claim your retirement benefit Who can claim a retirement benefit? Additional requirements apply if you are invested in the Direct Investment option. Before you complete this form, please see the Exiting the Direct Investment option flyer at caresuper.com.au/ exitDIO for information on how to make a claim.

Complete all the required sections applicable to your claim. Please complete the form in blue or black pen and block letters.

Applies to members who: 1  Have reached preservation age and have permanently retired from the workforce OR 2 Have attained age 60 and since then ceased an employment arrangement OR 3  Are aged 65 or over. Temporary residents are not eligible to claim a retirement benefit. If you want to open a CareSuper Pension account, you do not need to complete this form. Please call us on 1300 664 781 and we’ll help you get started.

Section 1 – Your member details CareSuper member number

Date of birth (DD/MM/YYYY)

/ / Surname Title

Given names

Residential address State Postcode





Postal address (if different from residential address) State Postcode



Country

Telephone (home)



Telephone (mobile)

Email Name of last employer who contributed to CareSuper

Date you left your employer (DD/MM/YYYY) /

/

Section 2 – Circumstances of retirement Please indicate which circumstance applies to you.

Please tick (✔) one box only.

I have reached my preservation age (see page 5 for more information) and permanently retired from the

workforce

I have attained age 60 and ceased an employment arrangement

I am aged 65 or over.

See over > Page 1 of 6

CARE Super Pty Ltd (Trustee) ABN 91 006 670 060 AFSL 235226. CARE Super (Fund) ABN 98 172 275 725

CR/RTRMNT/CLM 734.4 07/17 06/16 ISS8 ISS7

Section 3 – Details of payment Before deciding how to have your super paid, we recommend speaking to a financial planner. Visit caresuper.com.au/advice or call the CareSuperLine on 1300 360 149 to be put in touch with a CareSuper Financial Planner. You can use this section to transfer between CareSuper accounts. If you are considering opening a CareSuper Pension account, you do not need to complete this form. Please download and read the Pension Guide PDS available from caresuper.com.au/PensionGuide and complete the application form in the Guide. Please indicate the amount, and where you would like your benefit paid. For partial payment, you must retain a minimum account balance of $1000.

Please indicate where you would like your benefit paid.

$

Lump sum payment (certified ID required) If you’re choosing this option, please go to sections 5 and 7 of this form.

$

Rollover to another super or pension account (if choosing this option, go to section 4 of this form)

Rollover to CareSuper Pension You will need a minimum of $10,000 to open a CareSuper Pension. You do not need to complete this form – please read the CareSuper Pension Guide and complete the application form in the Guide. Please note that an exit fee of $40 may apply to this transaction. Refer to the Member Guide PDS available at caresuper.com.au/PDS for more information.

Please complete this section to request a rollover of your CareSuper benefit to another account. Complete section A.

Section 4 – Details of new account If you have indicated in Section 3 that you would like all or part of your CareSuper balance paid to another superannuation or pension account, please complete section A, then section B or C.

A) Name of receiving fund

Member number in the receiving fund

Complete sections B or C.

B) If you are transferring your balance to another super fund or pension account outside CareSuper (other than an SMSF), please complete the following details:

Fund contact number





Australian Business Number (ABN) of receiving fund



Unique Superannuation Identifier of receiving fund

OR

C) If you are transferring your balance to a Self Managed Super Fund please complete the following SMSF bank* details:

SMSF account name SMSF BSB number SMSF account number



–





* Please provide a copy of your SMSF bank statement so we can verify that the details you have provided are correct. If we are unable to verify your SMSF bank details, we will be unable to process your transfer as an EFT payment. Certified ID must be provided with this form if you are transferring to an SMSF.

CARE Super Pty Ltd (Trustee) ABN 91 006 670 060 AFSL 235226. CARE Super (Fund) ABN 98 172 275 725

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CareSuper will only pay a lump sum withdrawal into an individual or joint bank account (which includes the member’s name). Payments cannot be paid to third party accounts (ie. companies).

Section 5 – Electronic funds transfer (EFT) details I would like my benefit payment to be paid to me electronically.

My nominated bank account details are as follows: Account name: Name of Bank or Financial Institution: Branch: BSB number:

Account number:

–

Please provide a copy of your bank statement so we can verify that the details you have provided are correct. The name and address on the statement must match the information we have on record for your account. If we are unable to verify your bank details, we will be unable to process your claim as an EFT payment. I confirm I have included a copy of my bank statement.

Section 6 – Investment option allocation Additional requirements apply if you are invested in the Direct Investment option. Please call the CareSuperLine on 1300 360 149 for more information.

Tick (✔) box only if you have selected a partial payment.

Deduct my payment from each investment option in proportion to the value of my total investment

options with CareSuper at the time of payment.

Deduct my payment from the following investment options in the proportions I have requested. Please

nominate the percentage (%) of the withdrawal you would like withdrawn from each option. Take care

that your proportions add up to 100%.

This section is optional. If no selection is made then the withdrawal is processed according to the first method.

Managed options

You must have funds invested in the selected investment option for your withdrawal to be processed.

Complete this section only if you wish to claim a tax deduction for personal contributions made during this financial year. Please tick (✔) box to acknowledge statements.

Asset Class options

Capital Guaranteed

%

Capital Secure

%

Capital Stable

%

Fixed Interest

%

Conservative Balanced

%

Direct Property

%

Balanced (default)

%

Australian Shares

%

Sustainable Balanced

%

Overseas Shares

%

Alternative Growth

%

Growth

%

Section 7 – Personal deductible contributions nomination Deduction for personal super contributions For the tax year ending 30 June

, I have contributed

to CareSuper and intend to claim a tax deduction of $ as nominated above.

,

$

,

.

.

for the financial year

I acknowledge the following statements:

1. I am an eligible person.*



2. Any amount not claimed is not tax deductible.



3. T  he amount claimed does not cover the whole, or any part included in a previous notice.



4. I cannot revoke or withdraw this notice.



5. I cannot give a notice to the Trustee of CareSuper after I have ceased to be a member of the Fund.



6. C  ontributions tax will apply to the amount I claim. In addition, the benefit may further be taxed upon claim prior to retirement.

* Please refer to ‘Definitions’ on page 5 of this form.

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CARE Super Pty Ltd (Trustee) ABN 91 006 670 060 AFSL 235226. CARE Super (Fund) ABN 98 172 275 725

CR/RTRMNT/CLM 734.4 07/17 ISS8

Please complete this section if you would like your TFN to be used for identification purposes, even if previously provided to the Fund.

Section 8 – Your tax file number (TFN) I advise that my tax file number is:



Providing your TFN to CareSuper is not compulsory and not supplying it is not an offence. However, if you don’t tell us your TFN: ●●

Your contributions to CareSuper via your employer will be taxed at the highest rate plus Medicare levy

●●

CareSuper may not be able to accept contributions for you

●●

You may pay more tax than you have to when you claim your superannuation benefits

●●

It may be more difficult for CareSuper to locate or consolidate all your superannuation benefits

●●

You will need to provide certified proof of identity documents with this form.

CareSuper is authorised to collect your TFN under the Superannuation Industry (Supervision) Act 1993. We will treat it as confidential and only use it for lawful purposes. This includes disclosing it to another superannuation fund when we’re arranging a transfer of funds for you. However, you may request in writing that your TFN not be disclosed to any other trustee. I understand the above statements and agree to provide my TFN.

Section 9 – Authorisation

Important Please read the important information about Proof of identity before signing this form.

I authorise CareSuper to process my benefit request in accordance with my instructions. Where the full balance of my account is to be paid from CareSuper, I authorise the termination of my membership and I release the Trustee from any further liability to me, my dependants or my Legal Personal Representative in respect of my membership in CareSuper. I confirm that I have read the information regarding tax file numbers and declare that the information supplied by me on this form is true and correct.

Proof of identity Under the Anti-Money Laundering and Counter Terrorism Financing Act 2006 superannuation funds are required to identify, monitor and mitigate the risk that the fund may be used for the laundering of money or the financing of terrorism. To meet these requirements CareSuper reserves the right to request further information to verify your proof of identity before making any cash payment.

Privacy I confirm that I have read CareSuper’s Privacy Policy at caresuper.com.au/privacypolicy. I understand how CareSuper intends to handle my personal information and acknowledge that my personal information will only be used for the purposes specified. I consent to the collection and use of my personal information by the Trustee to establish and administer my superannuation account. By providing my email and/or mobile, I agree that CareSuper can use my email and/or mobile to send me important information about my super electronically (including statements and notices of product and other changes to my account) via an email attachment or link to a website. If I wish to receive my statement by post rather than email, or want to change my communication preferences, I will call CareSuper or log in to MemberOnline.

I confirm that I am an Australian citizen, New Zealand citizen or permanent resident of Australia.

You must sign and date this form before returning it to CareSuper.

I authorise CareSuper to use or disclose any ID information provided to electronically match identity details against Government records or other identification sources. The identity match process may involve the use of the Australian Government’s Document Verification Service and our third-party identity match provider. Member’s signature Date (DD/MM/YYYY)



/

/

I have read and agree to the above Member declaration statements.

Return this completed form to: CareSuper Locked Bag 5087 Parramatta NSW 2124 For more information call the CareSuperLine

1300 360 149 CARE Super Pty Ltd (Trustee) ABN 91 006 670 060 AFSL 235226. CARE Super (Fund) ABN 98 172 275 725

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Important information Providing identification

Change of name – if applicable

For security reasons, you must provide certified copies of identification documents if you:

I have included a certified copy of one of these documents with this form:

●●

Are transferring funds to an SMSF

●●

Marriage certificate

●●

Are requesting a lump sum payment, or

●●

Decree Absolute*

●●

Deed poll/change of name documentation

●●

Want to rollover and prefer not to provide your TFN.

The identification must be current (i.e. valid and not expired) and the copy must have been certified in the last three months prior to being received by CareSuper. However, an Australian passport that has expired within the last two years can also be used for certification purposes. Please note that CareSuper does not accept documentation that has been certified by family members. I have included with my claim a certified copy of: A primary photographic identification document ●●

Driver’s licence

●●

Passport

OR A primary non-photographic identification document

* If divorced, we require a certified copy of a marriage certificate showing the change from maiden name. In addition, we also require a recent document showing that you’re now legally referred to by your maiden name.

Examples of such documents are: ●● Amended drivers licence ●● Bank statement ●● Statutory Declaration ●● Tax assessment notices in both the old and new names showing the same tax file number (proof that the ATO has recognised the name change).  For more information on certification of documents, see the Certifying your identification documents fact sheet available at caresuper.com.au/CertifyingID.

Payment instruction checklist

●●

Birth certificate

●●

Citizenship certificate

●●

Centrelink pension card

Attached my proof of identity

A secondary identification document

 Provided all relevant supporting documentation (where applicable)

and ●● ●●

●●

Centrelink payment letter Government or local council payment notice  (less than one year old) clearly showing your name and residential address



Confirmed my tax file number in Section 8 (or attached proof of identity)

Completed the residency statement.

Your name must be the same as shown on your proof of identity, or additional change of name documentation must also be provided.

Definitions Complying fund A superannuation fund which complies with the operating standards specified in SIS Legislation and is thereby eligible to receive concessional taxation treatment.

Eligible person – tax deductibility

Return this completed form to:

Personal deductible contributions Personal contributions for which you wish to claim a tax deduction. Once you nominate personal contributions as deductible contributions, contributions tax will be applied and they will be treated as concessional contributions.

Preservation age Your preservation age can be determined using the table below.

A person who is eligible to claim a tax deduction for personal superannuation contributions.

Date of birth

Preservation age

Minimum balance

After 30/6/1964

60

For partial payment, you must retain a minimum account balance of $1000 including interest and fees. If the non-preserved portion is less than $1000 then the entire non-preserved portion should be withdrawn.

After 30/6/1963 and before 1/7/1964

59

After 30/6/1962 and before 1/7/1963

58

After 30/6/1961 and before 1/7/1962

57

After 30/6/1960 and before 1/7/1961

56

Before 1/7/1960

55

CareSuper Locked Bag 5087 Parramatta NSW 2124 For more information call the CareSuperLine

1300 360 149 CARE Super Pty Ltd (Trustee) ABN 91 006 670 060 AFSL 235226. CARE Super (Fund) ABN 98 172 275 725

Page 5 of 6 CR/RTRMNT/CLM 734.4 07/17 ISS8

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CARE Super Pty Ltd (Trustee) ABN 91 006 670 060 AFSL 235226. CARE Super (Fund) ABN 98 172 275 725

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