Transfer to pension. PremiumChoice Retirement Service. 1. Existing Investor details. 2. Eligibility to start a pension account

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1 Transfer to pension PremiumChoice Retirement Service Please tick where appropriate: transfer to the PremiumChoice Retirement Service Pension Service This form should be completed to transfer your current account to a new pension account. Please complete a separate form for each pension account you want to commence. Before you sign this form, you must read the current Product Disclosure Statement and any Supplementary Product Disclosure Statement for the PremiumChoice Retirement Service (as applicable). The Product Disclosure Statement will help you to understand the product and decide if it is appropriate to your needs. Please complete these instructions in BLACK INK using BLOCK letters. Return to us at: GPO Box 1610 Melbourne Victoria 3001 Tel: Fax: Existing Investor details Existing Investor account name Existing Investor account number Existing account type PremiumChoice Retirement Service Superannuation Service PremiumChoice Retirement Service Pension Service 2. Eligibility to start a pension account I am eligible to start a pension account as I am an Australian citizen, New Zealand citizen or a permanent resident of Australia and have satisfied one of the following conditions of release (tick one): I have reached my preservation age (currently 55), but not yet 65. I am not gainfully employed and never intend to become gainfully employed on a full or part time basis I am 60 or over, but not yet 65, and have ceased employment with an employer at or after age 60 I have attained the age of 65 I have a terminal medical condition* I have reached preservation age and want to commence a non-commutable pension * To meet this condition of release, investors must satisfy all of the following: two registered medical practitioners have certified that the person suffers from an illness or has incurred an injury that is likely to result in death within a period (the certification period) no greater than 12 months; at least one of the registered medical practitioners must be a specialist practising in the area related to the illness or injury suffered by the person; and for each of these certifications, the certification period (12 months) has not ended.

2 3. Amount to transfer All of my super account (go to section 5) Partially transfer an amount of $,. from my super account (go to section 4) 4. Partial transfers If you are requesting a partial transfer from super to pension, you need to fill in the following component and investment details: A) Preservation component details Preserved $,. Restricted non preserved $,. Unrestricted non preserved $,. B) Tax Optimisation Apply first in first out (FIFO) to this transaction Apply high cost first out (HCFO) to this transaction Note: To amend your account default tax optimisation method please complete an Account Amendment form. HCFO is not available for transactions on Model Portfolios. If you do not elect a default tax optimisation method the default will be FIFO. C) Investment details Investment name(s) APIR/ASX Code Units and/or Amount ($ or %) (Minimum $500 per share) 5. Pension details This pension will be used for the Transition to Retirement Facility No Please select the payment level (Refer to the PDS, which explains the minimum annual pension payment limits) Min Max (TTR pension only) OR Annual payment required $, Annual payment escalation % or CPI Payment is gross of tax Please note: except for TTR accounts, the annual pension payment amount will be pro rated if your pension commences during the financial year.

3 6. Pension payment details I would like my pension to be paid: Monthly Quarterly Half-Yearly Yearly Starting from date / / My nominated bank details are: BSB number - Account name Account number Bank address Town or suburb State Postcode 7. Nomination of reversionary pensioner In the event of my death, I nominate my account-based pension to revert to: Name Gender Date of birth Male Female / / * A reversionary pensioner must be one of the following at date of your death: Relationship: Spouse De facto spouse Child less than age 18 Child 18 or over but: under age 25 financially dependent on you, or has a section 8 (1) disability as described in the PDS (Pension payments to a child can only be made to age 25 unless the child has a section 8(1) disability at the time of payments after age 25.) Not your child and Interdependency relationship dependant Dependant (including financial) Refer to the current PremiumChoice Retirement Service PDS for further details. Any valid reversionary pensioner nomination will override a binding death benefit nomination. Postal address Town or suburb State Postcode Phone number (BH) (AH or Mob)

4 8. Pension Commencement Fee options (Retirement Plan only) Refer to the PDS for a full explanation on the fee options. By completing the section below you are confirming: you have negotiated a Pension Commencement Fee with your financial adviser; for partial transfers, any existing Quarterly Service Fees will remain on your Superannuation account; and for full account transfers, any existing Quarterly Service Fees will be charged prior to the transfer to your Pension account. Adviser Initial Pension Commencement Remuneration (i) Upfront Pension Commencement Fee. % or $, (to a maximum of 4.29%) (ii) Deferred Pension Commencement Fee option 1* Deferred Pension Commencement Fee option 2* * Exit fees will apply under this option if you fully withdraw from the Pension Service within the first four years. 9. Tax deduction notice You may be eligible to claim a tax deduction if you are self employed or substantially self employed and you have made personal contributions to your PremiumChoice Superannuation account. If you intend to claim a tax deduction, you must complete and sign the declaration below before the transfer is effected. Investor account name Investor account number I understand that this is a notice advising the Trustee (NULIS Nominees (Australia) Limited) that I am an eligible person and able to claim a tax deduction in respect of my personal contributions. Financial Year: Last Financial Year Current Financial Year Total personal contributions: $,. $,. Personal contributions I am claiming as a tax deduction: $,. $,.

5 Declaration under section of the Income Tax Assessment Act 1997: I am lodging this notice before both of the following dates: the day that I lodged my income tax return for the 20 /20 financial year; and the end of the income year after the said financial year. At the time of completing this notice: I am still a member of the fund named in this Transfer to pension form; I intend to claim the personal contributions stated in this notice as a tax deduction; I have not yet commenced a superannuation income stream based in whole or part on these contributions; and the amount covered by this notice has not been included in a previous notice for the 20 /20 financial year. I understand that this notice cannot be revoked or withdrawn but may be varied by reducing the amount advised in this notice if: my claim has been disallowed and I am reducing the amount claimed as a deduction by the amount which has been disallowed. Member s signature 7 Member s address Suburb State Postcode Note: you are ineligible to claim a tax deduction once you are in the Pension Service. 10. Authorisation I have read and understood the current Product Disclosure Statement applicable to my investment; I authorise the tax file number for this application to be used with this account; I confirm the ongoing fee structure agreed with my financial adviser remains the same as my Superannuation Service. If I choose to change these fees, I will complete an Account Amendment form; and I acknowledge and accept that where I have agreed to provide my financial adviser with initial remuneration via the Pension Commencement Fee, this will be in addition to any Contribution Fees already deducted. Privacy - I understand that by completing this form, I am consenting to my personal information being used and disclosed as outlined in the Privacy Policy, which I can obtain by contacting PremiumChoice Client Services on or through investinfo.com.au/premiumchoice Signature of Investor/Authorised Representative 7 Date / /

6 11. Adviser d et ails Adviser name Contact name (if different) Contact phone number Adviser declaration customer identification documentation I have attached the appropriate customer identification documentation* No (this information has been provided previously or the investor was an existing customer with the Administrator prior to 12 December 2007) Financial adviser signature 7 Date / / * For details of the appropriate customer identification documentation please refer to our website investinfo.com.au/premiumchoice or call PremiumChoice Client Services on Trustee: NULIS Nominees (Australia) Limited ABN AFSL Administrator: Navigator Australia Limited ABN AFSL PremiumChoice Retirement Service ABN M1210

7 Section A: To be completed by the PAYEE 1 What is your tax file number (TFN)? See Privacy of information on page 4 of the Instructions. OR I have made a separate application/enquiry to the ATO for a new or existing TFN. OR I am claiming an exemption because I am under 18 years of age and do not earn enough to pay tax. Tax file number declaration This declaration is NOT an application for a tax file number. Use a black or blue pen and print clearly in BLOCK LETTERS. Print X in the appropriate boxes. Read all the Instructions before you complete this declaration. OR I am claiming an exemption because I am in receipt of a pension, benefit or allowance. 2 What is your name? Title: Mr Mrs Miss Ms Surname or family name 6 On what basis are you paid? (Select only one.) Full-time employment Part-time employment Labour hire Superannuation income stream 7 Are you an Australian resident for tax purposes? 8 Do you want to claim the tax-free threshold from this payer? Only claim the tax-free threshold from one payer. No ORIGINAL ATO copy Casual employment You must answer No at question 8. If you have more than one source of income and currently claim the tax-free threshold from another payer, do not claim it now. Answer No at questions 9 and 10 unless you are a non-resident No claiming a senior Australians, zone or overseas forces tax offset. First given name Other given names 3 If you have changed your name since you last dealt with the ATO, show your previous family name 9 Do you want to claim the senior Australians tax offset by reducing the amount withheld from payments made to you? Complete a Withholding declaration (NAT 3093), but only if you are claiming the tax-free threshold from this payer. If you have more than one payer, see page 3 of the Instructions. No 10 Do you want to claim a zone, overseas forces, dependent spouse or special tax offset by reducing the amount withheld from payments made to you? Complete a Withholding declaration (NAT 3093). No 4 What is your date of birth? 5 What is your home address in Australia? Day Month Year 11 (a) Do you have an accumulated Higher Education Loan Program (HELP) debt? Your payer will withhold additional amounts to cover any compulsory repayments. (b) Do you have an accumulated Financial Supplement debt? Your payer will withhold additional amounts to cover any compulsory repayments. No No Suburb or town State/territory Postcode DECLARATION by payee: I declare that the information I have given is true and correct. Signature Date Day Month Year You MUST SIGN here There are penalties for deliberately making a false or misleading statement. Once Section A is completed and signed, give it to your payer. Section B: To be completed by the PAYER (if you are not lodging online) 1 What is your Australian business number (ABN) or your withholding payer number? Branch number (if applicable) 4 What is your business address? S T K I L D A R D 2 If you don t have an ABN or withholding payer number, have you applied for one? See More information on page 4 No of the Instructions. 3 What is your registered business name or trading name (or your individual name if not in business)? N A V I G A T O R A U S T R A L I A L I M I T E D DECLARATION by payer: I declare that the information I have given is true and correct. Signature of payer Date Day There are penalties for deliberately making a false or misleading statement. NAT [JS 15580] Month Year Suburb or town M E L B O U R N E State/territory 5 Who is your contact person? Business phone number Postcode V I C C L I E N T S E R V I C E S If you no longer make payments to this payee, print X in this box Return the completed original ATO copy to: For WA, SA, NT, VIC or TAS For NSW, QLD or ACT Australian Taxation Office Australian Taxation Office PO Box 795 PO Box 9004 ALBURY NSW 2640 PENRITH NSW 2740 TAXPAYER-IN-CONFIDENCE (when completed) IMPORTANT See reverse side of PAYER s copy for: payer obligations lodging online.

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9 Tax file number declaration Section A: To be completed by the payee Question 1 What is your tax file number (TFN)? This question asks you to supply your TFN. Your payer and the ATO are authorised by the Taxation Administration Act 1953 to collect your TFN on this form. It is not an offence not to quote your TFN. However, your payer is required to withhold at the highest marginal rate plus Medicare levy (46.5% for the 2010/11 financial year) from all payments made to you if you do not: provide a Tax file number declaration (NAT 3092) to your payer quote your TFN, or claim an exemption from quoting your TFN. You will find your tax file number (TFN) on: your income tax notice of assessment correspondence sent to you by the ATO, or a payment summary issued by your payer. If you have a tax agent, they may also be able to tell you your TFN. If you still cannot find your TFN phone between 8.00am and 6.00pm, Monday to Friday. You will be asked for details only you, or your authorised representative would know. You may claim an exemption from supplying your TFN. Print X in the appropriate box if you: have lodged a TFN application or enquiry form for individuals or made a phone or counter enquiry to obtain your TFN. Your payer will withhold at the standard rate but, if they do not have your TFN after 28 days, they will withhold an amount at the top marginal rate of tax plus Medicare levy (46.5% for 2010/11 financial year) from future payments, or are claiming an exemption from quoting a TFN. You are exempt from quoting your TFN if you are: under 18 and do not earn enough to pay tax, or an applicant or recipient of certain pensions, benefits or allowances from: - Centrelink however you will need to quote your TFN if you receive Austudy, Newstart, sickness or parenting allowance - Department of Veterans Affairs a service pension under the Veterans Entitlement Act 1986, or - the Military Rehabilitation and Compensation Commission. For more information about the ATO s privacy and TFNs, see Privacy of information on the next page. Provision of your TFN to your superannuation fund Your payer must pass your TFN to the superannuation fund to which contributions are being made on your behalf. If your superannuation fund does not have your TFN, we can provide it to them. This enables: your superannuation fund to accept all types of contributions to your account(s) no increase to the tax on contributions to your superannuation account(s) no additional tax to be deducted when you start drawing down your superannuation benefits, other than the tax that may ordinarily apply, and ease in tracing different superannuation accounts in your name so that you receive all your superannuation when you retire. Under the Superannuation Industry (Supervision) Act 1993, your superannuation fund is authorised to collect your TFN, which will only be used for lawful purposes. These purposes may change in the future as a result of legislative change. The trustee of your superannuation fund may disclose your TFN to another superannuation provider, when your benefits are being transferred. You may request to the trustee of your superannuation fund, in writing, not to disclose your TFN to any other trustee. Questions 2, 3, 4 and 5 Fill in your personal information. Question 6 On what basis are you paid? Check with your payer if you are not sure of the basis of your payment. Question 7 Are you an Australian resident for tax purposes? Generally, the ATO considers you to be an Australian resident for tax purposes if you: have always lived in Australia or you have come to Australia and now live here permanently are an overseas student doing a course that takes more than six months to complete have been in Australia continuously for six months or more and for most of that time you worked in the one job and lived in the same place, or will be or have been in Australia for more than half of the financial year (unless your usual home is overseas and you do not intend to live in Australia). If you go overseas temporarily and do not set up a permanent home in another country, you may continue to be treated as an Australian resident for tax purposes. The criteria the ATO uses to determine your residency status are not the same as those used by the Department of Immigration and Citizenship or Centrelink. Non-resident tax rates are different A higher rate of tax applies to non-residents taxable income and non residents are not entitled to a tax-free threshold. It is against the law to claim the tax-free threshold and tax offsets if you are a non-resident of Australia for tax purposes. However, there is an exception with zone or overseas forces tax offsets, go to question 10 for more information. If you need help deciding whether you are an Australian resident for tax purposes, phone Answer NO to this question if you are not an Australian resident for tax purposes. You must also answer NO at questions 8, 9 and 10 (unless you are a non-resident claiming a senior Australians, zone or overseas forces tax offset). Question 8 Do you want to claim the tax-free threshold from this payer? The tax-free threshold is the amount of income you can earn each year that is not taxed (currently, the tax-free threshold applies to the first $6,000 of your annual income). It is available only to people who are Australian residents for tax purposes (that is, people who answered YES at question 7). Answer YES if you: are an Australian resident for tax purposes are not currently claiming the tax-free threshold from another payer, and want to claim the tax-free threshold. Change to withholding for low income If you answer YES your payer will reduce your withholding to allow a claim for 50% of the low income tax offset amount relevant to this level of regular earnings. Answer NO if you: answered NO to question 7 have claimed the tax-free threshold from another payer, or do not wish to claim the tax-free threshold.

10 Do you have more than one job or payer? You can claim the tax-free threshold from only one payer at a time. Generally you should claim it from the payer you expect to pay you the most income during the year. If you want to change the payer you are currently claiming the tax-free threshold from, you must also give them a Withholding declaration (NAT 3093) to advise them that you no longer want to claim the tax-free threshold from them. If you receive any taxable Centrelink payments or allowances such as Newstart, Austudy or Youth Allowance, you are probably already claiming the tax-free threshold with Centrelink. This means you cannot also claim it from another payer. If you expect to earn more than $16,500 from the job where you have claimed the tax-free threshold, you may end up with a tax debt at the end of the income year. To avoid having a debt, you should ask one or more of your payers to withhold additional amounts by completing a Withholding declaration upwards variation (NAT 5367). For more information on deciding whether you can claim the tax-free threshold, which payer you should claim it from or how to vary your withholding rate, phone Question 9 Do you want to claim the senior Australians tax offset by reducing the amount withheld from payments made to you? Claim benefits and tax offsets with only one payer It is against the law to reduce your withholdings, or claim the senior Australians tax offset, with more than one payer at the same time. If you receive income from more than one source, contact the ATO on between 8.00am and 6.00pm, Monday to Friday for advice prior to completing this question. Answer YES if you are eligible and choose to receive the senior Australians tax offset by reducing the amount withheld from payments made to you during the year. You need to complete a Withholding declaration (NAT 3093). Answer NO if you are: not eligible for the senior Australians tax offset, or eligible and want to claim your entitlement to the tax offset as a lump sum in your end-of-year income tax assessment. For more information on your eligibility to claim the tax offset or rebate income, phone Question 10 Do you want to claim a zone, overseas forces, dependent spouse or special tax offset by reducing the amount withheld from payments made to you? Claim tax offsets with only one payer It is against the law to claim tax offsets from more than one payer at the same time. Answer YES to this question if you are eligible and choose to receive the zone, overseas forces, dependent spouse (married or de facto) or special tax offsets (including those for a dependent parent, spouse s parent or invalid relative, housekeeper, or child-housekeeper) by reducing the amount withheld from payments made to you. You also need to complete a Withholding declaration (NAT 3093). Answer NO to this question if you are not eligible or choose to receive any of these tax offsets as an end-of-year lump sum through the tax system. Non-resident If you are not a resident of Australia for tax purposes, you are not entitled to claim a dependent spouse tax offset or a special tax offset. You may be entitled to claim the zone or overseas forces tax offset. For more information on your entitlement: visit phone between 8.00am and 6.00pm, Monday to Friday. Question 11 (a) Do you have an accumulated Higher Education Loan Programme (HELP) debt? Answer YES if you have an accumulated HELP debt. Answer NO if you do not have an accumulated HELP debt, or you have repaid all your HELP debt in full. You have a HELP debt if either: the Australian Government lends you money under HECS-HELP, FEE-HELP, OS-HELP, VET FEE-HELP you have a debt from the previous Higher Education Contribution Scheme (HECS). (b) Do you have an accumulated Financial Supplement debt? Answer YES if you have an accumulated Financial Supplement debt. Answer NO if you do not have an accumulated Financial Supplement debt, or you have repaid all your Financial Supplement debt in full. Have you repaid this debt? When you have repaid your accumulated HELP or Financial Supplement debt, you must complete a new Withholding declaration (NAT 3093). This publication was current to 1 July Privacy of information The ATO is authorised by the tax laws, including the Income Tax Assessment Act 1936 to ask for the information on this declaration. This information will help the ATO to administer those laws. Where the ATO is authorised by law to do so, it may give this information to other government agencies. These agencies could include Centrelink, the Australian Federal Police, the Child Support Agency, and the Departments of Families, Housing, Community Services and Indigenous Affairs, Veterans Affairs, and Education, Employment and Workplace Relations. Only certain people and organisations can ask for your TFN. These include employers, some Australian Government agencies including Child Support Agency, trustees for superannuation funds, payers under the PAYG system, higher education providers and investment bodies such as banks. The ATO is authorised by the Taxation Administration Act 1953 to collect your TFN. You are not required by law to provide your TFN. However, quoting your TFN reduces the risk of administrative errors and having extra tax withheld. If you need more information about how the tax laws protect your personal information, or have any concerns about how the ATO has handled your personal information, phone between 8.00am and 6.00pm, Monday to Friday. Please ensure that you have answered all the questions and have signed and dated the declaration. Give the completed form to your payer. Trustee: NULIS Nominees (Australia) Limited ABN , AFSL GPO Box 1610 Melbourne Victoria 3001 Telephone Facsimilie M1210