Benefit Payment Option Form Please make your benefit payment choice by filling out the relevant sections below. You can make your selection from Parts B, C or D, or a combination of the three. When returning this form, be sure to attach your certified proof of identity as required by law (see the last page of this form for more information). Defined Benefit members If you are a member of IPE Super s Defined Benefit section and you wish to apply for a Lifetime Pension through the Fund, you should complete a Lifetime Pension Application Form, which is available for downloading from the Fund s website at www.ipesuper.com.au or by calling the IPE Super Helpline on 1800 257 135. You should only complete this Benefit Payment Option Form for any part of your benefit that you do not wish to take as a pension. PART A Your personal details (please print) Title (please tick): Dr Mr Ms Mrs Miss Membership No.: (See your latest Benefit Statement) Given name: Surname: Home address: Telephone: (Business Hours) ( ) Date of birth: / / Email: PART B Leaving your super in the Retained Benefits section of the Fund I want to leave: All of my benefit in the Retained Benefits section. Part of my benefit in the Retained Benefits section. (If you select this option, then you will also need to indicate the amount you wish to leave in the Fund.) I wish to leave or of my benefit in the Retained Benefits section. % $ please turn over to complete
PART B Leaving your super in the Retained Benefits section of the Fund (continued) If you indicated on the previous page that you want to leave some or all of your benefit in the Retained Benefits section, tell us how you want your super invested. Choice 1 Choose from the pre-packaged options OR Choice 2 Design your own investment option 100% Conservative 100% Active Balanced* 100% Assertive 100% Assertive Plus Conservative % Active Balanced* % Assertive % Assertive Plus % Cash % Diversified Fixed Interest % International Shares % Australian Shares % Total 100% For information about each investment option, refer to. If you are leaving IPE Super s Defined Benefit section, the defined benefit portion of your benefit will be invested in the Cash asset class option until you make an alternative investment choice. If you are leaving IPE Super s Defined Benefit section and you have additional accumulation accounts (e.g. a Rollover account or an Additional Voluntary Contribution account), the investment choice(s) you have made for these accounts will continue to apply until you nominate otherwise. If you are a member who is leaving the Accumulation or Spouse section of IPE Super, your current investment choice(s) will continue to apply until you nominate otherwise. Your new investment choice will usually be implemented with effect from the working day following the date on which this form is received by the Fund Administrator. The Trustee reserves the right to suspend or delay processing of investment switches in special circumstances such as during periods where investment markets are closed for trading, or until market movements that occurred prior to your requested switch are fully reflected in the Fund s earning rates. * This is also the option for MySuper members. PART C Transferring your benefit to an external super fund I want to transfer: All of my benefit into an external super fund. Part of my benefit into an external super fund. (If you select this option, then you will also need to indicate the amount you wish to transfer into an external fund.) I wish to transfer $ or % of my benefit into an external fund. continue Part C overleaf
PART C Transferring your benefit to an external super fund (continued) If you wish for all or part of your benefit to be transferred into an external fund, please indicate your choice of fund: Please note that ALL sections below MUST be completed, otherwise your form will be returned to you. If you are transferring your benefit to more than one fund, please attach the same details shown below for your other fund(s) and indicate the amount or percentage of your benefit to be transferred to each fund. If you are rolling over to more than one fund, the tax components will be split between your chosen funds in proportion to the amount rolled over to each fund. Note: You will need to attach certified proof of identity if taking all or part of your benefit in cash or transferring your benefit to another super fund. See the last page for more information. Benefits can only be rolled over to a complying superannuation fund. I wish to transfer my benefit to an external superannuation fund as follows: Name of fund/institution: Address: Telephone: Email address: Cheque to be made payable to: Fund Australian Business Number (ABN): Unique Superannuation Identifier (USI): Member/Policy number: IMPORTANT NOTE: The ABN, USI and Member/Policy Number of your chosen fund are required before payment will be made. Please contact your chosen fund to obtain these details. Note that the ABN has 11 digits and the USI has 14 digits. PART D Taking all or part of your benefit in cash Remember, you cannot generally withdraw your preserved amount in cash until you reach your preservation age and the Trustee is satisfied that you intend to permanently retire* from the workforce. However, if you have reached your preservation age, you can access your preserved amount while you re still working provided that you roll over your super into a transition to retirement pension. IPE Super s Account-Based Pension qualifies as a transition to retirement pension under the law. For more information on your preservation age and accessing your super under the transition to retirement rules, refer to. No tax will apply to your benefit if you are over age 60. Please tick the box (or boxes) below that applies to you. I have reached my preservation age and am permanently retiring from the workforce. I am aged above 60 years and either ceased employment after reaching that age or have ceased employment and intend to permanently retire. I have reached my preservation age and wish to roll over part or all of my super into a transition to retirement pension. (Note: If you choose this option, you should complete an Application & Change Form for Account-Based Pension Members which is available from the Fund s website at www.ipesuper.com.au or by calling the IPE Super Helpline on 1800 257 135.) I am at least 65 years of age. * Permanently retire means you intend never again to be gainfully employed for more than 10 hours a week. continue Part D overleaf
PART D Taking all or part of your benefit in cash (continued) I wish to withdraw: None of my benefit in cash. The maximum amount available to me in cash. Part of my benefit in cash. (If you select this option, then you will also need to indicate the amount you wish to withdraw in cash.) I wish to withdraw $ of my benefit in cash. The tax components of any cash payment will be in proportion to your total benefit (i.e. equally from your taxable and tax-free benefit components). Benefits paid to members aged 60 or over are tax free. If the amount you nominate is more than the maximum amount you can take in cash, you will only be paid the maximum cash amount available. Note: You will need to attach certified proof of identity if taking all or part of your benefit in cash or transferring your benefit to another super fund. See the next page for more information. Please indicate your payment option: Pay the cash amount by posting a cheque in the mail. Pay the cash amount by direct deposit into my nominated bank account: (If you select this option, please note that the account you nominate MUST be in your name. You will need to provide a certified copy of the bank statement verifying the account details below. We will notify you once the money has been deposited into your account). Name of fund/institution: Institution name: BSB number: Account number: Branch: PART E Insurance Continuation Option Income Protection Your Leaving Service Notification letter may refer to an Insurance Continuation Option if you had Income Protection insurance immediately before you ceased employment with your employer. The option is generally available for 60 days from the date you cease employment (please refer to your Leaving Service Notification letter for more details). If you would like more information about the Continuation Option, and a quotation, please indicate by ticking the box below: Yes, I would like to receive an Insurance Continuation Option quotation. If you would like an Insurance Continuation Option quotation, please advise if you are a smoker: Yes No PART F Declaration I declare that all statements made herein to claim my benefit are true to the best of my knowledge and belief. Signature: Date: / / Remember to attach certified proof of your identity. (See the next page for information on what are classified as acceptable proof of identity documents.) Return your completed form to: The Fund Administrator, IPE Super, PO Box 1442, Parramatta NSW 2124.
Acceptable proof of identity documents The following documents may be used: EITHER One of the following documents only: A driver s licence issued under State or Territory law, or A passport. OR One of the following documents: A birth certificate or birth extract, A citizenship certificate issued by the Commonwealth, or A pension card issued by Centrelink that entitles the person to financial benefits. AND One of the following documents: A letter from Centrelink regarding a Government assistance payment, or A notice issued by the Commonwealth, or a State or Territory Government or local council within the past twelve months that contains your name and residential address. For example, a Tax Office Notice of Assessment, or rates notice from your local council. Have you changed your name or are you signing on behalf of another person? If you have changed your name, or are signing on behalf of the applicant, you will need to provide a certified linking document. A linking document is a document that proves a relationship exists between (two or more) names. The following table contains information about suitable linking documents. Purpose Change of name Signed on behalf of applicant Suitable linking document Marriage Certificate, Deed Poll or Change of Name certificate from the Births, Deaths and Marriages Registration Office. Guardianship papers or Power of Attorney. Certification of personal documents All copied pages of ORIGINAL proof of identification documents (including any linking documents) need to be certified as true copies by any individual approved to do so (see below). The person authorised to certify documents must sight the original and the copy and make sure that both documents are identical, then make sure that all pages have been certified as true copies by writing or stamping certified true copy followed by their signature, printed name, qualification (e.g. Justice of the Peace or Australia Post employee) and date. The following people can certify copies of the originals as true and correct copies: A person who is enrolled on the roll of the Supreme Court of a State or Territory, or the High Court of Australia, as a legal practitioner, An agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public, An Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955), A Bailiff, A bank officer with two or more continuous years of service, A building society officer with two or more years of continuous service, A Chief Executive Officer of a Commonwealth court, A Clerk of a court, A Commissioner for Affidavits, A Commissioner for Declarations, A credit union officer with two or more years of continuous service, An employee of the Australian Trade Commission who is: (a) In a country or place outside Australia, and (b) Authorised under paragraph 3 (d) of the Consular Fees Act 1955, and (c) Exercising his or her function in that place. An employee of the Commonwealth who is: (a) In a country or place outside Australia, and (b) Authorised under paragraph 3 (c) of the Consular Fees Act 1955, and (c) Exercising his or her function in that place.
A Fellow of the National Tax Accountants Association, A finance company officer with two or more years of continuous service, A holder of a statutory office not specified elsewhere in this list, A Judge of a court, A Justice of the Peace, A Magistrate, A Marriage Celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961, A Master of a court, A member of Chartered Secretaries Australia, A member of Engineers Australia, other than at the grade of student, A member of the Association of Taxation and Management Accountants, A member of the Australian Defence Force who is: (a) An officer, or (b) A non-commissioned officer within the meaning of the Defence Force Discipline Act 1982 with two or more years of continuous service, or (c) A warrant officer within the meaning of that Act. A member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants, A member of: (a) The Parliament of the Commonwealth, or (b) The Parliament of a State, or (c) A Territory legislature, or (d) A local government authority of a State or Territory. A Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961, A Notary Public, A permanent employee of the Australian Postal Corporation with two or more years of continuous service who is employed in an office supplying postal services to the public, A permanent employee of: (a) The Commonwealth or a Commonwealth authority, or (b) A State or Territory or a State or Territory authority, or (c) A local government authority, with two or more years of continuous service who is not specified elsewhere in this list. A person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made, A Police Officer, A Registrar, or Deputy Registrar, of a court, A senior executive service employee of: (a) The Commonwealth or a Commonwealth authority, or (b) A State or Territory or a State or Territory authority. A Sheriff, A Sheriff s officer, A teacher employed on a full-time basis at a school or tertiary education institution, A member of the Australasian Institute of Mining and Metallurgy, An officer with, or authorised representative of, a holder of an Australian financial services licence, having 2 or more years of continuous service with one or more licensees, A licensed or registered Chiropractor, A licensed or registered Dentist, A licensed or registered Medical practitioner, A licensed or registered Nurse, A licensed or registered Optometrist, A licensed or registered Patent attorney, A licensed or registered Pharmacist, A licensed or registered Physiotherapist, A licensed or registered Psychologist, A licensed or registered Trademarks attorney, and/or A licensed or registered Veterinary surgeon. Issued by Towers Watson Superannuation Pty Ltd (ABN 56 098 527 256, AFSL No. 236049), as Trustee of the Incitec Pivot Employees Superannuation Fund (ABN 68 569 795 856). MySuper Authorisation number 68569795856660. ISSUED SEPTEMBER 2017