Essential Super Withdrawal Form – Fill Out and Use This PDF

Essential Super withdrawal form

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Essential Super

WITHDRAWAL FORM

Please phone us on 13 40 74 with any questions.

Please complete this form using BLACK INK and print well within the boxes in CAPITAL LETTERS. Mark appropriate answer boxes with a cross like the following × . Start at the left of each answer space and leave a gap between words. Please complete all fields to ensure that we hold the correct details.

Fields marked with an asterisk (*) must be completed for the purposes of anti-money laundering laws.

1 INVESTOR DETAILS

Essential Super account number

Surname* (Please supply relevant certified documents if details have changed)

Date of birth*

D D / M M / Y Y Y Y

Occupation and industry* (If retired, state RETIRED)

Your main country of residence, if not Australia*

Residential address (PO Box is NOT acceptable)*

State	Postcode	Country

Postal address for all communications and cheque payments (if applicable)

Cross (X) box where appropriate:

Same as residential address, as above

Same as existing postal address on account

Different address as provided below:

		State	Postcode			Country
Work phone number		Home phone number			Mobile phone number

Fax number

Email address

By providing your email address, you agree that we may use this address to provide you with information about your investment (such as transaction confirmations, statements, reports and other material). From time to time we may still need to send you letters in the post.

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2 Residency details – this section must be completed

If you do not complete this section your request may be delayed. If you are completing a rollover request to another superannuation fund, you can proceed to Section 3. If you are requesting to cash out your super benefit or requesting a rollover to commence a pension, you must complete the section below.

Cross (X) box as applicable

Australian citizen/resident

New Zealand citizen

Non-resident (has never been a temporary resident visa holder of Australia)

Holder of Retirement Visa subclass 405/410

If you have selected any of the above, please proceed to section 3 of this form.

Temporary resident visa holder of Australia

•Please complete Section 8 – Temporary resident visa holder – Conditions of release. Please obtain the ‘Temporary resident brochure for superannuation’ available at commbank.com.au/super or by calling us on 13 40 74 for further information on the super benefits you are entitled to.

3 Withdrawal instructions

Unless otherwise indicated, the amount shown should be NET of tax and withdrawal adjustments.

I would like to close my account. Please Pay to me (proceed to section 4) or Rollover (proceed to section 6)

OR

I would like to withdraw $

This payment is to be:

Please note: If you close your account without providing your Tax File Number, you may not be able to claim back any TFN tax that has been deducted.

Cross (X) one box only. If no option is selected, we will redeem as per your existing investment weightings.

I would like this withdrawal to be made in line with my investment allocation on the date of this transaction.

I would like this withdrawal to be made from my account as shown below. If this is a full withdrawal from an option, write ‘balance’ next to that option.

$

$

$

$

TOTAL $

Please note: If you have specified a restricted, suspended or unavailable option, we may not be able to process your request immediately. You should refer to our website for important information on any changes to the availability of particular investment options.

4 Payment instructions

Your instructions in this section overrides previous nominations. Only one method can be selected. Please cross (X) one:

Please note: If no payment method is selected, a cheque will be issued.

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5 Details of account to be credited

Please note: New bank account details via fax cannot be accepted, unless sent from a Commonwealth Bank branch. Name of Australian financial institution

Branch name

Branch number (BSB)		Account number

Name of account holder

You can only nominate a bank account that is held in your name.

6 Rollover details

Complete this section if you would like your withdrawal to be rolled over to another institution. Please complete all details and ensure that you provide us with a valid Australian Business Number (ABN) or Unique Superannuation Identifier (USI).

Rollover 1

Amount				Account/Membership number of fund
$
			AND USI
ABN
Rollover institution, fund name

Postal address

				State	Postcode		Country
Rollover 2
Amount				Account/Membership number of fund
$
ABN			AND USI

Rollover institution, fund name

Postal address

State	Postcode	Country

Note: If you require more than 2 rollovers to another institution, please attach a signed letter with your withdrawal form with the above details.

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7 Tax file number notification

I acknowledge that I am aware that:

•my provision, and your receipt, of my tax file number are authorised under the Superannuation Industry (Supervision) Act 1993

•if I provide my tax file number to you, you will use it only for legal purposes. This includes finding and identifying any superannuation benefits which you hold on my behalf, calculating tax on any superannuation benefits, calculating tax on my superannuation contributions and providing information to the Commissioner of Taxation. These purposes may change in future.

If I provide my TFN to you, I consent to you using it to:

•seek information about my superannuation accounts from the Australian Taxation Office (ATO) using the ATO’s Supermatch program or other facility provided by the ATO, or

•to locate information about superannuation accounts which I hold with other superannuation providers, and

•contacting those providers regarding my superannuation accounts.

I don’t have to supply my tax file number, and if I choose not to, I will commit no offence. However, if I don’t provide my tax file number:

•more tax may become payable on my taxable superannuation contributions and superannuation benefits

•you may be required to refund any other superannuation contributions (including a personal or self-employed contribution) to me within 30 days less taxes, fees and costs and insurance premiums and reduced or increased for market movements, and

•in the future it may be more difficult to locate or amalgamate my superannuation benefits

These consequences may change in the future.

If I provide my tax file number to you, you may provide it to another superannuation fund trustee or Retirement Savings Account provider to whom my superannuation benefits are to be rolled over, unless I request you not to do so in writing. You may also give my tax file number to the Commissioner of Taxation. In all other respects my TFN will be treated as confidential.

My tax file number is:

8 Conditions of release

Please indicate what type of super benefit you are eligible for. If you are, or once were, a temporary resident, please refer to Section 2.

a retirement benefit – I am aged 55 to 64 and have permanently retired and never intend to become engaged in gainful employment for 10 or more hours per week

a retirement benefit – I am aged 60 to 64 and have ceased a gainful employment arrangement since turning age 60

a retirement benefit – I am aged 65 or older

an unpreserved cash benefit – I am withdrawing unrestricted non-preserved amounts only

an unpreserved cash benefit – I am withdrawing restricted non-preserved amounts only and have terminated my employment with an employer who has contributed to this fund1

a total and permanent disablement (TPD) benefit – I am permanently incapacitated1

a financial hardship benefit – I am in severe financial hardship1

a compassionate grounds benefit – Compassionate grounds as approved by Medicare1

a terminal illness benefit – I have a terminal medical condition1

a pre-retirement pension – I am aged 55 to 64 but have not permanently retired and wish to commence a pre-retirement income stream1

a termination payment – I have ceased gainful employment with the sponsor that established this account and the balance is less than $200.

Please read the current PDS for more information on when you can be paid your super. This PDS is available free of charge on our website at commbank.com.au/super or by calling us on 13 40 74.

1 We have additional requirements to process the withdrawal on these grounds. Please call us on 13 40 74 for further information.

Temporary Resident Visa Holder – Conditions of release

Only complete this section if you are a temporary resident visa holder and wish to have any preserved or restricted non-preserved benefits paid to you or rolled over to an income stream.

Please indicate what type of super benefit you are eligible for:

a total and permanent disablement (TPD) benefit – I am permanently incapacitated1

a terminal illness benefit – I have a terminal medical condition1

an unpreserved cash benefit – I am withdrawing unrestricted non-preserved amounts only (that existed prior to 1 April 2009)

a retirement benefit – prior to 1 April 2009, I turned aged 60 or older and ceased a gainful employment arrangement

a retirement benefit – prior to 1 April 2009, I turned age 65 or older

an unpreserved cash benefit – I am withdrawing restricted non-preserved amounts and prior to 1 April 2009, I terminated my employment with an employer who has contributed to this fund.1

1 We have additional requirements to process the withdrawal on these grounds. Please call Investor Services on 13 13 36 for further information.

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9 Declaration and signature

I declare that:

•I have received and read the Essential Super PDS and I acknowledge I have access to all statements and information that are incorporated by reference, together referred to below as ‘the PDS’

•I acknowledge I am bound by the Commonwealth Essential Super Trust Deed (as amended from time to time), and

•I acknowledge I am bound by the terms and conditions of the PDS.

•all details in this form are true and correct

•if this form is signed under Power of Attorney, the Attorney declares that they have not received notice of revocation of that power (a certified copy of the Power of Attorney should be submitted with this application unless we have already sighted it)

•I have read and understood the important information provided with this form.

I acknowledge and agree that the trustee and/or its related entities (‘the Group’) will not be liable to me or other persons for any loss suffered (including consequential loss) where transactions are delayed, blocked, frozen or where the Group refuses to process a transaction or ceases to provide me with a product or service.

Investments in Essential Super USI FSF1332AU (referred to as ‘the fund’) are offered from Commonwealth Essential Super ABN 56 601 925 435 by Colonial First State Investments Limited ABN 98 002 348 352 AFS Licence 232468.

If you are signing under a Power of Attorney, please comply with the following:

•attach a certified copy of the Power of Attorney document

•each page of the Power of Attorney document must be certified by a Justice of the Peace, Notary Public or Solicitor.

•please also supply a certified copy of the identification documents for the Attorney, containing a sample of their signature,

eg Drivers Licence, Passport, etc. The Attorney will also need to complete a power of attorney identification form which can be obtained by phoning us on 13 40 74.

Please send the completed form to:

Essential Super

Reply Paid 86495, Sydney NSW 2001

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Essential Super

IDENTIfiCATION AND VERIfiCATION FORM – INDIVIDUALS

Full name of member

You or your adviser may also like to complete this form so that we can establish your identity (for the purposes of Anti-Money Laundering and Counter-Terrorism Financing laws) and assist us in processing any future request efficiently.

Financial advisers undertake identification and verification procedures by completing sections A to C of this form or by using other industry standard forms.

If you do not have a financial adviser, you will need to complete section A of this form and provide certified copies of the ID documents (do not send original documents).

The list of the parties who can certify copies of the documents is set out below. To be correctly certified we need the ID documents to be clearly noted ‘True copy of the original document’. The party certifying the ID documents will also need to state what position they hold and sign and date the certified documents. If this certification does not appear, you may be asked to send in new certified documents.

List of persons who can certify documents* (for the purposes of Anti-Money Laundering and Counter-Terrorism Financing laws):

•Justice of the Peace

•Solicitor

•Police Officer

•Magistrate

•Notary Public (for the purposes of the Statutory Declaration Regulations 1993)

•Employee of Australia Post (with two or more years of continuous service)

•Your financial adviser (provided they have two or more years of continuous service)

•Your accountant (provided they hold a current membership to a professional accounting body)

•Australian consular officer or an Australian diplomatic officer (within the meaning of the Consular Fees Act 1955)

•An officer of a bank, building society, credit union or finance company provided they have two or more years of continuous service.

* There are additional persons who can certify documents. A full list of the persons who can certify documents is available from our forms library at commbank.com.au/super

Section A: Verification procedure

Complete Part 1 (or if the individual does not own a document from Part 1, then complete either Part 2 or Part 3).

Part 1		Acceptable primary photographic ID documents
Cross
	×	Select ONE valid option from this section only

Australian State/Territory driver’s licence containing a photograph of the person

Australian passport (a passport that has expired within the preceding two years is acceptable)

Card issued under a State or Territory for the purpose of proving a person’s age containing a photograph of the person

Foreign passport or similar travel document containing a photograph and the signature of the person¹

1Documents that are written in a language that is not English must be accompanied by an English translation prepared by an accredited translator. An accredited translator is any person who is currently accredited by the National Accreditation Authority for Translators and Interpreters Ltd (NAATI) at the level of Professional Translator or above.

Continued over the page…

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Part 2	Acceptable secondary ID documents – should only be completed if the individual does not own a document from Part 1
Cross ×	Select ONE valid option from this section
	Australian birth certificate
	Australian citizenship certificate
	Pension card issued by Department of Human Services (previously known as Centrelink)
Cross ×	AND ONE valid option from this section
	A document issued by the Commonwealth or a State or Territory within the preceding 12 months that records the
	provision of financial benefits to the individual and which contains the individual’s name and residential address
	A Notice of Assessment issued by the Australian Taxation Office within the preceding 12 months which contains the
	individual’s name and residential address
	A document issued by a local government body or utilities provider within the preceding three months which records
	the provision of services to that address or to that person (the document must contain the individual’s name and
	residential address)
	If under the age of 18, a notice that was issued to the individual by a school principal within the preceding three
	months; and contains the name and residential address; and records the period of time that the individual attended
	that school
	Acceptable foreign photographic ID documents – should only be completed if the individual does not own
Part 3	a document from Part 1
Cross ×	Select one valid option from this section only
	Foreign driver’s licence that contains a photograph of the person in whose name it is issued and the individual’s date
	of birth¹
	National ID card issued by a foreign government containing a photograph and a signature of the person in whose
	name the card was issued¹

1Documents that are written in a language that is not English must be accompanied by an English translation prepared by an accredited translator. An accredited translator is any person who is currently accredited by the National Accreditation Authority for Translators and Interpreters Ltd (NAATI) at the level of Professional Translator or above.

Section B: Record of verification procedure

FINANCIAL ADVISER USE ONLY

Verify the individual’s full name and date of birth OR residential address.

By completing this Record of Verification Procedure I declare that I have verified the identity of the Customer as required by AML/ CTF Rules and that this identification procedure has been performed by an AFSL holder or an authorised representative of an AFSL holder.

ID document details

Document 1

Document 2 (if required)

Verified from

Original

Certified copy

Original

Certified copy

Document issuer

Issue date

D D / M M / Y Y Y Y

D D / M M / Y Y Y Y

Expiry date

D D / M M / Y Y Y Y

D D / M M / Y Y Y Y

Document number

Section C: Financial adviser details – Identification and verification conducted by:

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