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Paying off your surcharge debt

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					Electricity Industry Superannuation Scheme
Paying off your surcharge debt
The surcharge tax has been removed on
superannuation contributions made on
                                                  How do you arrange the                            If your AVC Account is insufficient to pay
                                                                                                    off your entire surcharge debt, you can
or after 1 July 2005. This means that you         transfer?                                         continue to make AVCs with a view to
can expect no new surcharge assessments           Should you wish to use your AVC Account           paying off the remainder of your surcharge
from the tax office (although it is possible      or a contribution to pay off your surcharge       debt at another time.
for the tax office to issue a late assessment     debt, please complete this form and return
or a surcharge re-assessment in relation to       it to the Scheme.                                 When will the transfer
contributions made before 1 July 2005).
                                                  You have the following options to pay off         occur?
The Electricity Industry Superannuation           your surcharge debt:                              You will need to return the form to the
Scheme allows you the opportunity to
                                                  1. Pay off your entire surcharge debt by          Scheme by 15th of the month and the
pay off your surcharge debt by way of
                                                     transferring the amount required from          transfer or payment will be processed
a contribution or a transfer from your
                                                     your AVC Balance (if your surcharge            effective the end of the month.
Additional Voluntary Contributions (AVC)
                                                     debt is less than your AVC Account);
Account.
                                                  2. Transfer the entire balance of your AVC        If you need help
How much is your                                     Account to your Surcharge Account (if          For assistance call the Scheme on
                                                     your surcharge debt is greater than the        1300 307 844.
current surcharge debt?                              AVC Account);
Your surcharge debt as at 30 June and your        3. Specify an amount to transfer from your
AVC Account balance as at 30 June are                AVC Account.
shown in your Annual Benefit Statement.
                                                  4. Enclose a cheque (payable to “Electricity
Please note these amounts change with
                                                     Industry Superannuation Scheme”) for
investment earnings.
                                                     the amount that you wish to pay off
                                                     your surcharge.


                                                                                      Please print in black or blue pen,
    Step 1 Complete your personal details                                             in uppercase, one character per box.
                                                                                                                               A   ✓




    Title Mr        Mrs        Ms        Miss       Other                  Date of birth            /            /
    Given names


    Surname


    Membership number


    Name of your employer




Issued by Electricity Industry Superannuation Board ABN 57 923 283 236 as Trustee for Electricity Industry Superannuation Scheme




20090616
                                                                                                 *ETSAC.L00991*
Step 2 Decide how much of your surcharge debt to be paid off from
       your AVC Account

     Option 1 – my surcharge debt is less than my AVC Account: I would like my entire surcharge debt to be paid off by
     transferring the amount required from my AVC Account. I understand that my AVC Account will be reduced by the amount
     of my surcharge debt;
or
     Option 2 – my surcharge debt is more than my AVC Account: I would like to transfer the entire balance of my AVC
     Account to my Surcharge Account. I understand that my AVC Account will be reduced to a zero balance;
or
     Option 3 – I would like          ,           .          to be transferred from my AVC Account to pay off some of my
     surcharge debt. I understand that my AVC Account will be reduced by the amount being transferred.
or
     Option 4 – I would like the attached cheque in the amount of            ,             .          to be credited against
     my surcharge debt. I understand that if the cheque is greater than the balance of my surcharge account, any excess credit
     amount will be added to my AVC account.




Step 3 Sign the form

By signing this form I understand that:
•	 The requested amount will be transferred from my AVC Account into my surcharge Account, or the attached cheque will be
   credited to my surcharge account;
•	 The transfer will be processed effective the end of the month if received by the Scheme by the 15th of the month.


Signature                                                      Date

 ✗                                                                      /          /

Send return your completed form to the Electricity Industry Superannuation Scheme,
GPO Box 4303,
Melbourne,
VIC 3001




                                                                                       *ETSAC.L00992*

				
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