Supplementary Product Disclosure Statement and Application Forms. Issued by Sandhurst Trustees Limited

Similar documents
The Bendigo Superannuation

Bendigo SmartStart Pension. This booklet contains: Application Form Binding Death Benefit Nomination Form Request to Transfer Form

Suburb State Postcode Mailing address (if different from above) Suburb State Postcode

Super and Pension Manager Supplementary Product Disclosure

Bendigo SmartStart Super Contribution Remittance Advice (for employer use only)

*Town/Suburb *State *Postcode. *Town/Suburb *State *Postcode

SuperChoice Superannuation Plan Pension Plan

Family Member Application Personal Division

Knight Superannuation Service Member Guide

The information in this Guide forms part of the Product Disclosure Statement (PDS) for the Core Superannuation Service Division

BT Portfolio SuperWrap Essentials

Bendigo SmartStart Pension

Bendigo SmartStart Super

Super and Pension Manager Supplementary Product Disclosure Statement

Incorporated Information Booklet

Super/Pension to pension transfer

Apply for a Super Payout

Knight Superannuation Service Product Disclosure Statement ( PDS )

Fact. sheet. 2. How super works. Overview. Member account. Contributions. Product Disclosure Statement

BT Term Life as Superannuation

Retained Benefits Maritime Super Division Membership Supplement

Allocated Pension Membership Application Form

Managed Accounts MH Division Product Disclosure Statement ( PDS )

Application for an RBF Account Based Pension

QIEC Income Stream INSIDE: Product Disclosure Statement. How to start a. QIEC Income Stream

Product Disclosure Statement ( PDS )

supplementary product disclosure statement legalsuper Allocated Pension & Non Commutable Allocated Pension

Bendigo SmartStart Super

Payment instruction form

Super Simplifier. Super & Pension Member Guide. Issued by Diversa Trustees Limited as the Trustee of the DIY Master Plan (Division)

Benefit Payment and Rollout Request. Step 2 Employment details (to be completed by all members)

The type of assets into which investments are made will depend on the investment strategy of your fund.

Accumulation Basic Stevedores Division Membership Supplement

Westpac Protection Plans Technical Guide.

Splitting Super Contributions

ADDITIONAL INFORMATION BOOKLET

The information in this Booklet forms part of the Accumulation & Pension Product Disclosure Statement (PDS)

Accumulation Plus Stevedores Division Membership Supplement

Asgard Elements Super/Pension

TRANSITION TO RETIREMENT GUIDE

Powerwrap. Superannuation Account Reference Guide

How to transfer your Bendigo SmartStart superannuation balance to a KiwiSaver scheme

Reliance Super a membership category of Maritime Super Membership Supplement

Contributions Splitting Application

AMA FINANCIAL SERVICES. Medical & Associated Professions Superannuation Fund. a sub-plan of IOOF Employer Super. Forms Booklet

Street address Suburb/Town State Postcode

Binding Death Nomination Form Super

Contributory Accumulation Seafarers Division Membership Supplement

intrust.com.au. Brisbane QLD 4000 Mail GPO Box 1416, Brisbane QLD 4001 Fax

Anchor. Anchor Superannuation Fund ABN Product Disclosure Statement Accumulation and Pension Products. Dated 22 December 2014

Spouse and Rollover Members

Title Mr Mrs Ms Miss Other M/F Date of birth / / Given names - - Step 2A What form of identification will you need to provide?

Newcastle Permanent Superannuation Plan

Member Booklet. Issued 1 October 2017

Smartwrap. Superannuation Account Reference Guide

Contributions Splitting Application

Eligible Rollover Fund Trustee Annual Report

Complete this form if you wish to withdraw part or all of your benefit from the Plan or you wish to begin a pension in the Plan.

Eligible Rollover Fund Trustee Annual Report to Members for the year ended 30 June 2014

Eligible Rollover Fund Trustee Annual Report to Members for the year ended 30 June 2013

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

Request for Partial/Full Commutation (Withdrawal) If you need help. Title Mr Mrs Ms Miss Other Date of birth / / Given names. Suburb State Postcode

claim your super form

Westpac Personal Superannuation Fund. Westpac Term Life as Superannuation.

Application for Payment of a Benefit Form.

Equip MyPension Application

StatePlus Retirement Fund

Apply for a super payout

Capital Guaranteed Super

Benefit Payment Request

Date of Birth / / Home Telephone Number

Portfolio Solutions ewrap Super/Pension

Transition to retirement pension application

Pitcher Partners Superannuation Fund general reference guide (PPS.02)

ASC Superannuation Plan Product Disclosure Statement

Challenger Guaranteed Personal Superannuation

Application for membership (Spouse Contribution Account (SCA) Section) Part A

Request for Partial/Full Commutation

Application to commence an Income Account in Gateway

*Suburb *State *Postcode. *Suburb *State Postcode*

A. GENERAL INFORMATION

Bendigo Funeral. Bond. Supplementary Disclosure Document. Issued by Australian Friendly Society. Dated 1 October 2013

The information in this document forms part of the EISS Super PDS dated 26 May 2017.

PERSONAL DIVISION PRODUCT DISCLOSURE STATEMENT

Family law instructions for payment of entitlement

The information in this document forms part of the ClearView LifeSolutions Super Rollover Product Disclosure Statement (PDS) 16 April 2012.

apply for a super payout

AMOU Staff Seafarers Division Membership Supplement

IOOF LifeTrack employer super general reference guide (LT.13)

Smartwrap Pension Account

The information in this document forms part of the ClearView LifeSolutions Super Rollover Product Disclosure Statement (PDS) 21 October 2016.

Application for Application Form

Eligible Rollover Fund Trustee Annual Report

How super is taxed. VicSuper FutureSaver Member Guide

Bendigo SmartStart Super

apply for a super payout

ANZ OneAnswer. Pension. Incorporated Material

Superannuation Contribution Splitting Application

Superannuation. A Financial Planning Guide

Transcription:

Supplementary Product Disclosure Statement and Application Forms This document is a Supplementary Product Disclosure Statement dated 17 February 2010 and must be read together with: The Bendigo Superannuation Plan Product Disclosure Statement dated 28 July 2008 comprising 2 parts: Part 1: General Information and Part 2: Investment option & Insurance rate information The Trustee and issuer of interests in the Bendigo Superannuation Plan is Sandhurst Trustees Limited ABN 16 004 030 737 AFSL No 237906 RSE Licence No L0000154 a subsidiary of Bendigo and Adelaide Bank Limited ABN 11 068 049 178 AFSL No 237879 Issued by Sandhurst Trustees Limited

Contact information Customer Service Centre Call Monday to Friday 8am to 6pm (Victorian time): Telephone: 1800 033 426 Facsimile: 03 6215 5800 Website: www.sandhursttrustees.com.au /super Email: superannuation@bendigobank.com.au Postal address Bendigo Superannuation Plan IOOF Investment Management Limited GPO Box 529 HOBART Tas 7001 The Bendigo Superannuation Plan (the Plan) has identifying numbers: ABN 57 526 653 420 RSE Registration No. R1000139 SPIN STL0003AU Trustee and Issuer Sandhurst Trustees Limited (Sandhurst or the Trustee) is the Trustee of the Plan and the issuer of interests in the Plan. Sandhurst is also known by other identifi ers: ABN 16 004 030 737 AFSL No. 237906 RSE Licence No. L0000154 Sandhurst is a wholly owned subsidiary of Bendigo and Adelaide Bank Limited ABN 11 068 049 178, AFSL No. 237879 and is part of the Bendigo and Adelaide Bank Group, which comprises Bendigo and Adelaide Bank Limited and any of its related entities. Administrator IOOF Investment Management Limited (the Administrator) ABN 53 006 695 021 (formally SMF Funds Management Limited ABN 23 009 564 354) About this Supplementary Product Disclosure Statement This is a Supplementary Product Disclosure Statement dated 17 February 2010 (SPDS) to The Bendigo Superannuation Plan Product Disclosure Statement dated 28 July 2008 comprising 2 parts: Part 1 General Information and Part 2 Investment option & Insurance rate information (the PDS). This SPDS updates information contained in the PDS and must be read together with the PDS and any updates to the PDS available on our website at www.sandhurstrustees.com.au/pds from time to time. Capitalised terms defi ned in the SPDS have the same meaning as the PDS, except where additional terms have been defi ned in this document or there is inconsistency, in which case this document prevails. All other information and statements in the PDS remain unchanged. Unless otherwise stated, references in this document to pages in the PDS are references to pages in Part 1 General Information of the PDS. The information given in this SPDS is of a general nature and has been prepared without taking into account your individual objectives, fi nancial situation or particular investment needs. Before making an investment decision, it is important that you consider these things. To help you make an informed decision, you should consider obtaining professional advice from a licensed fi nancial adviser. 2 Bendigo Superannuation Plan Supplementary Product Disclosure Statement

The changes a snapshot Changes to the Plan effective 17 February 2010 Contribution fee cap A contribution fee cap has been introduced for non advised members (i.e. Members who do not invest in the Plan via a fi nancial adviser). Members who do not have a fi nancial adviser will be charged 4.1% (including GST) per contribution up to a maximum of $1,000 for each contribution. Advised members continue to have the fl exibility to agree the amount of their contribution fee directly with their adviser, up to a cap of 4.1%. Adviser Service Fee cap An adviser service fee cap of $10,000 each year has been introduced. This replaces your adviser s ability to receive a percentage based adviser service fee on an ongoing basis. The amount paid to your adviser continues to be an amount agreed directly between you and your adviser. Key Changes in Legislation effective 1 July 2009 1 Page 4 4 Page Concessional pre tax contributions Super co-contribution Departing temporary residents The maximum concessional (pre tax) contributions cap has been reduced from $50,000 to $25,000 each year for Members under age 50. The maximum concessional contributions cap has been reduced from $100,000 to $50,000 (until 30 June 2012) for Members aged 50 or over. Co-contribution payment limits and matching amounts have been revised. Additional rules around the treatment of departing temporary residents superannuation benefi ts have been introduced. 5 5 6 Pension payments The minimum pension payments required to be taken from your Account-based pension plan has been halved temporarily. 6 Changes to Application forms Page The Personal Superannuation and the Account-based Pension Member Application forms have been replaced effective 17 February 2010, with the forms attached to this SPDS. A1 1 This information is a brief summary only and does not purport to address or detail all legislative changes. This summary is not intended to be nor should it be relied upon as a substitute for professional advice. Fees and other Costs Table Sandhurst Trustees Limited 3

Changes to the PDS 1. Fees and other Costs Fees and other Costs Table The Fees and other Costs table on page 58 and 59 of the PDS is amended by replacing the rows relating to the Contribution fee and the Adviser service fee with the information set out below. All amounts in the table are inclusive of GST where applicable. Type of fee or cost Investment Option Amount How and when Paid Contribution fee The fee on each amount contributed to your investment either by you or for you. All Advised members - Up to 4.1% of the gross contribution, to be agreed with your fi nancial adviser. Non-Advised Members - 4.1% of the gross contribution up to a maximum of $1,000 per contribution. Applies to all regular and lump sum contributions and to rollover amounts. Deducted from your Cash at Bank when the Administrator receives each contribution or rollover. The amount of this fee can be negotiated directly with your adviser. Refer to Additional explanation of fees and costs in the PDS. Adviser Service Fee An optional fee that your fi nancial adviser may charge, either upfront or on an ongoing basis, for their advice. All The fee is as agreed with your fi nancial adviser, up to a maximum of $10,000 each year. Deducted from your Cash at Bank and paid to your adviser s licensee each month. The amount of this fee can be negotiated directly with your adviser. Refer to Additional explanation of fees and costs in the PDS. Additional explanation of fees and costs The third paragraph under Contribution fee on page 60 is deleted and replaced with: If you do not invest in the Plan through an adviser, then your Contribution fee is capped at a maximum amount of $1,000 per contribution. The Trustee will retain the entire Contribution fee deducted. The sixth paragraph under What the Trustee pays your adviser on page 60 of the PDS is deleted. The fourth and fi fth paragraphs under Adviser Service Fee on page 60 of the PDS beginning If you do pay an ongoing adviser service fee, are deleted and replaced with: The ongoing adviser service fee negotiated between you and your adviser is an agreed dollar amount paid to your adviser and is capped at $10,000 each year. 4 Bendigo Superannuation Plan Supplementary Product Disclosure Statement

2. The Personal Superannuation Plan Taxation Tax on contributions The table under Tax on contributions on page 21 of the PDS is amended by replacing the row relating to Concessional (pre-tax) contributions with the information set out below: Contribution Type Concessional (pre-tax) contributions Tax on entry into the Plan 15% on fi rst $25,000/ $50,000 per person per year (depending on age) /46.5% on any excess Tax deductions for concessional (pre-tax) contributions The fourth and fi fth paragraphs under Tax deductions for concessional (pre-tax) contribution on page 21 are deleted and replaced with: The limit is: $25,000 a year; or if you are aged 50 or over (or reach age 50) at any time between 1 July 2009 and 30 June 2012, $50,000 a year for each of the years for which you are aged 50 or over and $25,000 for all years after 30 June 2012. The $25,000 concessional contributions cap will be indexed annually to refl ect a change in Average Weekly Ordinary Times Earnings (AWOTE) if that change is more than $5,000. Non-concessional (post-tax) contributions The last paragraph under Non-concessional (post-tax) contributions on page 22 of the PDS is deleted and replaced with: In future the non-concessional contributions cap will be revised to refl ect changes to the concessional contributions cap (which is indexed annually). The non-concessional contributions cap will be calculated at six times the level of the concessional contributions cap. Super co-contribution The following section should replace the subsection titled Super co-contribution on page 23 of the PDS. The Government will contribute up to $1 for every $1 of post-tax contribution made by employees or self employed people, depending on assessable income 1 from 1 July 2009 until 30 June 2012. This co-contribution rate is a reduction from the co-contribution of up to $1.50 per $1 for contributions made in the 2008-2009 year. The maximum co-contribution of $1,000 per annum for a post tax contribution of at least $1,000 applies to those with assessable income 1 of $31,920 per annum or less. The amount of the co-contribution is reduced by 3.33 cents per dollar of assessable income 1 over $31,920 per annum. The co-contribution is not applicable for those whose assessable income 1 is $61,920 per annum or more. The co-contribution rate will gradually increase in accordance with the table below: Date 1 July 2009 30 June 2012 1 July 2012 30 June 2014 From 1 July 2014 Amount received for every $1 of personal super contributions $1 for every $1 you contribute, up to a maximum co-contribution of $1,000 per year. 2 $1.25 for every $1 you contribute, up to a maximum co-contribution of $1,250 per year. 2 $1.50 for every $1 you contribute, up to a maximum co-contribution of $1,500 per year. 2 To qualify for the Super co-contribution you must: ensure that 10% or more of your assessable income 1 for the year is attributable to employment and/or carrying on a business; be a permanent resident (and not have held an eligible temporary resident visa); be aged less than 71 on 30 June of the year in which you contribute; lodge a tax return in the relevant income year; have provided your Tax File Number to the Trustee; and be either employed or self-employed. 1 For the 2008/2009 year assessable income included reportable fringe benefi ts, and net business income for self-employed people. From the 2009/2010 year total net investment losses and salary sacrifi ce superannuation contributions are also to be included. 2 The co-contribution amount is reduced by every dollar your total income is over the minimum income threshold (i.e. $31,920 in the 2010 income year). Sandhurst Trustees Limited 5

The Super co-contribution is based only on post-tax contributions you make on your behalf, concessional or pre-tax contributions do not qualify. Super co-contributions are preserved and are treated as post-tax contributions, which means they are not taxed when paid into the Plan or when taken as a benefi t. For more information visit the Australian Taxation Offi ce (ATO) website at www.ato.gov.au under Individuals / Check your superannuation / Super essentials / Growing and consolidating super. Payments to departing temporary residents The following paragraphs are inserted at the end of the Payments to departing temporary residents section on page 25 of the PDS. You should note that we are required to transfer any superannuation not claimed by departing holders of temporary visas to the ATO on request after 6 months or more has elapsed since: you departed Australia, or your visa was cancelled or has expired. You can still claim this benefi t directly from the ATO after this time. Please contact the ATO on 13 10 20. Alternatively, you can contact us and we will provide you with details of the transfer of your benefi t. 3. The Account-based Pension Plan Pension you receive each year The second paragraph and the table under Pension you can receive each year on page 31 of the PDS is deleted and replaced with: If you commence an account-based pension, then you must take a minimum payment from your pension each year. The minimum payment is calculated as a percentage of your account balance based on your age. The minimum pension amount for the 2009 2010 fi nancial year is represented in the table below. Age at 1 July 2009 Minimum annual payment % of account balance 55 64 2.0% 65 74 2.5% 75 79 3.0% 80-84 3.5% 85 89 4.5% 90 94 5.5% 95 or over 7.0% The minimum pension amount for the fi nancial years ending after 1 July 2010 is represented in the table below. Age at 1 July 2010 and each subsequent year Minimum annual payment % of account balance 55 64 4% 65 74 5% 75 79 6% 80-84 7% 85 89 9% 90 94 11% 95 or over 14% 6 Bendigo Superannuation Plan Supplementary Product Disclosure Statementtement

4. Application Forms The Personal Superannuation Application Form and the Account Based Pension Application Form are deleted and replaced with the forms contained within this SPDS. Please note from 17 February 2010 the Personal Superannuation Application Form and the Account-Based Pension Application Form contained in this SPDS are the only forms that will be accepted for new Applications to the Personal Superannuation and Account Based Pension Plans. Sandhurst Trustees Limited 7

This page has been left intentionally blank. 8 Bendigo Superannuation Plan Supplementary Product Disclosure Statement

Bendigo Superannuation Plan Personal Superannuation Application Form Page A1 Please refer to page 76 of the PDS for a step by step guide on how to complete it. Before you sign this Application Form, the Trustee or your licensed financial adviser is obliged to give you a Product Disclosure Statement (PDS) which contains important information relating to The Bendigo Superannuation Plan (the Plan). The PDS will help you to understand the product and decide if it is appropriate to your needs. Step 1 Member personal details Important Note: Information provided to the Trustee will only be used for the purposes specified in the PDS and on this form. It may be accessed and updated by you through our Customer Service Centre on 1800 033 426. It will only be disclosed to other parties where required by law (eg. to the ATO or other regulatory bodies) or to implement your request (eg. Insurance). If you do not provide all of the requested information we may not be able to action your request. Title Surname Given name(s) Current residential address Town/Suburb State Postcode Telephone (hm) Telephone (wk) Mobile Email Date of birth / / Sex Tax File Number (TFN * ) * Please read the information on Collection of TFNs in the Taxation section of this PDS about the consequences of not providing your TFN. Please provide your Employer s details if they will be making contributions for you to the Plan. Employers Name Employers phone Step 2 Spouse details (if applicable) I (the member) declare I am the eligible spouse of the person nominated below. I also declare that I satisfy the eligibility criteria for receiving eligible spouse contributions or splittable contributions from this person, as set out under the heading How to get started in The Personal Superannuation Plan section of the PDS. I agree to notify the Trustee immediately if I cease to be the spouse of the person nominated below. Name of spouse Sex Declaration by spouse of the member I declare that the member is my eligible spouse. I also declare that I satisfy the eligibility criteria for making a spouse contribution, as set out under How to get started in The Personal Superannuation Plan section of the PDS, and the contribution is a post-tax contribution for which I am not eligible to claim a tax deduction. I agree to notify the Trustee immediately if I cease to be the spouse of the member and to cease making contributions to this account immediately. Spouse signature Date / / Step 3 Investment strategy Please advise us of your investment selections. Please enter the Investment Code as per the Investment Options form on page A31 of the PDS or refer to the website for the ASX Code for Direct Investments. If there is insufficient space, please complete the Investment Authority form on pages A27 to A30 of the PDS. If you do not complete this section or the Investment Authority, the Standard Investment Strategy for your age will apply. (Refer to the Investments section of the PDS.) Investment code Investment name Percentage allocation Amount $ Step 4 Contribution eligibility. %,.. %,.. %,. I am under 65 years of age. OR I am at least age 65 and under age 75. I have worked at least 40 hours in not more than 30 consecutive days during this financial year. Sandhurst Trustees Limited ABN 16 004 030 737 AFSL No 237906 RSE Licence No L0000154 The Bendigo Superannuation Plan RSE Registration No R1000139 ABN 57 526 653 420 (17/02/2010) The Bendigo Superannuation Plan Supplementary Application form

Step 5 Initial payment details Page A2 Member personal contribution* $ Employer contribution $,.,. Is this a single deposit account only? No Yes Spouse contribution* $ If you would like us to debit contributions from,. your bank account, please complete the Direct Rollover payment $,. Debit Request Form on page A25 of the PDS * The Trustee cannot accept Member or Spouse non-concessional contributions unless you have provided your TFN. Step 6 Insurance cover Not required Death only Death and total permanent disablement Salary continuance If you require Death, Death and TPD and/or Salary continuance cover, please complete the Insurance Application and Personal Health Statement on pages A11 to A16 of the PDS. (Refer to the Insurance section of the PDS for more information.) Step 7 Nomination of beneficiaries If you wish to make a Binding Death Benefit Nomination you must read and complete the form on pages A17 and A18 of the PDS. Otherwise, in the event of your death, any benefits will be paid to your Legal Personal Representative and form part of your Estate. Step 8 Member declaration I have read and understood this Supplementary Product Disclosure Statement dated 17 February 2010 and the Product Disclosure Statement dated 28 July 2008 (Parts 1 & 2) and hereby apply to participate as a member of The Bendigo Superannuation Plan Personal Superannuation Plan and agree to be bound by the provisions of the Trust Deed constituting the Plan, as amended from time to time. I agree for Sandhurst Trustees Limited to act as Trustee of the Plan. I declare that, in accordance with the eligibility criteria applicable to the Plan from time to time (under the heading How to get started in The Personal Superannuation Plan section of the PDS), I am eligible to become a member of the Personal Superannuation Plan and make contributions to my account in the Personal Superannuation Plan. I acknowledge that future transactions in relation to my account will be made on the terms of the Trust Deed, as amended from time to time, and the terms and conditions applicable to the Plan from time to time. I consent to my employer or my spouse or any other permitted person, if applicable, making contributions to my accounts (note: if the contributions are to be eligible spouse contributions or split contributions, you and your spouse must also complete section 2 on page A1). Should any of the information I provide in this Application change then I will notify the Trustee of such changes as soon as possible. I consent to the collection and use of the above information by the Trustee for the purposes specified in this form and in the PDS. I confirm that all details supplied in this form are true and correct. I agree to receive PDSs by the Trustee making them available on the Plan website www.sandhursttrustees.com.au (Products / Superannuation / Bendigo Superannuation Plan / Product Disclosure Statement). I acknowledge that the Trustee has advised me that I will only receive a PDS in relation to an investment option where I instruct the Trustee to make an investment in an available Managed fund for the first time. After the initial investment in that particular separate product has been made on my behalf, I understand that I may not receive the most recent PDS, or disclosure of any material adverse changes or significant events that adversely affect a matter that would be required to be in a PDS for that separate product before the change or event occurs, when making further investments in the separate financial product. Signature Date / / Step 9 Adviser use only Adviser s name Adviser s signature Date / / Licensee s stamp Commission details Commission on contributions Commission on transfers in Ongoing commission Default 4. 0 0 % 4. 0 0 % 0. 3 5 % Cross (X). %. %. % Other (specify) Initial Adviser service fee (Flat fee $) Ongoing Adviser service fee Amount paid per month $,. $. (maximum $10,000 per annum * ) (maximum $834 per month * ) Note: All of these figures should be provided excluding GST. * The maximum adviser service fee paid in any 12 month period must not exceed $10,000. This includes the sum of the initial and ongoing adviser service fees. The Bendigo Superannuation Plan Supplementary Application form Sandhurst Trustees Limited ABN 16 004 030 737 AFSL No 237906 RSE Licence No L0000154 The Bendigo Superannuation Plan RSE Registration No R1000139 ABN 57 526 653 420 (17/02/2010)

Bendigo Superannuation Plan Account-based Pension Application Form Page A3 Please complete this form using BLOCK LETTERS and a BLACK or BLUE pen. Before you sign this Application Form, the Trustee or your financial adviser is obliged to give you a Product Disclosure Statement (PDS) which is a summary of important information relating to The Bendigo Superannuation Plan (the Plan). The PDS will help you to understand the product and decide if it is appropriate to your needs. Step 1 Member personal details Important Note: Information provided to the Trustee will only be used for the purposes specified in the PDS and on this form. It may be accessed and updated by you through our Customer Service Centre on 1800 033 426. It will only be disclosed to other parties where required by law (eg. ATO or other regulatory bodies) or to implement your request (eg. your nominated bank). If you do not provide all of the requested information we may not be able to action your request. Title Surname Given name(s) Current residential address Town/Suburb State Postcode Telephone (hm) Telephone (wk) Mobile Email Date of birth / / Sex Tax File Number (TFN * ) * Please read the information on Collection of TFNs in the Taxation section of the PDS about the consequences of not providing your TFN. Step 2 Nomination of beneficiaries Lump Sum: If you wish to make a Binding Death Benefit Nomination to receive a lump sum on your death, you need to read and complete the forms on A17 and A18 of the PDS, otherwise, in the event of your death, any benefits will be paid to your Legal Personal Representative and form part of your Estate. Reversionary Pension: You may nominate one eligible person* to receive a Reversionary Pension in the event of your death. This nomination must be made before you commence your Account-based Pension and generally cannot be changed once your pension commences. I elect my Account-based Pension to be provided on a reversionary basis to my Reversionary Beneficiary, as nominated below (only complete if nominating a Reversionary Beneficiary). Title Surname Given name(s) Current residential address Town/Suburb State Postcode Date of birth / / Relationship Spouse (married/de facto/former) Child* Interdependency relationship Financial dependant * Refer to How to get started in The Account-Based Pension Plan section of the PDS for more information on eligibility to receive a Reversionary Pension. Step 3 Investment strategy Please advise us of your investment selections by completing the Investment Authority form on pages A27 to A30 of the PDS. If you do not complete the Investment Authority, the Standard Investment Strategy for your age will apply. (Refer to the Investments section of the PDS.) Sandhurst Trustees Limited ABN 16 004 030 737 AFSL No 237906 RSE Licence No L0000154 The Bendigo Superannuation Plan RSE Registration No R1000139 ABN 57 526 653 420 (17/02/2010) The Bendigo Superannuation Plan Supplementary Application form

Step 4 Contribution details Page A4 Contribution eligibility (if contributing): I am under 65 years of age. OR I am at least age 65 and under age 75. I have worked at least 40 hours in not more than 30 consecutive days during this financial year. Personal contribution* $,. Spouse contribution* $,. *I intend to claim a tax deduction for this personal contribution (Tick if applicable). Note: The Trustee cannot accept Member or Spouse non-concessional contributions unless you have provided your TFN. Refer to Contributions if you are 70 or over in The Personal Superannuation Plan section of the PDS for contribution eligibility information. For rollover amounts (if any): Institution name Expected amount $,. Institution name Expected amount $,. Please complete the Whole Balance Transfer Authority form on pages A21 to A22 of the PDS. Existing Plan balance (if any): Please commence my Account-Based Pension with my existing Bendigo Superannuation Plan Personal/ Employer-Sponsored Superannuation account. Indicate amount if not whole balance $,. Step 5 Pension payment details **Please pay my initial pension payment on the 7th day of 20 Frequency Monthly Quarterly Half-yearly Yearly Indexation rate Pension amount Minimum Maximum* Other amount $ Gross/Net,. % * For Transition to Retirement Pension members only. If Maximum pension and starting after 1 July, please tick if full amount (rather than pro rata) required. ** If you do not nominate a start date for your payments, we will commence your pension in the first available payment period following receipt of all requirements. Step 6 Bank details (to receive pension payments) Name of bank Branch address Town/Suburb State Postcode Account name Branch (BSB) number Account number Step 7 Member declaration I have read and understood this supplementary Product Disclosure Statement dated 17 February 2010 and the Product Disclosure Statement dated 28 July 2008 (Parts 1 & 2) and hereby apply to participate as a member of The Bendigo Superannuation Plan Account-based Pension Plan and agree to be bound by the provisions of the Trust Deed constituting the Plan, as amended from time to time. I agree for Sandhurst Trustees Limited to act as Trustee of the Plan. I understand that while I may make an initial contribution into the Account-based Pension Plan, I cannot make subsequent contributions (however, it may be possible to commence a different Account-based Pension). I declare that, in accordance with the eligibility criteria applicable to the Plan from time to time (see The Account-based Pension Plan section of the PDS), I am eligible to become a member of the Account-based Pension Plan and to make this contribution to my account. I acknowledge that future transactions in relation to my account will be made on the terms of the Trust Deed, as amended from time to time, and the terms and conditions applicable to the Plan from time to time. The Bendigo Superannuation Plan Supplementary Application form Sandhurst Trustees Limited ABN 16 004 030 737 AFSL No 237906 RSE Licence No L0000154 The Bendigo Superannuation Plan RSE Registration No R1000139 ABN 57 526 653 420 (17/02/2010)

Step 7 Member declaration (continued) Page A5 Should any of the information I provide in this Application change then I will notify the Trustee of such changes as soon as possible. I declare that the information supplied is true to the best of my knowledge. I consent to the collection and use of the above information by the Trustee for the purposes specified in this form and in the PDS. I agree to receive PDSs by the Trustee making them available on the Plan website www.sandhursttrustees.com.au (Products / Superannuation / Bendigo Superannuation Plan / Disclosure Documents). I acknowledge that the Trustee has advised me that I will only receive a PDS in relation to an investment option where I instruct the Trustee to make an investment in an available Managed fund for the first time. After the initial investment in that particular separate product has been made on my behalf, I understand that I may not receive the most recent PDS, or disclosure of any material adverse changes or significant events that adversely affect a matter that would be required to be in a PDS for that separate product before the change or event occurs, when making further investments in the separate financial product. I declare that: (tick one) I have reached my preservation age and am still working. I am applying for a non-commutable, Transition to Retirement Pension. I have reached my preservation age and I am no longer gainfully employed. I do not intend to rejoin the workforce on either a full-time or part-time basis at any time in the future. I am 60 years old or over and I have ceased gainful employment since turning age 60. I have been declared totally and permanently disabled. I am age 65 or older. If you are retired or not currently working, please provide the date you were last gainfully employed. Date / / Please also complete and send us an ATO Tax File Number declaration form (NAT 3092) if aged under 60 (or if your superannuation has an untaxed element) which can be obtained from selected newsagents or the ATO by calling 1300 720 092, and provide Proof of Identity as described on page A19 of the PDS. Signature Date / / Step 8 Adviser use only Adviser s name Adviser s signature Date / / Licensee s stamp Commission details Commission on contributions Commission on transfers in Ongoing commission Default 4. 0 0 % 4. 0 0 % 0. 3 5 % Cross (X). %. %. % Other (specify) Initial adviser service fee (Flat fee $) Ongoing adviser service fee Amount paid per month $,. $. (maximum $10,000 per annum * ) (maximum $834 per month * ) Note: All of these figures should be provided excluding GST. * The maximum adviser service fee paid in any 12 month period must not exceed $10,000. This includes the sum of the initial and ongoing adviser service fees. Sandhurst Trustees Limited ABN 16 004 030 737 AFSL No 237906 RSE Licence No L0000154 The Bendigo Superannuation Plan RSE Registration No R1000139 ABN 57 526 653 420 (17/02/2010) The Bendigo Superannuation Plan Supplementary Application form

Page A6 This page has been left intentionally blank. The Bendigo Superannuation Plan Supplementary Application form Sandhurst Trustees Limited ABN 16 004 030 737 AFSL No 237906 RSE Licence No L0000154 The Bendigo Superannuation Plan RSE Registration No R1000139 ABN 57 526 653 420 (17/02/2010)

Proudly part of Bendigo and Adelaide Bank Limited ABN 11 068 049 178 (S35030) (06/11) BEN50WM026