Your super application and change form

United Technologies Corporation Retirement Plan Your super application and change form Accumulation members UTC gives you a number of options for your super. Use this form to: < Join the Plan if you are a new employee of the UTC Group or associated companies; < Make or change voluntary contributions to your super; < Choose or change the investment option for your super; < Take out, change or stop additional voluntary insurance; and < Tell us who you would like to receive your benefit if you die while you are a member of the Plan. For more information on your super options, please read the Plan s Product Disclosure Statement. Return this completed form to your Company payroll contact. Contact the Plan s superannuation helpline on 1800 628 849 if you have any questions. Please tick the relevant box: I am applying to join the UTC Retirement Plan for the first time. OR I am already a member and wish to change my super options. Section 1: Your personal details Title: Mr Mrs Miss Ms Other Gender: (Please tick) Male Female Surname: Given names: Address: State: Postcode: Date of birth: / / Daytime phone number: Email*: ( ) * The Trustee may decide to provide information about the Plan or your benefits electronically in the future. This might include Product Disclosure Statements, Benefit Statements, Annual Reports, newsletters or information on material changes to your super or significant events. If you d like to receive information electronically, where available, please provide your email address. 1

Section 2: Your Tax File Number Your Tax File Number (TFN)*: Under the Superannuation Industry (Supervision) Act 1993, the Trustee is authorised to collect your TFN, which will only be used for lawful purposes. These purposes may change in the future as a result of legislative change. The Trustee may disclose your TFN to another superannuation provider, when your benefits are being transferred, unless you request the Trustee in writing that your TFN not be disclosed to any other superannuation provider. You do not have to provide your TFN. However, giving your TFN will have the following advantages, which may not otherwise apply: The Plan will be able to accept all types of contributions to your account; The tax on contributions to your superannuation accounts will not increase; Other than the tax that may ordinarily apply, no additional tax will be deducted when you start drawing down your superannuation benefits; and It will make it much easier to trace different superannuation accounts in your name so that you receive all your superannuation benefits when you retire. Section 3: Your voluntary contributions Do you want to make voluntary contributions to your super from your salary? You can choose to make or change the amount of your voluntary contributions at any time. These can be either regular contributions, or one-off lump sum contributions. (Tick one box only.) No, I don t want to make voluntary contributions to the Plan. (Go to Section 4.) I wish to make a one-off lump sum voluntary contribution to the Plan. I wish to make regular voluntary contributions to the Plan. I wish to change the amount of regular voluntary contributions I currently make to the Plan. I wish to cease making regular voluntary contributions to the Plan. If you want to make voluntary contributions, please tell us how much you wish to contribute and whether you want your voluntary contributions to be deducted from your before-tax* or after-tax salary. (For one-off lump sum contributions, complete only the $ box.) I wish to contribute % of my salary OR $ each pay period (or one-off, as applicable). I wish to make my contributions from my (please tick one box only): Before-tax salary (i.e., by salary sacrifice) OR After-tax salary * Making voluntary contributions by salary sacrifice is subject to Company approval. Section 4: Your investment choice Complete this section to make an investment choice for your benefits in the Plan. How would you like to invest your contributions and account balance? Tick one box only: Cash option Stable option Balanced* option High Growth option OR in one of the 50/50 mix options: 50% Cash option and 50% Stable option 50% Stable option and 50% Balanced option 2 50% Balanced option and 50% High Growth option * If you do not make an investment choice within the first 28 days of joining the Plan, your super will be invested in the Balanced option, which is the Plan s default MySuper investment option. If you choose to switch your investment options, you can do so free of charge on the first day of any month. Provided this form is received by the Plan Administrator by the 25 th day of the month, investment switches are effective from the first day of the following month. For more information on the Plan s investment options, read the Plan s Product Disclosure Statement.

Section 5: Additional voluntary insurance As a member of the Plan, you are provided with standard insurance cover*. However, you may also apply for additional voluntary insurance. Please tick one box below: I would like to take out additional voluntary insurance cover. If yes: (please tick) I was Actively at work on the date I signed this form. I was at work for the normal daily hours of work performing the full, unrestricted or unmodified duties of my normal occupation. I would like to change my current level of additional voluntary insurance cover. I would like to stop my additional voluntary insurance cover. Additional voluntary insurance for death and total and permanent disablement (TPD) is available in units. If you are under age 55, each unit provides $50,000 of cover. The value of each unit of TPD cover reduces once you are over age 55. The amount of each unit of death cover remains at $50,000 until you reach age 70, when no insurance is payable. There is no limit to the number of units you can apply for, however, your total insurance under the Plan may not exceed $5 million for TPD cover. The standard cost of insurance is shown in the Insurance Guide. Insurance costs are deducted from your account each month. The Plan s insurer may increase the cost based on the medical evidence you provide. * Casual employees are not eligible for TPD cover. To opt out of standard cover, you should write to the Plan Administrator at PO Box 1442, Parramatta NSW 2124. You can opt out of your standard TPD cover and retain your death cover, or you can opt out of both your standard death cover and TPD cover. How much and what type of cover do you want? I would like to purchase, or change my existing, additional voluntary insurance to: units of additional voluntary insurance cover (insert chosen number of units here, e.g. 1, 2, 3). I would like cover for: Death only OR Death and TPD. Note: Casual employees are not eligible for TPD cover. The cost of additional voluntary insurance will be deducted from your account in the Plan. If you take out this cover, you must be prepared to make extra contributions if your account balance cannot support the cost of extra cover. Your cover will stop if there is no money in your account to meet the cost. Voluntary insurance without medical evidence If all of the following apply to you, one unit of voluntary insurance may be available without having to provide medical evidence.* I am Actively at work as described above; and I am applying within 90 days of one of the following Life Events and attach the requested proof of the Life Event. Life Event Marriage: Dependent child starts secondary school: Birth of child: Adoption: New or increased mortgage on your principal place of residence: Proof Required Marriage Certificate Letter of admission from secondary school Birth Certificate Certificate of Adoption Loan document or other evidence from lender * Within the first six months of a Life Event increase, cover provided is for accident only, not sickness or illness. Full cover commences after six months. In all cases, your insurance must be assessed by the Plan s insurer who will require medical evidence unless you qualify in the section above. The Plan Administrator will contact you if medical or other evidence is required and insurance will only commence when we advise that your application is accepted. While your medical evidence is being assessed, you will be covered for accidental death and TPD for up to 90 days. If you do not provide the required evidence, your application will lapse. 3

Section 6: Nominating your beneficiaries Who would you like to receive your super benefit if you die? The Trustee can only pay your death benefit to: < Your dependants, including your spouse (including a de facto or same sex partner), children (including step children and adopted children) or any person who is financially dependent on you, or anyone with whom you have an interdependency relationship*. < Your estate, where your benefit will be distributed according to your Will. * An interdependency relationship is where: 1. two people have a close personal relationship; 2. they live together; 3. one or each of them provides the other with financial support; and 4. one or each of them provides the other with domestic support and personal care. However, if two people have a close personal relationship and either one, or both, suffer from a physical, intellectual or psychiatric disability, then they are still considered to have an interdependency relationship for the purposes of the law and are not required to fulfill the other three criteria. Name of dependant or estate Relationship to you (Spouse/Child/Dependant) Share of benefit (must total 100%) Total 100% 4

Section 7: Your approval Please sign and date your approval of the instructions provided on this form. I hereby acknowledge that: (Please tick.) < I agree to be bound by the Trust Deed. < I have received and understood the Plan s Product Disclosure Statement. < I have read and understood the Plan s Privacy Policy and agree to the use of my personal information as discussed therein. < I understand the superannuation contribution options available to me and that these will be made into my super accounts with the UTC Plan in accordance with my stated wishes. < Taxes and fees that may apply will be deducted from my super accounts. < My super will be invested in the option I have chosen until I provide further instructions. < I understand that if I do not make a choice, my accumulation accounts and future contributions will be invested in the Balanced option, the Plan s default MySuper investment option. < Investment returns are based on the actual net earnings of my chosen investment option and returns can be positive or negative in any given year. < I understand that neither the UTC Group nor the Trustee is giving investment advice through the information provided on the Plan s website or other super communication materials. < I understand that if I were to die, the distribution of any benefit payable will be at the discretion of the Trustee. < I authorise my employer to provide my Tax File Number to the Trustee and acknowledge that I do not have to make this authorisation. < This instruction overrides all previous authorities and remains effective until I provide further instructions. I declare that the information in this form is true to the best of my knowledge and belief. If I have provided my email address, I agree that the Trustee may use that email address to send me information including Product Disclosure Statements, Benefit Statements, Annual Reports, newsletters or information on material changes to my super or significant events, electronically. Your signature: Date: / / UTC Company Pay Office/HR Use Only Insurance Location Date received: / / Date joined Plan: / / Date joined Company: / / TFN: / / Plan Salary: $ Payroll ID: OFRS (OTIS only please circle): Y / N Comments: Permanent over 15 hours Permanent under 15 hours Casual over 30 hours Casual under 30 hours Contractor over 30 hours Contractor under 30 hours OTIS VIC OTIS WA OTIS SA OTIS NSW OTIS QLD OTIS Monthly OTIS Weekly Carrier Sanscord Other, please specify Payroll signature: Print name: Issued by Towers Watson Superannuation Pty Ltd (ABN 56 098 527 256, AFSL 236 049) as Trustee of the UTC Retirement Plan (ABN 33 227 241 196, MySuper Authorisation No. 33227241196186). August 2016. 5