 1955; and exercising his or her function in that place Employee of the Commonwealth who is: in a country or place outside Australia; and authorised under paragraph 3(d) of the Consular Fees Act 1955; and exercising his or her function in that place Fellow of the National Tax Accountants Association Finance company officer with two or more years of continuous service Holder of a statutory office not specified in another item in this list Judge of a court Justice of the Peace Magistrate Marriage celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961 Master of a court Member of Chartered Secretaries Australia Member of Engineers Australia, other than at the grade of student Member of the Association of Taxation and Management Accountants Member of the Australian Defence Force who is either: an officer; or a non-commissioned officer within the meaning of the Defence Force Discipline Act 1982 with two or more years of continuous service; or a warrant officer within the meaning of that Act Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants Member of either: the Parliament of the Commonwealth; or the Parliament of a State; or a Territory legislature; or a local government authority of a State or Territory Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961 Notary public An officer with, or authorised representative of, a holder of an Australian financial services licence, having two or more years of continuous service with one or more licences Permanent employee of the Australian Postal Corporation with two or more years of continuous service who is employed in an office supplying postal services to the public Permanent employee of: the Commonwealth or a Commonwealth authority; or a State or Territory or a State or Territory authority; or a local government authority; with two or more years of continuous service who is not specified in another item in this list Person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made Police officer Registrar, or Deputy Registrar, of a court Senior Executive Service employee of either: the Commonwealth or a Commonwealth authority; or a State or Territory or a State or Territory authority Sheriff Sheriff s officer Teacher employed on a full-time basis at a school or tertiary education institution Member of the Australasian Institute of Mining and Metallurgy 6

7 Eligibility guidelines for reimbursement of insurance premiums inside Bendigo and Adelaide Bank Staff Super Plan sub plan of IOOF Employer Super ( BASSP ) Summary Balances inside BASSP are fully portable to other superannuation funds. It is important to note that the transfer of BASSP balances to another super fund may render members ineligible for the staff benefit of standard insurance premiums being reimbursed to their super accounts. Trustee requirements to maintain insurance cover When making a partial transfer to an external super fund, a balance of at least 10,000 must be retained inside BASSP to maintain existing Income Protection (IP) and Death and Total and Permanent Disablement (DTPD) insurance cover. If the balance drops below 10,000 then insurance cover inside BASSP will be cancelled. Employer policy on reimbursement of insurance premiums Standard insurance package The standard BASSP insurance package comprises IP as well as formula based DTPD insurance. This cover is automatically allocated without the need for health assessment to new permanent employees who work 15 or more hours per week and who become BASSP members within 60 days of starting work. Standard IP cover when one is too sick to work will pay 75% of salary for up to 2 years and has a 60 day waiting period. Formula based DTPD cover for permanent employees is calculated as follows: - Salary x 15% x number of years until age 65. Making extra super contributions to another super fund An employee can direct extra contributions to another super fund via Payroll. Provided the extra contributions are over and above the 5% salary sacrifice to BASSP and all other basic guidelines (above) are met, insurance premiums will continue to be reimbursed by your employer. Splitting contributions to a spouse Members of BASSP may split their contributions annually with a spouse and maintain insurance cover reimbursed by their employer provided that the receiving account is a Family Member Account also inside BASSP. Transition to Retirement Accounts Members accessing Transition to Retirement income streams inside BASSP continue to be eligible to have their insurance premiums reimbursed while they remain in the employer sponsors employment and provided they continue to meet the above three basic guidelines (above) with their accumulation super balances. Enquiries to Helen Sweeney Remuneration and Benefits Adviser Helen.sweeney@bendigobank.com.au Telephone Basic Guidelines Your employer will reimburse premiums for the standard package of DTPD and IP insurance provided that you: contribute at least 4% after tax or 5% before tax (salary sacrifice) to BASSP; and elect for your employer to contribute its Superannuation Guarantee (SG) to BASSP; and do not transfer any portion of your existing balance inside BASSP to another super fund. If conditions 2 or 3 are not met then an employer will cease to reimburse standard insurance premiums as a staff benefit. Insurance cover will be maintained provided a balance of at least 10,000 remains in the Plan (see Trustee requirement above). Insurance premiums will continue to be deducted from your superannuation account on a monthly basis. Employers will reimburse premiums for the standard insurance package only. Top up and enhancement to the standard insurance package is available with health assessment. Any variations to the standard package will not be reimbursed. These basic guidelines are also summarised in the BASSP Product Disclosure Statement. IOOF Investment Management Limited ABN AFS Licence No as Trustee of the IOOF Portfolio Service Superannuation Fund ABN