MLC Wrap Self Managed Super Withdrawals This form should be completed if you want to withdraw funds from your portfolio. Important: Before completing this form you should check for information about your benefits in the Service including information on exit, transfer, withdrawal and other fees, tax, any insurance cover you may have, and the availability of investment options. Withdrawals from capital protected products may also incur a fee and the amount withdrawn may not receive the benefit of capital protection. You should obtain this information to fully understand the effects of withdrawing benefits. For more details please contact us. Please complete these instructions in BLACK INK using BLOCK letters. Note: Please make sure you have completed all the relevant sections otherwise your request may not be processed. GPO Box 2567 Melbourne Victoria 3001 Phone: 1300 428 482 Fax: (03) 9869 1595 1. Fund details Investor account name Fund code 2. Investor details MLC Wrap Investments account name MLC Wrap Investments account number MLC Wrap Investments account name Member ID (eg 00001) Account type: Super Pension 3. Request type Please tick your request: Account closure Partial withdrawal Navigator Australia Limited ABN 45 006 302 987 AFSL 236466 MLC Wrap Self Managed Super Withdrawals Form Page 1 of 7
4. Withdrawal type Cash payment Lump sum withdrawal (super or pension) Additional pension payment Rollover 5. Investments to be sold Tax optimisation I would like to apply the following tax optimisation method to this transaction: First in first out (FIFO) High cost first out (HCFO) Note: To amend your account default tax optimisation method please complete an Account Amendment form. HCFO isn t available on Model Portfolios. If you don t elect a default tax optimisation method the default will be FIFO. Investment allocation Proportionately (as per current investing weighting) Investment name(s) APIR/ASX Code Units Amount (Minimum $500 per share) Percentage Total Important: If there is an existing automatic re-weighting facility on your MLC Wrap Investments account and the allocation above isn t in line with your target weight allocation, the automatic re-weighting facility will be cancelled. We recommend you review your additional investment allocation to ensure any future deposits into your account reflect the changes you ve requested above. To change your instructions for all future investment allocations you need to complete an Additional and regular investments form. For automatic re-weighting facilities (redeem from investments subject to automatic re-weighting only) Proportionately (as per customer investment weighting within my automatic re-weight portfolio) By target weight allocation Note: If the withdrawal can t be funded by the target weight allocation, we ll use the current investment weightings within the automatic re-weighting portfolio. 6. Adviser share transaction fee Amount $ (maximum of $110.00 per trade) % (maximum of 1.10% per trade value) The fees in this section are inclusive of GST. MLC Wrap Self Managed Super Withdrawals Form Page 2 of 7
7. Components (superannuation/pension accounts only) Preservation amounts Preserved $ Restricted non preserved $ Unrestricted non preserved $ 8. Tax file number notification (if not previously supplied) You re not required to provide your Tax File Number (TFN) to us. Declining to quote your TFN isn t an offence. However, if you don t provide your TFN you may incur additional tax and certain superannuation contributions may not be permitted. TFN Exemption Code * * 01 If you receive the age, service, invalid or veteran s pension 02 If you receive another pension (wife, carer, widow, sole parent or special benefit pension) 03 If you re an entity which is not required to lodge a tax return (association etc) 04 If you re a Territory resident 05 If you re a non-resident of Australia 9. Preferred payment method Please attach a separate sheet for multiple payees. Payment to rollover institution (superannuation accounts only) Please supply a letter of compliance from the rollover institution. If payment is to a Self Managed Super Fund we may require additional documents. Name of Institution ABN number SPIN New account number Address of Institution Suburb State Postcode Re-contribute payments to a MLC Wrap account (superannuation/pension accounts only) Details of account to contribute to: Investor account name Investor account number Contribution type: Personal contribution non-concessional Eligible spouse contribution MLC Wrap Self Managed Super Withdrawals Form Page 3 of 7
9. Preferred payment method continued Payment by direct credit pay to my nominated bank account pay to account below: BSB Account number Name of account holder Name of financial institution Branch address State Postcode Payment via cheque Payee Address Unit number Street number Street name Suburb State Postcode Country 10. Withdrawal amount Total withdrawal amount $ Before tax After tax MLC Wrap Self Managed Super Withdrawals Form Page 4 of 7
11. Temporary Resident declaration (super accounts only) Members of the Superannuation service are required to answer the following questions: A Are you a permanent resident of Australia or now an Australian citizen, a New Zealand citizen or have held at any time a Subclass 405 (Investor Retirement) visa or a Subclass 410 (Retirement) visa? No Go to part B Yes B If you answered No to part A, are you a temporary resident or have you ever been a temporary resident? No Yes If you answered yes to part B, the Trustee can only pay you a benefit in cases of permanent or temporary incapacity, terminal medical condition, on your permanent departure from Australia, or in the event of your death unless you met the requirements of another condition of release before 1 April 2009. The following conditions of release no longer apply if you are a temporary resident, or were a temporary resident and have now left Australia, unless you met their requirements before 1 April 2009: attaining age 65, resignation from employment after age 60, employment terminated where benefit is less than $200, to pay excess contributions tax, retirement after preservation age, commencing a pension after preservation age, severe financial hardship or compassionate grounds. If you met the requirements of one of these conditions before 1 April 2009, please supply details below: 12. Conditions of release (super accounts only) You can use some or all of your superannuation to start an account based pension if you are over your preservation age, whether you have retired or are still working. If retired, your superannuation will have become unrestricted non-preserved, and you will be able to make commutations and receive lump sum benefits from your account based pension account balance as well as receive pension payments. If still working, your pension is a non-commutable account based pension and until you meet a further condition of release you will only be able to make commutations from an account based pension from any unrestricted non-preserved amount. For conditions of release at any age involving permanent incapacity or financial hardship, please contact us. I am an Australian citizen, New Zealand citizen or a permanent resident of Australia and have satisfied one of the following conditions of release (tick one): withdrawing unrestricted non-preserved monies, or I have reached my preservation age and wish to commence a non-commutable pension, or I am 55 or over, but not yet 65 years of age. I am not gainfully employed and I never intend to again become gainfully employed, either on a full-time or part-time basis, or I am 60 or over, but not yet 65 years of age, and an arrangement under which I was gainfully employed has come to an end after the age of 60, or I have attained age 65, or I have a terminal medical condition, or other condition of release MLC Wrap Self Managed Super Withdrawals Form Page 5 of 7
13. Trustee declaration I: authorise my TFN to be used with this account acknowledge that I have access to NAB s privacy policy available on mlc.com.au and any NAB company may collect, use, disclose and handle my personal information in a manner set out in that policy understand that neither the Trustee nor the Operator has any liability for any costs that the withdrawal may incur have attached the appropriate customer identification documentation or previously provided this information or was an Investor prior to 12 December 2007 have attached the required documentation to rollover money to a Self Managed Super Fund, where applicable. Name of Trustee / Authorised person Signature of Investor / Authorised person 1 Date (DD/MM/YY) 14. Financial adviser s declaration I have attached the correct customer identification documents* Yes No, this information has been previously provided or the Investor was an existing Customer with the Operator prior to 12 December 2007 Financial adviser s name Financial adviser s signature Date (DD/MM/YY) * For details of the appropriate customer identification documentation please refer to our website mlc.com.au or call us on 1300 428 482. 15. Financial adviser s details Adviser name Adviser code Office Dealer group Contact name (if different) Contact telephone number (business hours) Adviser stamp MLC Wrap Self Managed Super Withdrawals Form Page 6 of 7
MLC Wrap Self Managed Super Tax Deduction Notice Section 290-170 Navigator Australia Limited ABN 45 006 302 987 AFSL 236466 (the Operator ) December 2012 You may be eligible to claim a tax deduction if you are self-employed or substantially self-employed and you have made personal contributions to your MLC Wrap Self Managed Super account. You can use this form if you are transferring from an existing super account to a pension account and intend to claim a tax deduction. Fund name Member account name Member ID (eg 00001) I understand that this is a notice advising Navigator Australia Limited that I am an eligible person and able to claim a tax deduction in respect of my personal contributions. Financial Year Last Financial Year Current Financial Year Total personal contributions $ $ Personal contributions I am claiming as a tax deduction $ $ Declaration under Section 290-170 of the Income Tax Assessment Act 1997: I am lodging this notice before both of the following dates: the day that I lodged my income tax return for the 20 / 20 financial year, and the end of the income year after the said financial year. At the time of completing this notice: I am still a member of the fund named in this notice, I intend to claim the personal contributions stated in this notice as a tax deduction, I have not yet commenced a superannuation income stream based in whole or part on these contributions, and the amount covered by this notice has not been included in a previous notice for the 20 / 20 financial year. I understand that this notice cannot be revoked or withdrawn but may be varied by reducing the amount advised in this notice if: I have not lodged my income tax return and it is on or before 30 June in the financial year following the year I made the contribution, or my claim has been disallowed and I am reducing the amount claimed as a deduction by the amount which has been disallowed. I may claim a tax deduction in respect of my personal contributions at a later date (for partial withdrawals). Important note: You are not required by law to make this declaration before the payment of a partial withdrawal. But if you do not, some of your personal contributions will default to increase the tax-free component of the partial withdrawal payment. If you subsequently provide your Section 290-170 notice in regard to the contributions listed after a partial payment is made, any lump sum PAYG we withheld may be less than the tax payable, and the Payment Summary we issued with the payment will no longer be valid and we will issue a replacement. Any under/over tax paid will be adjusted in your tax assessment for the relevant financial year. Member s signature Name Date (DD/MM/YY) Address Suburb State Postcode Country 80171M1212 MLC Wrap Self Managed Super Withdrawals Form Page 7 of 7