Power Of Attorney Details Form

Power Of Attorney Details Form About this form This form is used to lodge a Power of Attorney with us and advise us of an Attorney s details. Note: Attorney(s) conducting transactions, whether financial or non financial, can only do so by calling ING DIRECT on 133 464 or writing to ING DIRECT, Reply Paid 2682, Sydney NSW 2001 (no stamp required). They are not able to conduct transactions using one of our interactive services. When completing this form please: *use CAPITAL letters *mark boxes with an X where applicable *use black pen 1 Your ING DIRECT details (to be completed by the account holder/s) Account Holder ING DIRECT Client Number First Name Mr Mrs Ms Other Middle Initial Surname 2 Which ING DIRECT products do you want this authority to cover All Accounts - Note: This authority will apply to all future accounts held subject to the terms of the Power of Attorney Or Personal Savings Accounts Transaction Accounts Mortgage Accounts Super and Retirement Accounts NOTE: The Trustee will only act on this authority in relation to the Super and Retirement Accounts. 3 What you will need to send us with this completed form An Original Ink Certified copy of a Legal Enduring or General Power of Attorney Document. An Original Ink Certified identification document of the Attorney(s) being appointed Refer Appendix A NOTE: If any Attorney(s) have been appointed jointly, the above documents must be provided for EACH Attorney. *Please Note: Should we need to contact the account holder, and for medical reasons the account holder cannot be verbally validated, the following documentation will need to be provided: An Original Ink Certified copy of a Medical Certificate confirming that the account holder cannot verbally validate that they are appointing an Attorney. Our mailing details When the above checklist has been completed, please mail this form and the supporting documentation to us at: ING DIRECT Reply Paid 2682 Sydney NSW 2001 (no stamp required) Page 1 of 6

4 Attorney(s) verification details (to be completed by the Attorney(s) Attorney 1 Attorney 2 (if applicable) Mr Mrs Ms Other First Name Middle Initial Mr Mrs Ms Other First Name Middle Initial Surname Surname Mandatory Security Details Mandatory Security Details Date of Birth (DD/MM/YYYY) Date of Birth (DD/MM/YYYY) Mother s Maiden Name (mother s original surname/family name) Mother s Maiden Name (mother s original surname/family name) Residential Address (PO Boxes not accepted) Unit Number Street Number Residential Address (PO Boxes not accepted) Unit Number Street Number Street Name Street Name Suburb Suburb State Postcode State Postcode Contact Details (You must provide at least one phone number) Mobile Phone Number Contact Details (You must provide at least one phone number) Mobile Phone Number Other Phone Number (for landline, please provide area code) Other Phone Number (for landline, please provide area code) Email Email Please provide your ING DIRECT Client Number if you are an existing ING DIRECT client. Please provide your ING DIRECT Client Number if you are an existing ING DIRECT client. 5 Attorney(s) to read and sign below By signing below, I/We declare that: a) I am/we are the attorney(s) identified in the Power of Attorney; b) I am/we are authorised by the Power of Attorney to operate the account(s) held by the Account Holder on their behalf; c) I/we have not received notice of revocation of the Power of Attorney, and I/we make these declarations at the time of signing this form and each time I/we operate, access or conduct any activity in relation to the Account Holder s account(s). I/we undertake to advise ING DIRECT in writing immediately upon receiving notice of any amendment, limitation or cancellation affecting the Power of Attorney; d) I/we declare that the personal information and security details provided above are true and correct and I/we authorise ING DIRECT to verify this information; e) I/we have read the Privacy Statements in Appendix B of this form as appropriate and I/we consent to my/our personal information being collected, used and disclosed in the manner and for the purpose set out in the Privacy Statements; and f) I/we authorise ING DIRECT to use and disclose my/our personal information to help ING DIRECT and any of its associated companies or subsidiaries to provide or tell me/us about products and services that may be of interest to me/us. Attorney 1 Attorney 2 (if applicable) Signature of Attorney 1 Signature of Attorney 2 Date (DD/MM/YYYY) Date (DD/MM/YYYY) Page 2 of 6

Appendix A Identification Document and Certification Identification Documents You need to choose either 1 document from List A or two documents from List B. Please note the certified copies will not be returned. The documents must verify the following details: - Your full name; and - Residential Address or Date of Birth LIST A Australian Driver s Licence (must be current, show current residential address and photograph) LIST B One of the documents Birth Certificate (issued by a State or Territory in Australia) A Citizenship Certificate (issued by the Commonwealth of Australia) Pension Card or Health Card (must be current and issued by Centrelink entitling financial benefits) An Australian Passport (either a current passport or a passport that expired within the last 2 years) AND Proof of Age Card / NSW Photo Card (must be current and show date of birth and photograph) International Passport (current, containing a photograph and a signature and accompanied by a translation from a Professional Translator accredited by the National Accreditation Authority for Translators and Interpreters if not in English) A Social Security notice issued by the Commonwealth, State or Territory in the past 12 months containing your name and residential address which records financial benefits provided to you Notice Issued by the Australian Tax Office within the past twelve months that contains your name and residential address and records debts payable by you A Rates or Utilities notice issued in the last 3 months containing your name and residential address and recording the provision of services to you/your address. Document Certification Take the originals and copies of your identification documents to a document certifier from the list below. Ask them to follow the Instructions below. 1. A Pharmacist 2. A Justice of the Peace 3. A Notary Public Officer 4. A Medical Practitioner or Nurse 5. A Police Officer 6. An Accountant (CA/CPA) 7. A Legal Practitioner 8. A Full-time teacher (school or tertiary) 9. Bank/Credit Union/Building Society Officer with at least two years continuous service 10. A permanent employee of a Commonwealth, State/Territory or local government with at least two years continuous service. Certifier Instructions Once you (the certifier) have sighted the original proof of identity document and the copy and confirmed that both documents are identical on each page of the copy complete the following: 1. Certify as true copies by writing or stamping I hereby certify that these pages are a true copy of the original document shown to me on [date] 2. Sign each document and print your Name and Certifier Classification. For example; John Smith, Accountant Page 3 of 6

Appendix B Privacy Statements Below are the Privacy Statements for ING DIRECT and ING DIRECT Living Super. Both Privacy Statements apply for holders of ING DIRECT Living Super Accounts. The Privacy Statement for ING DIRECT applies for holders of banking accounts and the use of personal information by ING DIRECT. Privacy Statement ING DIRECT At ING DIRECT, we are committed to ensuring the confidentiality and security of your personal information. We are bound by the Privacy Act, 1988 and the National Privacy Principles (NPPs) regulated by the Federal Privacy Commissioner to guide us in our responsible handling of personal information. The ING DIRECT Privacy Statement provides an overview of the key aspects of our Privacy Policy in relation to your personal information including: Collection of your personal information from you or other sources; ING DIRECT only collects such personal information as is necessary to manage the account and to communicate with you about ING DIRECT and the products and services we offer. We also collect any personal information necessary for the purposes of the Anti-Money Laundering and Counter-Terrorism Financing Act, 2006. Use and Disclosure of your personal information; In managing the account, there may be occasions where we need to disclose your personal information to: i. Other financial institutions To other financial institutions, such as bank, credit unions, building societies and payment services such as VISA, in order to set up and manage the account and manage banking transactions. ii. Other organisations Other ING Group entities and third parties, such as: Other ING Group entities in order to service other products you may have within the Group and portfolio analysis; Other ING Group entities located overseas for account administration and security purposes; ING Group entities for marketing purposes; Organisations providing financial tools and calculators on our website; Mortgage intermediaries, your financial adviser, your power of attorney, or your appointed solicitor; Organisations undertaking reviews of the accuracy and completeness of our information; Our solicitors, valuers and insurers for loan products; Organisations providing mailing services, document storage services, marketing bureau services (eg, telemarketing), data verification services and printing our standard documents and correspondence; Organisations maintaining our information technology systems and providing information technology services; Credit reporting or information verification agencies in order to obtain and provide details of credit history or status or to verify other information about you including your identity; Organisations providing analysis and research regarding our products, services and customer relationships; Organisations undertaking identity verification services to verify information about you including your identity; Organisations involved in securitisation arrangements. These organisations include trustees of those arrangements, investors and their advisers; Organisations who perform services or functions on our behalf; Organisations undertaking compliance reviews of financial advisers or mortgage intermediaries; Organisations providing trustee services in relation to superannuation; Organisations providing administration services in relation to superannuation; Organisations providing custodial services in relation to superannuation; Organisations providing insurance services in relation to superannuation; Organisations providing broker and share trading services in relation to superannuation; and Organisations providing financial planning advice services in relation to superannuation. We only disclose personal information to such organisations for the provision of the specified services. Personal information will only be disclosed to other third parties if we are permitted, authorised or required to do so by law; you have authorised us to do so; or it is necessary to assist with law enforcement. Access to your personal information; You may request access to the personal information that we hold about you, the account(s) and any other ING products or services by contacting us on 133 464 or by writing to the ING Privacy Officer at GPO Box 4094, Sydney, NSW, 2001. Requests for access to your personal information may only be made by you. Receipt of further ING Group information; ING DIRECT may supply customer information to marketing bureau services (e.g telemarketing) or other ING Group entities or any of the service providers in relation to the superannuation fund to which ING DIRECT is the promoter (including the trustee) for the sole purpose of those companies contacting you about ING DIRECT or ING products and services. ING DIRECT may also send you information about products and services provided by ING DIRECT or ING Group entities directly. You may notify the marketing bureau service or the relevant entity of your decision not to receive any further contact at the time of their call or you may notify us directly. Page 4 of 6

ING DIRECT may also send you information about its financial products and services from time to time. You may notify ING DIRECT of your decision to stop receiving such information by contacting ING DIRECT directly. Alternatively, you may place your phone number on the Do Not Call Register established under the Do Not Call Register Act, 2006. You may contact the Register on its website https://www.donotcall.gov.au/ or by calling 1300 792 958. Updating your personal information; ING DIRECT relies on the accuracy of information that you supply to us. If any of your personal information is incorrect, has changed or requires updating, please assist by contacting us. Use of internet cookies; ING DIRECT may use cookies to assist you in accessing information on our websites which is of interest and relevance to you. Cookies are a way of storing information on your computer so you do not have to enter the same data every time you access our sites - for instance, your e-mail address or your logon-id. We may also use cookies to capture general information about how you have found our website, or to track the number of visitors to a site, but we do not store any of your personal details when we do this. Our Privacy Statement may be updated from time to time, as we strive to improve the standard of service we provide to you. If you would like further information regarding privacy, you can review the ING DIRECT Privacy Policy online at our website or request a copy by either calling or writing to us. This Privacy Statement applies to ING Bank (Australia) Limited and to its trading name ING DIRECT. Privacy Statement for ING DIRECT Living Super The ING DIRECT Living Super Privacy Policy details how we treat your personal information. The following provides an overview of the key aspects of the ING DIRECT Living Super Privacy Policy. For the purposes of the ING DIRECT Living Super Privacy Policy the terms we, us or our refer to the Trustee and/or Promoter. Collection of your personal information from you or other sources We only collect personal information that is necessary to establish and manage your account and to provide you with further information about other products and services offered by us. We seek your consent to our collection, use and disclosure of your personal information via our application forms, our administration processes including any insurance processes and other methods by which we capture information. Use and disclosure of your personal information The primary reason that we collect, use or disclose your personal information is to establish your account in the Fund, including the verification of your identity and then administer and maintain your account in the Fund. This involves us collecting your personal information on behalf of the service providers for the Fund, including the Insurer. It may be necessary for us to disclose your personal information to certain ING Group entities or third parties in order to assist us in providing, managing and administering your account in the Fund. These include: the administrator of the Fund undertaking the administration and day-to-day operation of the Fund including establishing and maintaining customer records, processing contributions, rollovers and benefits, and providing regular statements; the custodian of the Fund providing custody services; the Insurer responsible for providing insurance cover and assessing insurance claims to members of the Fund; the broker or share trader responsible for buying and selling of listed securities; the provider of financial tools and calculators on the designated Fund website; the ATO to conduct searches on the ATO s Lost Members Register; organisations providing financial planning services with which ING DIRECT has entered into an agreement for them to provide financial planning advice services to members of the Fund; your financial adviser, your power of attorney, or your appointed representative; entities in the ING Group or The Trust Company Group in order to service the Fund or other products you may have within these Groups; ING Group entities located overseas for administration and security purposes; ING Group entities for marketing purposes; organisations undertaking reviews of the accuracy and completeness of our information; organisations providing mailing services, document storage services, marketing bureau services (eg, telemarketing), data verification services and printing our standard documents and correspondence; organisations maintaining our information technology systems and providing information technology services; organisations providing analysis and research regarding our products, services and customer relationships; organisations undertaking identity verification services to verify information about you including your identity; and doctors, medical services or other organisations providing services in the collection, collation or assessment of personal information (including health information) for the purpose of assessing your claim. Access to your personal information You may request access to the personal information that we hold about you and your interest in the fund by calling ING DIRECT on 133 464 or writing to GPO BOX 4094, Sydney NSW 2001. Page 5 of 6

Receipt of information about other financial products and services ING DIRECT may also send you information about our financial products and services from time to time. You may notify us of your decision to stop receiving such information by contacting us directly. ING DIRECT may also supply customer information to marketing bureau services (e.g. telemarketing), or other group entities or any of the service providers in relation to the Fund for the sole purpose of those companies contacting you about their products and services. These entities may also send you information about products and services provided by them directly. You may notify the marketing bureau service or the relevant entity of your decision not to receive any further contact at the time of their call or you may notify us directly. ING DIRECT may consider any of the personal information we collect about you in connection with us, marketing bureau services, our other group entities or any of the service providers in relation to ING DIRECT when contacting you about products or services. You may be contacted by electronic message (eg: email), telephone and other means, unless you request us to stop contacting you. Updating your personal information We rely on the correctness of the information that you supply to us. Please assist us by contacting ING DIRECT if any of your personal information is incorrect, has changed or requires updating. If you would like further information regarding privacy, you can review the ING DIRECT Living Super Privacy Policy online at our website or request a copy by either calling or writing to us. The Trust Company (Superannuation) Limited ABN 49 006 421 638, AFSL 235153, RSE L0000635 is the Trustee of the ING DIRECT Superannuation Fund ABN 13 355 603 448 (Fund) and the issuer of interests in the Fund. ING DIRECT Living Super is a product issued out of the Fund. ING DIRECT, a division of ING Bank (Australia) Limited ABN 24 000 893 292, AFSL 229823, is the Promoter of the Fund. Page 6 of 6