Claiming Financial Hardship For Statewide Super Form – Fill Out and Use This PDF

Application Guide

Early Access to Eligible Benefits Due to Severe Financial Hardship

The information in this document has been prepared for members who have a Marketlink account.

Release of superannuation

Generally, superannuation can only be claimed when you permanently retire from the workforce after reaching your preservation age (55 to 60, depending on your date of birth), or on earlier death or total and permanent disability.

However, there are limited circumstances that may enable you to access a portion of your benefit prior to your retirement. These include severe financial hardship and certain compassionate grounds.

Financial hardship release

Commonwealth Government legislation allows the Trustee to release a portion of your superannuation benefit if:

Claim Type 1

•You have been (and still are) in receipt of an eligible Commonwealth income support payment for a period of no less than 26 continuous weeks, and

•you are able to demonstrate severe financial hardship.

Claim Type 2

•You are aged over 55 and you have been in receipt of an eligible Commonwealth income support payment for a period of no less than 39 cumulative weeks since reaching age 55.

If you satisfy the conditions of Claim Type 2 you don’t have to demonstrate financial hardship. You only need to declare that you are not gainfully employed at the time of application.

How much can be released

The amount you can claim depends on the extent to which you are unable to meet your expenses on your current income. You should only apply for the amount needed to meet 12 months of your net expenses, and to prevent you suffering more debt from these expenses. We can release a maximum of $10,000 gross (before tax), in any 12 month period for Claim Type 1. For Claim Type 2 there is no maximum cashing restriction and we may release up to your total account balance.

Only one payment can be made in any 12 month period.

Tax may be deducted from the amount released. For further information please refer to the Taxation section.

Commonwealth income support payments

Eligible income payments include but are not limited to:

•Age and service pension

•Disability support pension

•Newstart allowance.

Income payments that are not eligible include:

•Family payments (formerly known as family allowance payments)

•Austudy/Abstudy or other youth allowance payments in relation to full time study.

Centrelink will be able to tell you whether the particular payment you receive qualifies.

To demonstrate your eligibility, you will need to provide us with your Centrelink Customer Reference Number (CRN) on your application. More information on the CRN is detailed below.

Centrelink Customer Reference Number (CRN) and Customer Confirmation eService (CCeS)

To confirm that you are being paid an eligible Commonwealth income support payment, we use the Customer Confirmation eService (CCeS).

CCeS is an internet based service offered by Centrelink to help us verify your eligibility electronically and therefore immediately.

To confirm your details on CCeS, we will use your name, date of birth and your Centrelink Customer Reference Number (CRN).

When accessing your details on the CCeS, the Trustee is bound by the legislative requirements of confidentiality, including the Privacy Act 1988.

This means we cannot disclose your CRN to anyone other than Centrelink or use it for any purpose other than to verify whether you have received qualifying Commonwealth income support for the period required to be eligible to access your benefits on the grounds of severe financial hardship.

Centrelink Reference Number (CRN) and Customer Confirmation eService (CCeS) cont.

To obtain your CRN you can contact Centrelink.

The relevant contact numbers are:
Newstart and other allowances	13 28 50	Disability support pension	13 27 17
Age pension	13 23 00	Department of Veterans’ Affairs	13 32 54

Demonstrating severe financial hardship

If you are claiming under Claim Type 1 you must be able to demonstrate that you are in severe financial hardship.

Severe financial hardship means that you are unable to meet reasonable and immediate family living expenses from your current income and assets.

Expenses

An immediate living expense is one that is due and payable at the time of application. Generally, future expenses are not considered unless the expense is urgent in nature and will become payable very soon.

Guidelines on common types of expenses are shown in the ‘Expenses guidelines’ section below.

Income

You will need to show all forms of income, including income support payments, maintenance payments, interest on bank accounts, and income from any part-time or full-time work. A copy of all bank account statements for the last 6 months is required.

Assets

If you have any liquid assets (eg cash or shares) or other things that could reasonably and realistically be sold to meet your expenses (the family home excluded) you are unlikely to meet the requirements of severe financial hardship.

For example, if your net liquid assets exceed $50,000, you may be ineligible to claim severe financial hardship.

Expenses guidelines

We have detailed below some of the common types of expenses and how they will be treated. These are guidelines only and if you have any questions on specific expenses, please contact our Client Services team on 1300 65 18 65.

Credit cards and other loans

Generally we will consider the immediate minimum outstanding balance only. You will need to include copies of your latest credit card or loan statements with your application.

Personal loans from family or friends are generally not allowed unless you are able to provide evidence (bank statements, paid bills) and a statutory declaration from the person to whom the money is owed stating:

•the details of the loan,

•the loan is immediately due and payable,

•you received the money lent to you by family or friends, and

•that the loan was needed to meet reasonable and immediate family living expenses.

General bills

Expenses for utilities such as gas, water, electricity, phone etc will generally be approved provided that the funds are to cover amounts due at the date of the application. Therefore you must include copies of the most recent and due bills.

We may also approve release for expenses such as rates or body corporate expenses provided we receive sufficient documentary evidence of these being due and payable at the time of application.

Insurance

We will generally release funds for payment of outstanding insurance premiums (house, car, contents, medical) provided we receive sufficient documentary evidence of these being due and payable at the time of application.

Motor vehicle

We can only approve payments for repairs to a motor vehicle where they are required to make the vehicle roadworthy. If you are claiming on these grounds you will need to provide a quote along with documentary evidence that the repairs are essential.

Funds for the purchase of a motor vehicle will not be approved except in exceptional circumstances.

Education expenses

We may release funds to meet educational expenses for you or your dependants (such as school fees, uniforms, books etc) where they are due and payable at the time of application.

Medical expenses

We may release funds for outstanding medical bills where documentary evidence is provided.

If you have substantial medical costs, you should consider contacting the Department of Human Services (DHS) on 1300 131 060 as they can assess the release of funds in excess of $10,000 for such a purpose on compassionate grounds.

Continued over

Application for early access to eligible benefits due to severe financial hardship

You need to complete this form if you have a Marketlink account.

To enable us to consider your application please complete each section of this form and return together with the supporting documents and certified proof of identification.

The form includes a Statutory declaration that must be signed and witnessed before your application will be assessed.

1. Your details

Member number

(for existing members)

Yes! I have read the information about TFNs above and give StatewideSuper consent to use my TFN to search the ATO database to locate accounts held on my behalf and to seek information from a retirement savings account provider or super fund about accounts I hold with them, to facilitate consolidation of my accounts. Note: If we already have your TFN, you don’t need to provide it again, but you do need to tick the ‘Yes’ box above if you consent to the search.

	Are you or have you ever been a temporary resident of Australia?		Yes		No
	Dependants
	List your financial dependants (eg spouse/partner and children)
	Full Name:	Relationship:	Age:
	Full Name:	Relationship:	Age:
	Full Name:	Relationship:	Age:
	Full Name:	Relationship:	Age:

2. Proof of Commonwealth income support

Your Centrelink Customer Reference Number (CRN) is required for us to confirm with Centrelink that you have received Commonwealth income support payments in order to qualify for early release of superannuation on the grounds of severe financial hardship.

Your Centrelink CRN:

Please turn over

*FHD*	LS040
		Issued by Statewide Superannuation Pty Ltd ABN 62 008 099 223 (ASFL 243171), RSE Licensee and Trustee of Statewide	Page 1 of 6| Last updated 1 January 2013
		Superannuation Trust ABN 54 145 196 298

3. Claim details

I wish to apply for early access to eligible benefits due to severe financial hardship (please tick one)

Claim type 1: I have been in receipt of an eligible Commonwealth income support payment for a period of no less than 26 continuous weeks. I understand the maximum amount I can apply for is the lesser of my account balance or $10,000 gross and I can only apply to have the money released once each 12 month period.

Claim type 2: I am over age 55 and have been in receipt of an eligible Commonwealth income support payment for a period of no less than 39 cumulative weeks since reaching age 55. I also confirm that I am not gainfully employed at the time of application.

4. Claim type 1

Please provide the reasons why you are now unable to meet your reasonable and immediate family living expenses, setting out the causes behind your financial hardship and how the money would be used if approved. Also, provide any additional information you wish to support your application, including details of any urgent expenses.

Have you had any benefits released or have you made any applications for release on grounds of severe financial hardship or compassionate grounds in the last two years?

	No		Yes, gross amount	$
Fund name					Date	/	/

A. Income details

Please provide details of your net fortnightly income and attach supporting documentation.

B. Expenses details

Please provide details of your expenses and any arrears/overdue payments. These expenses should relate directly to you, your spouse and/or dependants, and should not include any business expenses. Any item listed as an arrears/overdue payment below must be accompanied by supporting documentation, ie. a copy of the overdue bill or account. Loan and credit card payments should be based on the minimum payments required, not the total amount owing.

Calculate your eligibility

To check your eligibility use the totals from A and B and calculate below.

Are your reasonable and immediate living expenses more than your income?

Yes

No

If you have answered yes, you may be entitled to access your StatewideSuper benefit on severe financial hardship grounds. You should complete the remainder of this form.

If you have answered no, your claim may not be approved. Contact us to discuss your application.

Please turn over

Personal assets details

Please provide details of assets owned by either you or your spouse. Do not list business assets.

5. Payment details

If your claim is approved your benefit is credited to your nominated bank account. Please provide details below.

Name of financial institution

Account name

BSB number

Account number

Investment choice (partial withdrawals only)

Indicate below where you would like your withdrawal deducted from. If you leave this section blank, your withdrawal will be deducted proportionately from your investment option(s) at the time of processing your payment.

6. Proof of Identity

You will need to provide certified proof of identification with this form (eg a copy of your driver’s licence certified by a Justice of the Peace). Please refer below to the list of acceptable documents and who can certify them.

Acceptable documents

The following documents may be used:

EITHER

One of the following documents (certified copy)

•Driver’s licence issued under State or Territory law

•Passport.

OR

One of the following documents (certified copy):	AND One of the following documents (certified copy):
• Birth certificate or birth extract	• Letter issued within the last 12 months from Centrelink
• Citizenship certificate issued by the Commonwealth	regarding a Government assistance payment
• Pension card issued by Centrelink that entitles you to the named	• Tax Office Notice of Assessment issued within the last
financial benefits.	12 months that contains your name and residential address
	• Notice issued within the last 12 months from a local
	government body that contains your name, residential address
	and the service provided to you or to your address.

Certification of personal documents

All copied pages of original proof of identification (including any linking documents) need to be certified as true copies by an individual approved to do so (see below).

The person who is authorised to certify documents must sight the original and the copy to make sure both documents are identical, then make sure all pages have been certified as true copies by writing or stating ‘certified true copy’ followed by their signature, printed name, qualification (eg Justice of the Peace) address and date.

The following persons are eligible to certify copies of documents:

•A person enrolled on the roll of the Supreme Court of a State or Territory or the High Court of Australia as a legal practitioner

•A judge of a court

•A magistrate

•A Chief Executive Officer of a Commonwealth Court

•A registrar or deputy registrar of a court

•A Justice of the Peace

•A notary public officer

•A police officer

•A permanent employee of Australia Post with 5 or more years of continuous service

•An Australian consular officer or an Australian diplomatic officer (within the meaning of Consular Fees Act 1995)

•A finance company officer with 5 or more years of continuous service with one or more finance corporations (for the purposes of the Statutory Declaration Regulations 1993)

•An officer with, or authorised representative of, a holder of an Australian Financial Services Licence, having 5 or more continuous years of service with one or more licensees.

7. Checklist

We want to make sure your claim is processed as quickly as possible. To help us do this please review the following checklist before sending this form to us.

I have completed all applicable sections of the application.

I have signed the Statutory declaration in the presence of an eligible witness.

I have provided the appropriate certified proof of identification.

I have included copies of outstanding bills and required evidence of debts and expenses (Claim type 1).

I have provided evidence of my current fortnightly income, including a copy of all bank account statements for the last 6 months (Claim type 1).

Please turn over and sign the back of this form

8. Declaration

Your signature below indicates you have read, understood and agree with the following statements:

•I give consent to the Trustee to confirm with Centrelink that my name, date of birth and Centrelink Customer Reference Number (CRN) details supplied in this application match Centrelink records, and whether I have a qualifying income support payment for the period required for the early access to eligible benefits due to severe financial hardship.

•I understand that my personal information will be handled by the Trustee to access my application. For this purpose it may be disclosed to the Trustee’s administrator (if applicable), and other parties and business support service providers as required, including the trustee of any other fund I may transfer to. By signing this form I consent to this handling of my personal information. I may access my personal information by contacting the Privacy Officer.

•I acknowledge that if my benefit is subject to a family law split, my request may result in a splittable payment becoming payable.

•I understand that my benefit payment instructions will be processed at the applicable unit price(s) and that the Trustee may deduct tax from any amount withdrawn.

•I understand that if I am closing my account with StatewideSuper my insurance cover (if any) will cease.

•I understand that if details have not been completed or the relevant documentation and required certified identification supplied, my application cannot be processed.

•I acknowledge that the Trustee does not accept any liability for any action I may take or fail to take in relation to my superannuation and recommends that before I make any decision I seek independent financial advice regarding my personal circumstances.

•By providing your email address you agree to receive promotional material via email from us. If you do not want to receive promotional material from us but you want us to retain your email address on your account records for contact purposes, please call us on 1300 65 18 65.

I have provided the appropriate certified identification and completed the Statutory declaration.

X Signature:	Date:
Name (print):

Statutory Declaration

This Statutory declaration must be signed before a person authorised to witness a Statutory declaration such as a Justice of the Peace or Police officer.

Insert the name and address of persons making the declaration.

Full Name:

of Residential address:

MAKE this solemn declaration by virtue of the Statutory Declarations Act 1959, and subject to the penalties provided by that Act for the making of false statements in statutory declarations, conscientiously believing the statements contained in this declaration to be true in every particular.

I declare that the information provided by me in the application attached to this Statutory declaration is true and correct and that I am:

under age 55, meet the 26 weeks income support requirements, and am unable to meet my reasonable and immediate family living expenses from my current income and assets, and that I am not applying for a similar payment from another fund, or

age 55 or over, meet the 26 weeks income support requirements, and am unable to meet my reasonable and immediate family living expenses from my current income and assets, and that I am not applying for a similar payment from another fund, or

age 55 or over, meet the 39 weeks income support requirements, and am not gainfully employed on a full-time or part-time basis on the date of my application.

Declared at:		in the State of:
X	Signature:	Date:
Before me		Qualification:
X	Signature:	Date:

If you have any questions please call us on 1300 65 18 65.

Please return this completed form to StatewideSuper PO Box 7035 Hutt Street Adelaide SA 5000