Change of Personal Details Form
Form 7
1
Title
Member’s old details
Family Name Vision Super Membership Number
Given Name/s
Date of Birth
Home Address
State
Postcode
2
Provide your new details
New address
State Contact Phone Number Mobile Number
Postcode
Email Address
Family Name
Given Name(s)
Important: For your change of name to be registered on our records you must:
•
Attach a certified copy of your Marriage Certificate, or other legal name change documents
3
Please change my beneficiaries to
Given Name(s) Nature of dependency (ie. Spouse ) % share
Family Name
% % % %
Please ensure total equals 100% TOTAL
4
Sign the declaration
Signature
I declare that the details given above are true and correct in every particular, and I authorise Vision Super to update its records accordingly. I understand Vision Super may retain a copy of any documentation accompanying this Form for its records This information is required for the sole purpose of managing and payment of superannuation benefits and entitlements and will be protected in accordance with the provisions of the Privacy Act 1988 and Vision Super privacy policies Date
IMPORTANT: PLEASE DO NOT SEND ORIGINAL DOCUMENTS TO VISION SUPER
Please forward this completed form to Vision Super, PO Box 18041, Collins Street East, Melbourne VIC 8003 September 08 Phone (03) 9911 3222 Regional 1300 300 820 Fax (03) 9911 3299 Website www.visionsuper.com.au
Vision Super Pty Ltd ABN 50 082 924 561 AFSL 225054 is the Trustee of the Local Authorities Superannuation Fund RSE L0000239
*BAD*
Change of Personal Details Information Sheet
Changing your name or date of birth If you are changing your name or date of birth please attach a certified copy of one of the following as applicable: • Marriage Certificate • Deed poll • Divorce Certificate • • • Birth Certificate Passport Drivers Licence
Please note: All documents need to display a clear link between past and present names. How to certify a copy of a document
Step 1 – Make a copy of the original document Step 2 – Take a copy and the original document to a person who is legally allowed to certify documents. These people include: • • • • • • • • • • • • • • • • • • • • A permanent employee of Australia Post with two or more years of continuous service An agent of Australia Post who is in charge of an officer supplying postal services to the public A finance company officer with two or more years of continuous service with one or more finance companies (for the purposes of the Statutory Declaration Regulations 1993) An officer with 2 or more continuous service with one or more financial institutions (for the purposes of the Statutory Declaration Regulations 1993) An officer with, or authorised representative of, a holder of an Australian Financial Services Licence (AFSL), having two or more years continuous service with one or more licensees A notary public officer (for the purposes of the Statutory Declaration regulations 1993) A police officer A registrar or deputy registrar of the court A Justice of the Peace A person enrolled on the roll of a State or Territory Supreme Court of Australia, as a legal practitioner An Australian consular officer or an Australian diplomatic officer (within the meaning of the Consular Fees Act 1955) A judge of a court A magistrate A Chief Executive Officer of a Commonwealth Court A member of the Institute of Chartered Accountants in Australia, CPA Australia or the National Institute of Accountants with two or more years of continuous membership A Medical Practitioner who is currently registered or licensed to practice, or A Pharmacist who is currently registered or licensed to practise.
Step 3 – Ask the person who’s certifying the document to do the following: Write on the copy ‘ I certify this to be a true copy of the original document as sighted by me’ Sign and print his or her name Provide contact details, qualification, professional registration/accreditation number (if applicable) and the date
NOTE – Preferred Beneficiaries
Death benefits from the Vision Super Defined Benefit plan, Additional Benefits Contracts and Deferred Benefit plan are paid to Member’s legal personal representative in all cases, whether or not Preferred Beneficiaries have been nominated. Death benefits from Vision Super Saver, Vision Personal Plan, Vision Partner Plan, Vision Allocated Pension, Vision Term Pension and Vision Growth Pension will be paid to, or applied the benefit of: • • Your dependants, and/or Your legal personal representatives The Trustee will determine in what proportions (if any) your benefits is paid. • • • Your spouse Your child(ren) Any other person who, at all time of your death, was wholly or partially dependant on you, or has a right to financial support from you
Please forward this completed form to Vision Super, PO Box 18041, Collins Street East, Melbourne VIC 8003 September 08 Phone (03) 9911 3222 Regional 1300 300 820 Fax (03) 9911 3299 Website www.visionsuper.com.au
Vision Super Pty Ltd ABN 50 082 924 561 AFSL 225054 is the Trustee of the Local Authorities Superannuation Fund RSE L0000239