Make a lump sum withdrawal or rollover For a transition to retirement income stream

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1 CSC retirement income RI04 04/13 Make a lump sum withdrawal or rollover For a transition to retirement income stream Use this form if you have a transition to retirement income stream and wish to > > make a cash lump sum withdrawal from your account > > roll over a partial amount to another complying superannuation fund. Please complete this form using BLACK ink, in clear BLOCK LETTERS, and mark answers in boxes with an X. Access to your money As a transition to retirement income stream member, your ability to access amounts from your account (as either income payments, lump sum withdrawals or partial rollovers to other complying superannuation funds) is restricted by law. Unless you satisfy one of the conditions of release listed below, you are subject to a maximum annual withdrawal amount. Your annual withdrawals cannot exceed this amount, which is 10% of your account balance for that year, calculated on the date you commence your income stream in your first year and on 1 July for each year thereafter. If you do satisfy a condition of release, however, you can request to change your account from a transition to retirement income stream to a standard retirement income stream. Conditions of release > > You have reached your preservation age, ceased working and do not intend to work for more than 10 hours a week in the future (you have permanently retired) > > You have reached age 65 > > You changed employment on or after age 60 (you do not need to have permanently retired) > > You retire due to permanent disablement or invalidity > > You have a terminal medical condition as defined under superannuation law > > You are a temporary resident permanently leaving Australia (except New Zealand citizens). I satisfy a condition of release and wish to make a lump sum withdrawal or rollover Please do not complete the remainder of this form. Instead, you should do the following: > > Complete the Change your account details form available at cscri.gov.au to change the status of your account from a transition to retirement income stream to a standard retirement income stream. > > Complete the Make a lump sum withdrawal or rollover for a standard retirement income stream form available at cscri.gov.au Note: You can complete and send us both your forms together at: I do not satisfy a condition of release but still wish to make a lump sum withdrawal or rollover You can still make a withdrawal or rollover, providing that you do not exceed your maximum annual withdrawal amount. In addition, the amount you do wish to withdraw (and are eligible by law to withdraw) must not be less than $5,000. If you wish to proceed with your withdrawal or rollover, please complete the remainder of this form and return it to us at the above address. Any financial product advice in this document is general advice only and has been prepared without taking account of your personal objectives, financial situation or needs. Before acting on any such general advice, you should consider the appropriateness of the advice, having regard to your own objectives, financial situation or needs. You may wish to consult a licensed financial advisor. You should obtain a copy of the Product Disclosure Statement and consider its contents before making any decision regarding your super. Commonwealth Superannuation Corporation (CSC) ABN: AFSL: RSEL: L Commonwealth Superannuation Corporation retirement income () is offered by CSC, the trustee of the Public Sector Superannuation accumulation plan (PSSap) ABN: RSE: R of 5

2 Before you complete this form > > Contact us on during business hours to: > > confirm how much you can withdraw or roll over from your account > > receive a pre-payment statement detailing the tax components of your withdrawal and/or rollover. > > Read your Product Disclosure Statement available to view and download at cscri.gov.au Expert financial advice for your situation Speak to a licensed financial planner to receive advice for your own objectives, financial situation and needs. Commonwealth Superannuation Corporation has partnered with Industry Fund Services to make an advice service available to you. To find out more, please visit csc.gov.au/advice To book your first appointment, which is provided without obligation or charge, please call during business hours. Section A Confirm your personal details Member Number Personal information (as currently displayed on your account) Title Mr Mrs Ms Miss Other Surname Given name(s) Date of birth D D M M Y Y Y Y / / Section B Nominate your withdrawal or rollover option I wish to: (please choose ONE option only) Make a partial lump sum withdrawal (cash payment to me) Go to Section C Section C Provide your withdrawal payment details Make a partial rollover to another complying superannuation fund Go to Section D Partial lump sum withdrawal amount Note: The maximum amount by law that you can withdraw each year is 10% of your account balance which covers all types of withdrawals income stream payments, lump sum withdrawals and partial rollovers. This is your maximum annual withdrawal amount. It is calculated on the day your income stream commences in your first year (and is not pro-rated) and 1 July for every year thereafter. Please note that if you wish to make a lump sum withdrawal, it must also be no less than $5,000. To confirm how much you can withdraw, please call us on during business hours. Please make my partial lump sum payment to me as follows: Amount: Section C continued on next page 2 of 5

3 Payment method I wish to receive my lump sum withdrawal as: Electronic payment into the same bank account used for my regular income stream payments Cheque sent to the postal address nominated on my account Electronic payment into my bank account as follows: Name(s) in which your account is held Name of your bank/financial institution Account number BSB Note: Your benefit can only be deposited into an account held in your name or jointly in your name. Only an Australian financial institution with a BSB number will be accepted. We will not be liable for any errors that occur based on the account details you provide. If the electronic payment to the above account is unsuccessful, we will issue a cheque payable to you and send it to the postal address we hold for your account on-file. Investment option drawdown (if in two or more options) Complete this section to indicate from which investment option or mix of options your partial lump sum amount will be withdrawn. You should only complete this part if you wish to make a partial withdrawal and your account balance is currently invested in two or more investment options. Cash Income Focused (default option) Balanced Aggressive Total Please ensure your total amount is the same as the lump sum withdrawal amount you listed above. Section D Provide your rollover payment details Rollover amount Note: The maximum amount by law that you can withdraw each year is 10% of your account balance which covers all types of withdrawals income stream payments, lump sum withdrawals and partial rollovers. This is your maximum annual withdrawal amount. It is calculated on the day your income stream commences in your first year (and is not pro-rated) and 1 July for every year thereafter. Please note that if you wish to roll over a partial amount, it must also be no less than $5,000. To confirm how much you can roll over, please call us on during business hours. Please roll over part of my account balance to another complying super fund as follows: Amount: Section D continued on next page 3 of 5

4 Your other superannuation fund Fund name Phone Postal address Suburb State Post code Your membership number Superannuation Product Identifier Number (SPIN) Australian Business Number (ABN) Cheque made payable to: Rollovers to Self-managed super funds (SMSFs) If you are transferring an amount to a SMSF, you must ensure that the details you provide about your SMSF on or with this application match exactly the details shown on the super fund lookup website. If you do not, we may need to request further information from you, possibly delaying your rollover request. Before you submit this form, we recommend that you search for your SMSF at superfundlookup.gov.au > > If your SMSF appears as a Complying fund, you do not need to provide any documents relating to your SMSF. > > If your SMSF cannot be found on that website OR if your SMSF is listed with a Non-Complying state, we are not allowed to process your request by law. You must resolve these issues with the Australian Taxation Office (ATO) before you submit this form. > > If your SMSF appears as Registered Status not determined, please provide a certified copy of one of the following documents: New member letter from the ATO to confirm that you are a member of the SMSF The latest annual return lodged with the ATO for the SMSF Investment option drawdown (if in two or more options) The Trust Deed of the SMSF we prefer a certified copy of the full Trust Deed, however a certified extract containing at least the first five pages and the later pages that list each member of the SMSF and include the trustee and member signatures will generally be sufficient. Please note that if we determine that the extract provided is not sufficient, we will write to you requesting further details. Complete this part of the form to indicate from which investment option or mix of options your partial rollover amount will be withdrawn. You should only complete this part if you wish to make a partial rollover (not a full rollover) and your account balance is currently invested in two or more investment options. Cash Income Focused (default option) Balanced Aggressive Total Please ensure your total amount is the same as the partial rollover amount you listed above. 4 of 5

5 Section E Declaration By signing this request form I am making the following statements: > > I have read and understood the Product Disclosure Statement. > > I declare that, to the best of my knowledge, the information I have provided on this form is true and correct. > > I authorise to transfer and/or pay my benefit as instructed on this form. > > I discharge Commonwealth Superannuation Corporation, the trustee of PSSap through which is offered, from all further liability in respect of the benefits transferred and/or paid. Signature Date signed D D M M Y Y Y Y / / Please send your completed form to: phone financial advice post web overseas callers fax of 5

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