What information do you need to give us? You ll need to provide the documents listed below so we can assess your claim.

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1 MLC Superannuation Guide to Claiming a super or pension death benefit This guide will help you understand what to send us for a super death benefit claim Please return the information to Trustee Services PO BOX 1585 North Sydney NSW 2059 Any questions? If you have any questions please call us on between 8 am and 6 pm (AEST) Monday to Friday. What information do you need to give us? You ll need to provide the documents listed below so we can assess your claim. 1. Potential Beneficiary Statutory Declaration Each potential beneficiary needs to complete this form and indicate if they want to make a claim. For potential beneficiaries under 18, a legal guardian will need to complete the form on their behalf. 2. Certificate of Death A certified copy of the Registrar s full Certificate of Death. If the cause of death isn t on the certificate, then please send us a certified copy of any document showing the cause of death. 3. Will and Probate/Letters of Administration A certified copy of the member s last known Will and where applicable Probate/Letters of Administration. Probate/Letters of Administration is only necessary if the Trustee decides to pay the benefit to the Legal Personal Representative and may not be required to finalise the claim. Please send through available documentation for assessment. 4. Proof of Identity The Trustee can only make a payment once they ve received certified proof of the beneficiary s identity. However, simply providing proof of identity doesn t commit the Trustee to make a payment. You can find a list of documents you can provide in the Proof of identity brochure enclosed. 5. Payment Instruction form This payment Instruction will be used to finalise the death benefit payment once the Trustee has determined who to release the death benefit to. Simply completing this form doesn t commit the Trustee to make a payment. Please obtain financial advice prior to completing this form. What is a certified copy? A certified copy means a document certified by an authorised person. Certified copies need to be signed, dated and include the following; This is a true copy of the original document sighted by me. This fact sheet is issued by NULIS Nominees (Australia) Limited ABN AFSL as Trustee of MLC Superannuation Funds, whose registered office is at Miller Street, North Sydney, NSW It is intended to provide general information only and should not be used as the basis for any financial or other decision. It has been prepared without taking into account any particular person s objectives, financial situation or needs. A person should therefore consider the appropriateness of this information to their particular circumstances and obtain financial advice. NULIS Nominees (Australia) Limited is a member of the National Australia Group of companies. Page 1

2 MLC Superannuation Questions and answers Claiming a super or pension death benefit We answer some of your questions about claiming a super death benefit Any questions? If you have any questions please call us on between 8 am and 6 pm (AEST) Monday to Friday. How do we decide who receives a death benefit? In the absence of a valid binding nomination, the Trustee will determine who receives a Member s death benefit. To make this decision the Trustee takes into account a range of factors such as: the member s Will any nominations made by the member submissions made by potential beneficiaries, and if the Trustee isn t able to find a dependant or Legal Personal Representative, submissions made by any other person. Is the death benefit part of the member s Estate? The death benefit is only part of the member s Estate if the Trustee decides to make a payment in favour of the Estate; or if a binding death benefit nomination directs the Trustee to pay the Legal Personal Representative. Who is a potential beneficiary? Generally, a potential beneficiary can be: the member s spouse, including a de facto spouse or same sex partner the member s child (including an adopted child, stepchild, ex-nuptial child, or their spouse s child) any person with whom the member, at the time of their death, had an interdependency relationship anyone financially dependent on the member at the time of their death, or the Legal Personal Representative of the member. What s an interdependency relationship? This is when the member and another person at the time of death: a) had a close personal relationship b) were living together (unless temporarily living apart) c) one or each of them provided the other with financial support, and d) one or each of them provided the other with domestic support and personal care. It may also exist if the requirements from (b) to (d) couldn t be met because either person or both people suffered from a physical, intellectual or psychiatric disability. Who is a Legal Personal Representative? A Legal Personal Representative may be any of the following: an Executor granted Probate (where there was a Will) an Administrator who was granted Letters of Administration (where the deceased had no Will). Will there be an anti-detriment payment? An anti-detriment payment is designed to restore tax which was previously paid on contributions by the member. It is only payable if the death benefit is paid as a lump sum, or if a superannuation death benefit pension is commuted to a lump sum within six months of its commencement. The payment must be to a member s spouse, former spouse or child. This is only available for certain products, and will be automatically applied upon payment. Page 2

3 MLC Superannuation Superannuation or Pension Death Benefit Process What can I expect? Step 1 Notification received of Member s Death. Step 2 Forms sent: Potential Beneficiary Statutory Declaration form (to be completed by each potential dependant) Payment Instruction Form (where applicable) Proof of Identification brochure, and Privacy Notification. Step 3 Completed Potential Beneficiary Statutory Declaration form and required documentation returned to the Trustee. Where applicable, documentation will be sent to the Insurer for determination and eligibility of insurance. The Insurer may be in contact with you, should they need further information. Step 4 Trustee is to ascertain dependants of the deceased at the date of death, and may request further information from you if required. Step 5 When the Trustee has made a decision, potential beneficiaries will be notified of the Trustee s decision. Step 6 Potential Beneficiaries be given a chance to object to the decision within 28 days. Objection received. Step 7 No objection received. If no objection is received by the Trustee within 28 days or if all parties agree to the Trustee s decision then payment will proceed. If an objection is received by the Trustee, the information will be reassessed and further information may be requested. Variation or confirmation of the decision will then be communicated to all potential beneficiaries. Any complaints in relation to the Trustee s decision can be directed to the Superannuation Complaints Tribunal (SCT). No payment will be made by the Trustee until the SCT process is finalised. Page 3

4 MLC Superannuation Privacy Notification NULIS Nominees (Australia) Limited is a member of the National Australia Group (the Group). The Group includes banking, financing, funds management, financial planning, superannuation, insurance, broking and e-commerce organisations. This statement is an outline of certain matters relating to the collection and handling of your personal information by Group organisations. For more information To find out more information about your personal information and privacy, please call the MLC Client Service Centre on Collecting your personal information Group organisations will collect personal information for the purposes of: providing you with a product or service (including assessing your application) managing and administering the product or service identifying you and protecting against fraud verifying your authority to act on behalf of a customer determining whether a beneficiary will be paid a benefit upon a person s death letting you know about products or services from across the Group that might better serve your financial, e-commerce and lifestyle needs or promotions or other opportunities in which you may be interested. If you provide the Trustee with incomplete or inaccurate personal information, we may not be able to process your requests and applications or manage or administer your products or services. It may also not be possible to tell you about other products or services from across the Group that might better serve your financial, e-commerce and lifestyle needs. Using and disclosing your personal information Group organisations may disclose your personal information to other organisations: involved in providing, managing or administering the products and services the Group offers, including third-party suppliers (eg printers, posting services), other Group organisations, its advisers and loyalty and affinity program partners who are your financial or legal advisers or representatives and their service providers involved in maintaining, reviewing and developing the Group s products, business systems, procedures and infrastructure including testing or upgrading the Group s computer systems involved in a corporate re organisation or involved in a transfer of all or part of the assets or business of a Group organisation involved in the payments system including financial institutions, merchants and payment organisations which are Group organisations which wish to tell you about their products or services that might better serve your financial, e-commerce and lifestyle needs or promotions or other opportunities, and their related service providers, except where you tell the Group not to as required or authorised by law and/or where you have given your consent. Your personal information may also be used in connection with such purposes. Because the Group operates throughout Australia and overseas, some of these uses and disclosures may occur outside your state or territory and outside Australia. Gaining access to your personal information Subject to some exceptions allowed by law, you can gain access to your personal information. If access is denied, you will be given reasons for this. In some cases, your request may be dealt with over the telephone. Page 4

5 MLC Superannuation Commonwealth Government of Australia Statutory Declaration Act 1959 (Cth) Potential Beneficiary Statutory Declaration Issued by NULIS Nominees (Australia) Limited (ABN AFSL ), the Trustee of MLCS Superannuation Trust (ABN ) and MLC Super Fund ABN Issued by Navigator Australia Limited (ABN AFSL ) for and on behalf of NULIS Nominees (Australia) Limited (ABN AFSL ), the Trustee of: MLC Superannuation Fund (ABN ); PremiumChoice Retirement Service (ABN ); DPM Retirement Service (ABN ) and MLC Super Fund ABN A. Deceased member s details Policy/Member number Product name Title Mr Mrs Miss Ms Other Middle name Date of birth (DD/MM/YYYY) Date of death (DD/MM/YYYY) Residential address (Member s residential address can t be a PO Box) 1 What was the deceased s marital status at the date of death? Married Divorced Never married Married but separated Widowed De facto 2 If the deceased was living in a relationship at the date of death, what was the duration of the relationship? Name of Spouse/De facto/married but separated spouse Duration of relationship years months Potential Beneficiary Statutory Declaration Page 1 of 8

6 A. Deceased member s details continued 3 Were there any matters pending in the Family Court between the deceased and their spouse? Yes Please provide details below No Please go to Question 4 4 Did the deceased leave a Will? Yes No Please go to Question 5 5 Please provide the Estate s tax file number. B. Member s potential beneficiaries Please provide details of: spouse (including current spouse, separated spouse, de facto, ex-spouse or same sex spouse) child (regardless of age), including an adopted child, stepchild, ex-nuptial child or spouse s child a person in an interdependency relationship, any other person either wholly or partially financially dependent on the deceased at the time of death. Name of Potential Beneficiary One Title Mr Mrs Miss Ms Other Middle name Date of birth (DD/MM/YYYY) Contact number Relationship Potential Beneficiary Statutory Declaration Page 2 of 8

7 B. Member s potential beneficiaries Name of Potential Beneficiary Two Title Mr Mrs Miss Ms Other Middle name Date of birth (DD/MM/YYYY) Contact number Relationship Name of Potential Beneficiary Three Title Mr Mrs Miss Ms Other Middle name Date of birth (DD/MM/YYYY) Contact number Relationship Please attach document if additional space is required. C. Submission my details Title Mr Mrs Miss Ms Other Middle name Date of birth (DD/MM/YYYY) Relationship to the Deceased (spouse / child / financial dependant / interdependant / legal personal representative) Potential Beneficiary Statutory Declaration Page 3 of 8

8 C. Submission my details continued Residential address (your residential address can t be a PO Box) Home telephone Mobile phone number Business telephone 1 Claim details I do not wish to be considered as a Potential Beneficiary. Please go to Question 8. I wish to claim I wish to claim % of the benefit Please complete the remaining sections. % on behalf of the Estate as Legal Personal Representative. Please go to Question 8 and Sections D and E. 2 I am a sole trader Yes Please provide details below What is your business name? What is your business address? What is your ABN? No Please go to Question 3 3 I was a student at the date of death Yes Full time Part time No Please go to Question 4 4 I was employed at the date of death Yes Full time Part time Weekly wage Weekly wage $ $ No Please go to Question 5 Potential Beneficiary Statutory Declaration Page 4 of 8

9 C. Submission my details continued 5 I was receiving a Government Benefit at the date of death Yes Benefit type Weekly benefit $ No Please go to Question 6 6 Please list the people living with the deceased at the date of death. 7 Please state the nature and duration of your relationship to the deceased and information regarding any dependency on the deceased. Supporting documents should be attached to evidence the extent of financial dependency eg joint bank accounts, loans, shared living expenses, joint liabilities. Please provide evidence of payments, frequency and purpose of funds. Please attach document if additional space is required. 8 I would not object to the proceeds being paid to: Legal Personal Representative of the Deceased Other (please provide details below) Full name (please print) Relationship Portion of total benefit % Potential Beneficiary Statutory Declaration Page 5 of 8

10 D. Declaration I understand that a person who intentionally makes a false statement in a statutory declaration is guilty of an offence under section 11 of the Statutory Declarations Act 1959 (Cth), and I believe that the statements in this declaration are true in every particular and if any answers are not in my handwriting or attached to this form, I declare I have checked them and they are correct. Name of person making the declaration Middle name Signature of person making the declaration Date (DD/MM/YY) Declared at (place declared) On (date declared) (DD/MM/YYYY) Signature of person before whom the declaration is made Date (DD/MM/YY) Before me, person before whom the declaration is made Middle name Qualification(s) of person before whom the declaration is made (please print) Address of person before whom the declaration is made Please refer to page 8 for a list of persons before whom a statutory declaration may be made. If you are completing this form as the Legal Personal Representative, please continue to Section E. Potential Beneficiary Statutory Declaration Page 6 of 8

11 E. Legal personal representative only 1 Has a grant of Probate or a grant of Letters of Administration been received or applied for? Yes Please go to Question 2 No Please provide reasons below as to why an application will not be made 2 I declare that the Estate is solvent and has sufficient assets, apart from the superannuation death benefit, to cover all liabilities of the Estate. Yes No I will ensure that all proceeds from the superannuation lump sum death benefit which is paid in favour of the Estate, will be paid in its entirety, to all or any of the persons below, being spouse, former spouse or child of the deceased. Yes No Please list full name of beneficiary(ies) receiving the superannuation death benefit (please print) Name of Legal Personal Representative Signature of Legal Personal Representative Date (DD/MM/YY) Declared at (place declared) On (date declared) (DD/MM/YYYY) Before me, person before whom the declaration is made Signature of person before whom the declaration is made Date (DD/MM/YY) Qualification(s) of person before whom the declaration is made (please print) Address of person before whom the declaration is made Please refer to page 8 for a list of persons before whom a statutory declaration may be made. Potential Beneficiary Statutory Declaration Page 7 of 8

12 E. Legal personal representative only continued Note 1: A person who intentionally makes a false statement in a statutory declaration is guilty of an offence, the punishment for which is imprisonment for a term of 4 years see section 11 of the Statutory Declarations Act 1959 (Cth). Note 2: Chapter 2 of the Criminal Code applies to all offences against the Statutory Declarations Act 1959 see section 5A of the Statutory Declarations Act 1959 (Cth). A Statutory Declaration under the Statutory Declarations Act 1959 (Cth) may be made before: (1) A person who is currently licensed or registered under a law to practice in one of the following occupations: Chiropractor Dentist Legal Practitioner Medical Practitioner Nurse Optometrist Patent Attorney Pharmacist Physiotherapist Psychologist Trade Marks Attorney Veterinary Surgeon. (2) A Person who is in the following list: Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955) Bailiff Bank officer with 2 or more continuous years of service Building society officer with 2 or more years of continuous service Chief executive officer of a Commonwealth court Clerk of a court Commissioner for Affidavits Commissioner for Declarations Credit union officer with 2 or more years of continuous service 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 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 Fellow of the National Tax Accountants Association Finance company officer with 2 or more years of continuous service Holder of a statutory office not specified in another item in this Part Judge of a court Justice of the Peace Magistrate Marriage celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961 Master of a court Member of Chartered Secretaries Australia Member of Engineers Australia, other than at the grade of student Member of the Association of Taxation and Management Accountants 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 2 or more years of continuous service; or (c) a warrant officer within the meaning of that Act Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants 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 Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961 Notary public Permanent employee of the Australian Postal Corporation with 2 or more years of continuous service who is employed in an office supplying postal services to the public 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 2 or more years of continuous service who is not specified in another item in this Part Person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made Police officer Registrar, or Deputy Registrar, of a court Senior Executive Service employee of: (a) the Commonwealth or a Commonwealth authority; or (b) a State or Territory or a State or Territory authority Sheriff Sheriff s officer Teacher employed on a full-time basis at a school or tertiary education institution Member of the Australasian Institute of Mining and Metallurgy How to contact us MLC Client Service Centre If you have any questions, please contact your financial adviser, or the MLC Client Service Centre on between 8.00 am and 6.00 pm (AEST/AEDT) Monday to Friday. Return this form and any attachments to: Claims Department, MLC Life Insurance, PO Box 200, North Sydney NSW 2059 Potential Beneficiary Statutory Declaration Page 8 of 8

13 MLC Superannuation Payment Instruction Issued by NULIS Nominees (Australia) Limited (ABN AFSL ), the Trustee of MLCS Superannuation Trust (ABN ) and MLC Super Fund ABN Issued by Navigator Australia Limited (ABN AFSL ) for and on behalf of NULIS Nominees (Australia) Limited (ABN AFSL ), the Trustee of: MLC Superannuation Fund (ABN ); PremiumChoice Retirement Service (ABN ); DPM Retirement Service (ABN ) and MLC Super Fund ABN This payment instruction will be used to finalise your claim once the Trustee approves the release of your super. By submitting this form you agree for your payment instructions to be processed as soon as an approval for release is granted by the Trustee. Please obtain financial advice prior to completing this form. Your details Policy/Member number Product name Title Mr Mrs Miss Ms Other Middle name Date of birth (DD/MM/YYYY) Are you a sole trader? Yes No Residential address (your residential address can t be a PO Box) Tax File Number Mobile number Payment instruction 1 Please specify your payment type and percentage. This must add up to 100%. Lump Sum % Please go to Question 2 Pension % Contact us or your financial adviser for a Pension application form. Please go to Question 3 2 Please provide your account details. Where the Trustee is unable to electronically transfer money to your account a cheque will be issued. Name of Bank Name of account holder(s) BSB Account number Payment Instruction Page 1 of 2

14 Payment instruction (continued) 3 If contributions were made in the previous or current financial year, please specify in the table below. Contribution Current Financial Year 1 / 7 / 30 / 6 / Previous Financial Year 1 / 7 / 30 / 6 / Personal contribution $ $ Employer contribution $ $ Other contribution (Spousal or under 18) $ $ Total member contributions ($ amount only) $ $ 4 Do you intend to claim a tax deduction for the above personal contributions made in the current or previous financial year? The Trustee cannot accept a notice to claim a deduction once the benefit has been paid. No Please go to Question 5 Yes Please provide details in the table below I am making this claim before both of the following dates: the day that I lodged my income tax return(s) for the year(s) stated in the table below, and the end of the income year after the year(s) stated in the table below. I have not previously started a pension with any part of these contributions. My account still holds these contributions. I have not previously advised the Trustee that I am claiming the amount specified below as a tax deduction. Contribution Current Financial Year 1 / 7 / 30 / 6 / Previous Financial Year 1 / 7 / 30 / 6 / Amount of personal contributions you wish to claim as a tax deduction ($ amount only) $ $ Proof of Identity You must provide certified copies of identification before we can process your request. 5 Have you provided certified proof of identity? No Yes Please attach proof of identity (please refer to attached Proof of Identity brochure). Please go to Declaration Declaration I declare that: All details in this form are true and correct. I have not previously advised the Trustee that I am claiming the amount specified in Question 3 as a tax deduction. Where I have selected a pension, I have read the current Product Disclosure Statement for MLC Pension / Pension Fundamentals and have completed a separate application form. I understand that this payment instruction will generate a payment. Signature Full name (please print) Date (DD/MM/YY) Payment Instruction Page 2 of 2

15 Proof of Identity Issued by NULIS Nominees (Australia) Limited (ABN AFSL ), the Trustee of MLCS Superannuation Trust (ABN ) and MLC Super Fund ABN Issued by Navigator Australia Limited (ABN AFSL ) for and on behalf of NULIS Nominees (Australia) Limited (ABN AFSL ), the Trustee of: MLC Superannuation Fund (ABN ); PremiumChoice Retirement Service (ABN ); DPM Retirement Service (ABN ) and MLC Super Fund ABN You must provide certified copies of either of the following identification document(s) before any payment can be made. Part A. Acceptable primary documents If you do not own a document from this section, then provide documents from Part B. Provide only ONE document from this section (please tick). Australian State/Territory or foreign equivalent driver s licence containing a photograph of the person Australian passport or foreign equivalent (a Commonwealth passport that has expired within the preceding 2 years is acceptable) Australian card issued under a State or Territory for the purpose of providing a person s age containing a photograph of the person Part B. Acceptable secondary Australian ID documents If you do not own a document in Part A above, please provide TWO documents from Part B. Provide ONE document from this section (please tick) AND Australian or foreign equivalent birth certificate Australian or foreign equivalent citizenship certificate Australian pension card issued by the Department of Human Services Provide ONE document from this section (please tick). A document issued by the Australian 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 individuals name and residential address. A document issued by the Australian Taxation Office within the preceding 12 months that records a debt payable by the individual to the Commonwealth (or by the Commonwealth to the individual), which contains the individuals name and residential address. A document issued by an Australian local government body or utilities provider within the preceding 3 months which records the provision of services to that address or to that person (the document must contain the individuals 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 3 months and contains the name and residential address and records the period of time that the individual attended that school. * Documents that are written in a language that is not English, must be accompanied by an English translation prepared by an accredited translator. Proof of Identity Page 1 of 2

16 The Anti-Money Laundering and Counter-Terrorism Financing Rules 2007 (No. 1) list the following parties as being authorised to certify your ID documents: 1. A person who is currently licensed or registered under a law to practice in one of the following occupations: Chiropractor Dentist Legal Practitioner Medical Practitioner Nurse Optometrist Patent Attorney Pharmacist Physiotherapist Psychologist Trade Marks Attorney Veterinary Surgeon. 2. 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 (however described); or 3. A person who is on the following list: Agent of the Australian Postal Corporation who is in charge of an office supplying postal services to the public Australian Consular Officer or Australian Diplomatic Officer (within the meaning of the Consular Fees Act 1955) Bailiff Bank officer with 2 or more continuous years of service Building society officer with 2 or more years of continuous service Chief executive officer of a Commonwealth court Clerk of a court Commissioner for Affidavits Commissioner for Declarations Credit union officer with 5 or more years of continuous service 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 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 Fellow of the National Tax Accountants Association Finance company officer with 2 or more years of continuous service Holder of a statutory office not specified in another item in this Part Holder of an Australian financial services licence having 2 or more years continuous service Holder of Australian credit licence having 2 or more years continuous service Judge of a court Justice of the Peace Magistrate Marriage celebrant registered under Subdivision C of Division 1 of Part IV of the Marriage Act 1961 Master of a court Member of Chartered Secretaries Australia Member of Engineers Australia, other than at the grade of student Member of the Association of Taxation and Management Accountants 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 5 or more years of continuous service; or (c) a warrant officer within the meaning of that Act Member of the Institute of Chartered Accountants in Australia, the Australian Society of Certified Practising Accountants or the National Institute of Accountants 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 Minister of religion registered under Subdivision A of Division 1 of Part IV of the Marriage Act 1961 Notary public Permanent employee of the Australian Postal Corporation with 5 or more years of continuous service who is employed in an office supplying postal services to the public 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 2 or more years of continuous service who is not specified in another item in this Part Person before whom a statutory declaration may be made under the law of the State or Territory in which the declaration is made Police officer Registrar, or Deputy Registrar, of a court Senior Executive Service employee of: (a) the Commonwealth or a Commonwealth authority; or (b) a State or Territory or a State or Territory authority Sheriff Sheriff s officer Teacher employed on a full-time basis at a school or tertiary education institution Member of the Australasian Institute of Mining and Metallurgy Acceptable certification of ID documents Each copy of the ID must be certified by the approved certifier as follows. The approved certifier must write the following on each photocopy: This is a true copy of the original document(s) which I have sighted: Full name eg Michelle Helena Citizen Contact address and telephone number; Date of certification; Signature; The capacity in which they have certified the document (eg judge, magistrate, police officer, etc); Affix the official stamp or seal of the certifier s organisation. A Proof of Identity Page 2 of 2

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