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Application to split superannuation contributions

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					          Application to split superannuation contributions
    Notes to applicants
    You should use this form if you want to split your concessional (pre-tax) superannuation contributions (which includes salary sacrifice and
    employer contributions) with your spouse. Your spouse must have an active account with a superannuation fund (which may or may not
    be First State Super) to which the split contributions will be paid.

    What is superannuation contribution splitting?
    Each financial year, you can apply to the Trustee to make a single lump sum split of your previous year’s concessional contributions in
    favour of your spouse. You cannot split your non-concessional contributions.
    Generally, you may split up to the lesser of:
    ■   85% of your concessional contributions for a financial year; or
    ■   the concessional contributions cap for the financial year.
    Only one irrevocable application to split contributions can be made in a financial year. You can request that the split amount be sent to
    your spouse’s account in First State Super, or to another superannuation fund in which your spouse is a member. If the split is made to
    another fund, the standard withdrawal fee of $30 ($36 from 1 July 2009) is payable from your account.
    Spouse contribution splitting is not available for amounts rolled into First State Super or amounts previously transferred to your account
    under a spouse contribution splitting arrangement. Also, spouse contribution splitting is not available if your super is subject to a payment
    split or payment flag under a Family Law agreement or court order.
    Generally, you may not split contributions if your spouse:
    ■   is aged 65 or more, or
    ■   has retired at the time the application is made and is aged between his or her relevant preservation age and 65 years.
    If you wish to split your contributions with your spouse, you and your spouse should complete the relevant sections of this form. If your
    spouse is not already a member of a super fund, they can join First State Super by completing the application form in the back of the
    Personal Division Product Disclosure Statement (PDS). Copies of the PDS are also available from the website and Customer Service.

    Submitting your application
    Applications must be lodged between 1 July following the end of the financial year in which the contributions were made and the next
    30 June. However, if you elect to transfer your full benefit to another fund during a financial year, you may request to split contributions
    made during that financial year at the time of requesting the transfer.
    A withdrawal fee of $30 ($36 from 1 July 2009) will be applied if the split contribution is to be transferred to a superannuation fund other
    than First State Super. Any contributions split to a First State Super account will not be subject to any fee.
    Both you and your spouse will be notified in writing once your application to split contributions has been processed.

    Completing your application to split form
    Section A – Fund member (your) details
    You should complete this section as the member of First State Super who is applying to split superannuation contributions for the benefit
    of your spouse (the receiving spouse).
    Section B – Receiving spouse details
    This section is for your spouse’s details. Your spouse must have an active account with a superannuation fund to which the split
    contributions will be paid. Your spouse’s superannuation fund’s ABN/SFN and SPIN will help First State Super identify the correct
    superannuation fund and account to receive the split contributions. Your spouse can check these details with their superannuation fund,
    the Product Disclosure Statement or Member Statement.
    Section C – Contribution splitting details
    Only concessional contributions can be split to your spouse’s superannuation account. Record either the dollar amount or the
    percentage of eligible concessional contributions that you wish to split to your spouse’s superannuation account.
    Section D – Fund member request and declaration
    You should read and sign the declaration in Section D.
    Section E – Receiving spouse declaration
    Your spouse should read and sign the declaration in Section E.




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    If you need help with this form: Contact Customer Service between
    8:30 am and 5:30 pm AEST from Monday to Friday on 1300 650 873
FSS Trustee Corporation ABN 11 118 202 672 AFSL 293340 as the trustee of First State Super Scheme ABN 53 226 460 365            FSS 038 04/09   Page 1 of 4
    Proof of identity
    Proof of identity requirements
                                                                                  Foreign driver’s licence that contains a photograph of the
    In order to protect your benefit entitlement and to ensure your               person in whose name it was issued and the individual’s
    privacy is maintained, we require you to provide certified                    date of birth*
    documentation verifying your identity before your request can be
    processed. You can provide any of the following documents:                    Pension card issued by Centrelink
    Complete either Part A or Part B                                              Health card issued by Centrelink
    (Note: Part B should only be completed if you do not own a
                                                                            * Documents not written in English must be accompanied by an
    document from Part A)
                                                                            English translation prepared by an accredited translator.
    Part A – Acceptable primary ID documents
    Select ONE valid document from this section (please tick the
                                                                            Have you changed your name, or are you signing
    document you are providing):                                            on behalf of the applicant?
                                                                            If you have changed your name or are signing on behalf of the
           Current Australian State/Territory driver’s licence containing   applicant, you will need to provide one of the following certified
           a photograph of the person                                       documents:

           Australian Passport (a passport that has expired within the      ■   if you have changed your name – Marriage certificate, deed
           preceding two years is acceptable)                                   poll or change of name certificate from Births, Deaths and
                                                                                Marriages Registration Office
           Card issued under a State or Territory for the purpose of        ■   if you are signing on behalf of the applicant – Guardianship
           providing a person’s age containing a photograph of the              papers or Power of Attorney.
           person
                                                                            Certification of personal documents
           Foreign passport or similar travel document containing a
                                                                            The person who is authorised to certify documents must sight
           photograph and the signature of the person*
                                                                            the original and the copy and make sure both documents are
    OR                                                                      identical, then make sure all pages have been certified as true
                                                                            copies by writing or stamping “certified true copy” followed by
    Part B – Acceptable secondary ID documents                              their signature, printed name, qualification (eg. Justice of the
    Select ONE valid option from this section (please tick the              Peace, Australia Post employee, etc) and the date.
    document you are providing):
                                                                            The following people can certify copies of the originals as true and
           Australian birth certificate                                     correct copies:
                                                                            ■   a Justice of the Peace
           Australian citizenship certificate
                                                                            ■   a person enrolled on the roll of a State or Territory Supreme
           National identity card issued by a foreign government                Court of the High Court of Australia as a legal practitioner
           containing a photograph of the person in whose name the          ■   an Australian consular officer or an Australian diplomatic officer
           card was issued*
                                                                            ■   a judge of a court
    AND                                                                     ■   a magistrate
    ONE valid option from this section (please tick the document you        ■   a registrar or deputy registrar of a court
    are providing):
                                                                            ■   a Chief Executive Officer of a Commonwealth court
           A document issued by the Commonwealth or a State or
                                                                            ■   a permanent employee of Australia Post with five or more years
           Territory within the preceding 12 months that records the
                                                                                of continuous service
           provision of financial benefits to the individual and which
           contains the individual’s name and residential address           ■   a finance company officer with five or more years of continuous
                                                                                service (with one or more finance companies)
           A document issued by the Australian Taxation Office within       ■   an officer with, or authorised representative of, a holder of an
           the preceding 12 months that records a debt payable by the           Australian Financial Services Licence (AFSL), having five or
           individual to the Commonwealth (or by the Commonwealth               more years continuous service with one or more licensees
           to the individual) which contains the individual’s name and
           residential address                                              ■   a notary public officer
                                                                            ■   a police officer.
           A document issued by a 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 individual’s name and residential
           address)




    If you need help with this form: Contact Customer Service between
    8:30 am and 5:30 pm AEST from Monday to Friday on 1300 650 873
FSS 038 04/09   Page 2 of 4
Section A Fund member (your) details
Please print clearly in black ink.
Member number                                      Title (Mr Mrs Ms Miss Dr)   Male   Female     Birth date
                                                                                                  D      D    M M       Y    Y        Y     Y
Family name


Given name/s


Residential address


Suburb                                                                                           State                 Postcode


Postal address (if different from residential address)


Suburb                                                                                           State                 Postcode


Daytime contact telephone number                                                        Mobile number


Email address



Section B Receiving spouse details
Member number                                      Title (Mr Mrs Ms Miss Dr)   Male   Female     Birth date
                                                                                                  D      D    M M       Y    Y        Y     Y
Family name


Given name/s


Residential address


Suburb                                                                                           State                 Postcode


Postal address (if different from residential address)


Suburb                                                                                           State                 Postcode


Daytime contact telephone number                                                        Mobile number


Email address


Name of fund


Postal address


Suburb                                                                                           State                 Postcode


Fund Australian Business Number (ABN)                                                   Telephone number of fund administrator


Fund Superannuation Product Identification Number (SPIN)                                Fund Superannuation Fund Number (SFN)



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If you need help with this form: Contact Customer Service between
8:30 am and 5:30 pm AEST from Monday to Friday on 1300 650 873
                                                                                                                      FSS 038 04/09       Page 3 of 4
    Section C Amount to be split
    Financial year ending
     3     0        0      6    Y    Y     Y   Y
    Concessional contributions to be split:

    $                                (in whole dollars)   OR                % of my concessional contributions (up to a maximum of 85%)


    Section D Fund member request and declaration
    I request that you split the contributions recorded in Section C to the superannuation account of my spouse as recorded in Section B.
    I declare that the information provided on this form is correct.
    Title (Mr Mrs Ms Miss Dr)       Family name


    Given name/s


    Signature
                                    Date
                                                                                                         D     D     M M          Y    Y   Y       Y


    Section E Receiving spouse declaration
    I declare that at the date of this application, I am the spouse of the applicant and I am aged less than my preservation age OR between my
    preservation age and 65 years and have not retired from the workforce.
    Title (Mr Mrs Ms Miss Dr)       Family name


    Given name/s


    Signature
                                                                                                        Date
                                                                                                         D     D     M M          Y    Y   Y       Y




                Return the completed form to First State Super PO Box 1229 WOLLONGONG NSW 2500
                If you have any enquiries please call Customer Service on 1300 650 873 between 8:30 am and 5:30 pm
                AEST from Monday to Friday for the cost of a local call (unless calling from a mobile or pay phone).

                                                                                                                    Clear form          Print
    Privacy notice
    The information you provide in this form is collected by and held for First State Super by the fund administrator, Pillar Administration, in
    accordance with the National Privacy Principles of the Commonwealth Privacy Act. For further information about privacy, please phone
    Customer Service on 1300 650 873 or visit www.firststatesuper.com.au to view the Privacy Policy.




    If you need help with this form: Contact Customer Service between
    8:30 am and 5:30 pm AEST from Monday to Friday on 1300 650 873
FSS 038 04/09     Page 4 of 4

				
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Description: Application to split superannuation contributions