1. Personal details Title Surname Given names Date of birth Home address Mailing address (if different) Work phone number Home phone number Mobile phone number Email BOC Super pension member number See how BOC Super protects your personal information on page 9. z As a Retirement Pension member you become eligible to invest your super in BOC Super s Pension options which offer tax free investment earnings. z Retirement Pension members are able to make a lump sum withdrawal if they wish. z As a Retirement Pension member, there is no maximum applied to your annual pension payment. z The Government has a transfer balance cap which limits the amount anyone can put into a retirement pension account to $1.6 million. If your super balance is more than $1.6 million, you can keep the excess in a BOC Super account. Page 1 of 9
2. How do you qualify for a retirement pension? Select the condition(s) that apply. I have ceased employment and intend to permanently retire from the workforce To be eligible for a retirement pension, you must satisfy at least one of these condtions. I am aged 60 or older and left my employer after reaching that age I am aged 65 or older I am permanently incapacitated* I am terminally ill* * Call the BOC Super Helpline on 1300 136 829 for information on the evidence you will need to provide in these cases. 3. How do you want your retirement pension account invested? Choose one or more of the following options. Investment options % of account z Aggressive % If you do not make an investment choice, your Super investments will be invested in the equivalent Pension options as shown in the table below. z Moderate % z Conservative % z Cash % Total (must be 100%) 100% Super investment options (Taxed investment earnings) Option Aggressive Growth High Growth (MySuper) Low Growth Cash Pension investment options (Untaxed investment earnings) Option Aggressive Moderate Conservative Cash Note that a buy-sell spread may apply to move your account. Page 2 of 9
4. How do you want to be paid? If you leave this blank we will continue to pay you as you previously requested. Only complete if you wish to change some aspect of how you are paid your pension. What annual income do you want? Minimum required Specified amount $ How frequently do you want to be paid? Fortnightly Monthly Quarterly Half yearly Yearly per year See the PDS for the rules on minimum payments. What Australian bank account should we deposit your payments to? Bank name Branch name Pension payments can only be paid into a bank account held in the name of the Retirement Pension member. BSB number Account number Name of account owner Page 3 of 9
5. Where do you want your payments drawn from? Choose either A or B if you wish. A. Nominated percentage (%) draw down Write the percentage of each account that you want your pension payment drawn from. Investment options z Aggressive % z Moderate % z Conservative % z Cash % Total (must be 100%) 100% OR B. Priority draw down % of each investment option to be drawn down Number each option in the order you wish them to be drawn down. Number 1 will be drawn down first, then number 2, etc. Investment options z Aggressive z Moderate z Conservative z Cash C. Proportional draw down Order of priority for draw down pension payment Please draw down my retirement pension payments in the same proportions as my account balance. Tick this box if you want your income payments drawn from your investment options in the same proportions as your account balance. We normally draw your income payments from your investment options in the same proportions as your account balance. Complete this section to request a different way for your payments to be drawn down. If you want your pension drawn completely from one option, write 100% next to that option. If you want a mix, specify the percentage of each option, making sure the total adds to 100%. Once there s no longer enough money in your chosen option(s), payments will automatically be deducted from the account balance invested in your other option(s). You ll be notified at the time and can adjust your investment choice if you want. Payments can be drawn from one investment option at a time in the order of priority that you choose. When your first nominated investment option runs out, payments will then be drawn from your next nominated option until this runs out, and will continue down your priority order. If you change your account investment options, this instruction will no longer apply. You can provide a new priority draw down instruction when you change your account investment options or at any other time. Page 4 of 9
6. Option for automatic annual increase Do you want your pension income to increase automatically each year? This is optional. Please increase my regular payment amount by: The annual change in the Consumer Price Index* OR My nominated percentage of % 7. Attach proof of identity * Automatic increases can be arranged each 1 July. The Australian Bureau of Statistics Consumer Price Index, Australia, All Groups value each March (Catalogue Number 6401.0) is used where applicable. Any increase is subject to the minimum payment amounts permitted, where applicable. I have attached a certified copy of the appropriate proof of identity as outlined in Completing proof of identity (see back of this form). 8. Declaration By signing this form I: z understand and consent to my information being collected, disclosed and used in the manner set out in this form z understand that I can access my personal information by writing to BOC Super s Privacy Officer, 10 Julius Avenue, North Ryde NSW 2113 z declare that to the best of my knowledge, the information provided on this form is true and correct and I acknowledge responsibility for its accuracy whether this form has been completed by me or by another person on my behalf. Signature Date / / Please return your completed form and your attached proof of identity documentation to: The Fund Administrator, BOC Gases Superannuation Fund, GPO Box 4303, Melbourne VIC 3001 Issued by BOC Superannuation Pty Ltd, ABN 83 080 598 821, AFS Licence No. 287131, as Trustee of the BOC Gases Superannuation Fund, ABN 49 620 344 668. Form issued July 2017. Page 5 of 9
BOCSUPER Proof required Primary photographic identification You will need to provide a copy of one of the following primary identification documents: z Current Australian or foreign driver s licence (including the back of the driver s licence if your address has changed) z Australian passport z Current foreign passport*, or similar document issued for the purpose of international travel* z Current card issued under a State or Territory for the purpose of proving a person s age z Current national identity card issued by a foreign government for the purpose of identification*. Identification documents must not be expired (excepting an Australian passport which may be expired within 2 years). OR Alternative identification If you are unable to provide any primary photographic identification, you will need to provide two identification documents, one from each of the following lists: Birth certificate or birth extract* Citizenship certificate issued by the Australian Government Pension card issued by the Department of Human Services (Centrelink) that entitles the person to financial benefits. AND Letter from the Department of Human Services (Centrelink) or other Government body in the last 12 months regarding a Government assistance payment Tax Office Notice of Assessment issued in the last 12 months Rates notice from local council issued in the last 3 months Electricity, gas or water bill issued in the last 3 months Landline phone bill issued in the last 3 months (mobile phone bills will not be accepted). * Translation If your identification is written in a language other than English, the identification must be accompanied by an English translation prepared by a translator accredited by the National Accreditation Authority for Translators and Interpreters Ltd. (NAATI) at the level of Professional Translator or higher (or an equivalent accreditation), to translate from a language other than English into English.
Name change If you have changed your name, you must provide a certified copy of the relevant name change document*, for example, a Marriage Certificate issued by the Registry of Births Deaths & Marriages, Decree Nisi or Deed Poll (in addition to the above identification). If your legal name or date of birth does not match exactly to our records (excluding aforementioned name changes), please contact us for further instructions. Signing on behalf of another person If you are signing on behalf of the applicant you will need to provide the following: A certified copy of the Guardianship papers or Power of Attorney; and A certified copy of the appropriate proof of identity for the holder of the Guardianship or Power of Attorney. Note: proof of identity is not required for the applicant only for the Power of Attorney. How to certify documents After sighting the original and the copy and making sure both documents are identical, the certifier must include on EACH page: Written or stamped certified true copy Signature and printed full name Qualification (such as Justice of the Peace, Australia Post employee, etc) Date (the date of certification must be within the 12 months prior to our receipt). IDENTIFICATION Certified true copy JSample Mr John Sample Justice of the Peace Registration No: 123456789 Date: 01/01/2013 A clear copy of the document that identifies you (i.e. your driver s licence (front & back) or passport Write or stamp certified true copy of the original document The authorised person s signature Full name, qualification, and registration number (if applicable) of the authorised person Date of authorisation (within 12 months of receipt) Verification A verification of the certifying party may be performed. If a discrepancy arises, you may be requested to re-certify documentation. Important Note The information in this leaflet is a guide only and we may request additional documentation prior to any payment. * Translation If your identification is written in a language other than English, the identification must be accompanied by an English translation prepared by a translator accredited by the National Accreditation Authority for Translators and Interpreters Ltd. (NAATI) at the level of Professional Translator or higher (or an equivalent accreditation), to translate from a language other than English into English.
Who can certify documents in Australia? Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public Australian Postal Corporation permanent employee with two or more years of continuous service who is employed in an office supplying postal services to the public Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955) Bailiff Bank officer, building society officer or credit union officer (with two or more continuous years of service) Commissioner for Affidavits or Declarations Court Officer, Registrar or Deputy Registrar of a Court, Judge, Clerk, Magistrate, Master of a Court, Chief Executive Officer of a Commonwealth Court Fellow of the National Tax Accountant s Association Finance Company Officer (with two or more continuous years of service with one or more finance companies) Justice of the Peace Legal practitioner Marriage celebrant (registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961) Medical practitioner, chiropractor, dentist, nurse, optometrist, physiotherapist, psychologist 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 Australasian Institute of Mining and Metallurgy Member of the Australian Defence Force (who is 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 Commonwealth Parliament, State Parliament, Territory Legislature or a Local Government Authority (State or Territory) Minister of Religion (under Subdivision A of Division 1 of Part IV of the Marriage Act 1961) Notary Public Officer with, or Authorised Representative of an Australian Financial Services Licensee (who has had at least two years of continuous service with one or more licensees) Officer with, or a credit representative of, a holder of an Australian credit licence (who has had at least two years of continuous service with one or more licensees). Permanent employee of the Commonwealth (or Commonwealth Authority) or a State or Territory (or State or Territory Authority) or a Local Government Authority with two or more years of continuous service Person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made Pharmacist Police Officer or Sheriff or Sheriff s officer Senior Executive Service Employee of the Commonwealth (or Commonwealth Authority) or a State or Territory (or State or Territory Authority) Teacher employed on a full-time basis at a school or tertiary education institution Trade marks attorney or patent attorney Veterinary surgeon. Allan Murphy, BOC s General Manager, Superannuation and Nathan Bell, BOC s Superannuation Operations Manager can certify documents. Both are at North Ryde. Who can certify documents outside of Australia? An authorised staff member of an Australian Embassy, High Commission or Consulate An authorised employee of the Australian Trade Commission who is in a country or place outside Australia An authorised employee of the Commonwealth of Australia who is in a country or place outside Australia A Member of the Australian Defence Force who is an officer or a non-commissioned officer with 5 or more years of continuous service A Notary Public from a country ranked 129 or below in the latest Transparency International Corruptions Perception Index: http://www.transparency.org. Issued by BOC Superannuation Pty Ltd, ABN 83 080 598 821, AFS Licence No. 287131, as Trustee of the BOC Gases Superannuation Fund, ABN 49 620 344 668. September 2015.
BOCSUPER Privacy Collection Statement BOC Super is administered by us along with our service provider, Mercer Outsourcing Australia Pty Ltd (Mercer). We collect, use and disclose personal information about you in order to manage your superannuation benefits and give you information about your super. We may also use it to supply you with information about the other products and services offered by us and our related companies. If you do not wish to receive marketing material, please call the BOC Super Helpline on 1300 136 829. Our Privacy Policies are available to view at www.bocsuper.com.au or you can obtain a copy by calling the BOC Super Helpline on 1300 136 829. If you do not provide the personal information requested, we may not be able to manage your superannuation. We may sometimes collect information about you from third parties such as your employer, a previous super fund, your financial adviser, our related entities and publicly available sources. We may disclose your information to various organisations in order to manage your super, including your employer, our professional advisors, insurers, our related companies which provide services or products relevant to the provision of your super, any relevant government authority that requires your personal information to be disclosed, and our other service providers used to assist with managing your super. In managing your super your personal information will be disclosed to service providers in another country, most likely to Mercer s processing centre in India. Our Privacy Policies list all other relevant offshore locations. Our Privacy Policies set out in more detail how we deal with your personal information and who you can talk to if you wish to access and seek correction of the information we hold about you. They also provide detail about how you may lodge a complaint about the way we have dealt with your information and how that complaint will be handled. If you have any other queries in relation to privacy issues, you may call the BOC Super Helpline on 1300 136 829 or write to our Privacy Officer, BOC Gases Superannuation Fund, GPO Box 4303, Melbourne VIC 3001. View our Privacy Policies at www.bocsuper.com.au or call the BOC Super Helpline on 1300 136 829 if you have any questions. Issued by BOC Superannuation Pty Ltd, ABN 83 080 598 821, AFS Licence No. 287131, as Trustee of the BOC Gases Superannuation Fund, ABN 49 620 344 668. MySuper Authorisation number 49620344668116. May 2016.