AMP Flexible Super®
Product Disclosure Statement
Super account and Retirement account for personal (retail) members
Issued 1 July 2013
Contents
1.
About AMP Flexible Super
2.
How super works
3.
Benefits of investing with AMP Flexible Super
4.
Risks of super
5.
How we invest your money
6.
Fees and costs
7.
How super is taxed
8.
Insurance in your super
9.
How to open an account
10. Other information
This Product Disclosure Statement (PDS) is a summary of significant
information and contains a number of references to important
information in the Fact Sheets (all of which form part of this PDS).
You should consider that information before making a decision about
AMP Flexible Super.
Information in the PDS may change from time to time. We may
update information which is not materially adverse to you on
amp.com.au/pdsupdates. The information can also be obtained (at
no charge) by calling us on 131 267 or from your financial planner.
The information provided in this PDS is general information only
and does not take account of your personal financial situation or
needs. You should obtain financial advice tailored to your
personal circumstances.
1. A
bout AMP Flexible Super
AMP Flexible Super can help you save for your retirement, allow you to
receive an income in retirement, and provide you with
insurance options.
You can join at any time and choose your account type depending on
your age and financial priorities:
–– Super account.
–– Transition to Retirement strategy (you have both a Super account
and a Retirement account).
–– Retirement account.
® Registered trademark of AMP Limited ABN 49 079 354 519.
The members in AMP Flexible Super can include the “employee
members” who are nominated as members by their employer and
“personal members” including family members with whom an employee
member has an eligible Family relationship. Employee members should
read the AMP Flexible Super PDS for employers and employee members
available at amp.com.au/flexiblesuper/employer.
AMP Flexible Super is part of a superannuation fund known as the AMP
Retirement Trust (the fund). AMP Superannuation Limited is the trustee
of the fund and is referred to as “the trustee”, “we” or “our” in this PDS.
2. How super works
Super is a long-term investment and a tax-effective way of saving for
your retirement. In most cases, your employer is required to make super
contributions for you. You are usually able to choose which super fund
you would like your employer to make their compulsory employer
contributions to.
The government also encourages you to invest in super by providing a
range of tax savings on super contributions, investment earnings and
withdrawals from your super account after retirement.
Boosting your super savings
There are additional types of contributions that can be made to help
boost your super. These include:
–– Salary sacrifice contributions.
–– Additional personal contributions.
–– Government co-contributions.
–– Spouse contributions.
You may also help build up your super savings more quickly by:
–– Consolidating all your super accounts into one account.
–– Finding your lost super.
Important: Before consolidating, you need to consider how your
existing superannuation accounts compare to AMP Flexible Super,
and what effect consolidating will have on any insurance cover and
whether any exit fees apply. If you are unsure, speak with your
financial planner or contact AMP.
Limits on contributions
There are limits on the contributions that can be made into your Super
account, depending on your age, how many hours you are working and
other factors.
The government also has set dollar limits (or caps) on the amount of
contributions that can be made to your super each year before
additional tax becomes payable. See “How super is taxed” on page 6.
Accessing your super
No switching fees
Because super enjoys tax advantages, the law restricts when you
can access your super money. These restrictions are known as
“preservation rules”.
You can switch between investment options at any time through
My Portfolio, or by completing a form. There is no fee for switching.
Generally this means that you can only access your money after you
reach your preservation age (between ages 55 and 60, depending on
your date of birth) and retire (with some exceptions). In certain limited
circumstances, money can be accessed before you retire. Once you have
satisfied the “preservation rules”, you can make partial withdrawals
from your Super account, withdraw your Super account as a lump sum
or access your super in the form of an account-based pension from a
Retirement account (see “Benefits of investing with AMP Flexible
Super” below).
When you are ready to start a Retirement account, by law we can only
accept a single lump sum of super money. You can consolidate your
super accounts into an AMP Flexible Super account before using the
total balance to start a Retirement account.
Temporary residents of Australia: If you are a non-resident who has
permanently left Australia and not withdrawn your superannuation
benefit within six months of your temporary visa expiring, we may be
required to pay your benefit to the Australian Taxation Office (ATO), after
which you will need to apply to the ATO to claim your superannuation.
You should read the important information about boosting your
super savings, limits on contributions and accessing your super
before making a decision. Go to the Information on your account
Fact Sheet (“How it works”, “Super account” and “Retirement
account”) and How to transact Fact Sheet (“Transacting on your
account”, “Money in”, “Direct Debit servicing agreement”, “Pension
Refresh® Facility”, “Choosing your super fund” and “Money out”)
available at amp.com.au/flexiblesuper. The material relating to
boosting your super savings, limits on contributions and accessing
your super may change between the time you read this PDS and
the day when you acquire the product.
® Registered trademark of AMP Life Limited ABN 84 079 300 379.
3. B
enefits of investing with
AMP Flexible Super
AMP Flexible Super is a flexible super and retirement solution that you can
keep with you from your working life into retirement, without needing to
change from one product to another. AMP Flexible Super gives you
flexibility, with access to a range of features when the time is right for you.
Tailor your account to suit your needs
Flexibility puts you in control – you can add or remove options at your
convenience. You also have access to self-education tools and
other benefits.
Simple, transparent fees
You only pay for the features and services you have agreed to. There are
no establishment fees or fees on contributions or withdrawals1. For
large accounts, you may benefit from lower management fees, known
as “Management Fee Rebates”.
1 Except for former GIO members in the Retirement account.
Investment choice from leading Investment managers
AMP Flexible Super caters for a variety of investment styles, with three
different levels for you to choose from:
Simple choices
Core
Investments
2
Select
Investments
Sophisticated choices
Choice
Investments
Insurance options to look after you and your family
You have the option to protect yourself and the people closest to you by
adding a level of life insurance cover. Premiums are paid from your Super
account, making it a convenient and possibly more tax-effective option for
you. There are two alternatives:
Essential Protection
Basic cover with limited
medical history requirements
Flexible Protection
More comprehensive and
flexible cover with higher
levels available
Income from your Retirement account
Once you are able to access your super savings, you can transfer some or
all of it to a Retirement account.
The Retirement account is designed to pay you a regular income from your
super savings. And, you don’t have to be retired to start one – if you have
reached your preservation age and are still working, you can access your
super from a Retirement account using a Transition to Retirement strategy.
Minimum annual income payments
Retirement accounts are required by law to pay you a minimum income
amount each financial year based on your age and account balance on
1 July in that year (or starting account balance if you started your
Retirement account within that year).
There is no maximum annual income payment from the Retirement
account, unless you start one as part of a Transition to
Retirement strategy.
Choose who receives your super
AMP Flexible Super provides a number of options for you to choose
about how you want your Death benefit to be paid if you die while you
are a member of AMP Flexible Super. You can nominate one or more
beneficiaries permitted by the superannuation law to receive your
Death benefit.
Easy to deal with
AMP Flexible Super puts you in control of your super and your
retirement, with many innovative features to help you save costs and
cut paperwork:
–– Choose how to apply through a financial planner, online, by calling
Customer Service or by completing the paper forms.
–– Access educational programmes to assist you.
–– View and manage your account online through My Portfolio at
any time.
–– Bring your super together with our Super Consolidation Service (at
no additional cost to you).
–– Keep up to date with information about your super through member
statements, annual product updates and reports.
–– With a Transition to Retirement strategy, the Pension Refresh Facility
streamlines the process of consolidating your Super and
Retirement accounts.
You should read the important information about the benefits of
investing with AMP Flexible Super before making a decision.
Go to the Information on your account Fact Sheet (“Super account”,
“Retirement account”, “My Portfolio – online information about
your account” and “How we invest your money”) available at
amp.com.au/flexiblesuper. The material relating to the benefits of
investing with AMP Flexible Super may change between the time
you read this PDS and the day when you acquire the product.
4. Risks of super
5. How we invest your money
All investing involves some risk – it’s the trade-off for the returns we all
want to earn. The key risk with investing in super is “investment risk”,
but there are also other significant risks you need to consider.
Depending on which Investment Level you choose in AMP Flexible Super,
you can have a choice of over 75 investment options, including various
multi-sector options and single-sector options managed by leading
Australian and international fund managers. You can change your
Investment Level, or options, at any time. No fee is charged
for switching.
Investment risk
Investment risk means the value of your investment and your returns
are likely to vary. It also means you may lose part or all of your
investment. Your investment and investment returns are not
guaranteed. This means you may experience negative investment
returns, and future returns may differ from past returns. Usually, the
investments with higher potential returns in the long term tend to
also have higher risks in the short term.
Super funds invest in a range of asset classes – for example, cash, fixed
interest, shares, property and alternatives. Each of these asset classes has
a different level of risk. In AMP Flexible Super, there are different levels of
risk across the variety of investment options, depending on their strategy
and how much they are invested in the different asset classes.
Other risks
When investing in super, it is important to understand that:
–– You may not be able to access your super, including insurance
proceeds, because of “preservation rules”.
–– Laws and regulations (such as superannuation and taxation)
affecting super may change, which may adversely affect the amount
of your super and when you can access it.
–– We can change the rules of AMP Flexible Super at any time.
–– Investment options may also be closed or terminated, or investment
managers replaced.
–– Processing of transactions may be delayed in some circumstances,
for example, when an investment manager delays issuing unit prices
and therefore is delayed in processing our request.
–– Your investment rate of return can be equal to or lower than the rate
of inflation. This means there is a risk that the value of your super
can fall, in real terms.
–– Your employer may fail to make correct contributions to
your account.
–– The trustee may not be able to pay you the proceeds of an insurance
claim if prevented from doing so by superannuation law.
–– Switches or withdrawals may be delayed if we are unable to realise
sufficient assets to satisfy your payment due to circumstances
outside our control – for example, restricted or suspended trading in
the market for an asset.
–– When applying for insurance cover, if you don’t comply with your
duty of disclosure set out in the Insurance Fact Sheet, the Insurer
may not pay if you make an insurance claim, or it may only pay part
of your claim.
–– Your investment and future super savings (including contributions
and returns) may not be sufficient to provide an income for the rest
of your life.
–– Other risks may also occur and you should seek appropriate advice
before investing.
Core
Select
Choice
–– Choose
up to two
investment
options
–– Choose up to five
options from the
seven investment
options available, or
–– Choose the Super
Easy LifeStages
strategy.
–– Choose up to 15
options from over 75
investment options
available, or
–– Choose one of three
LifeStages strategies
(Super Easy, AMP or
Future Directions).
There are three types of multi-sector investment options:
1.Multi-sector (Traditional) investment options use a long-term asset
allocation approach with investments spread over various asset
classes to provide pre-selected portfolios considered appropriate
under the following risk profiles:
–– Conservative
–– Cautious
–– Moderately Conservative
–– Balanced
–– Moderately Aggressive
–– Aggressive.
2.Multi-sector (Secure) investment options typically invest in multiple
asset classes and may be protected from capital losses at specified
times. This is only available in the Retirement account.
3.Multi-sector (Specialist) investment options use a broad range asset
allocation approach and are not based on risk profiles. They will
typically invest in multiple asset classes, but may also be
concentrated on a few asset classes.
Single-sector investment options typically have their assets invested in
a single asset class (usually in addition to cash). You can use these
options to construct a portfolio to match your own investor profile:
–– Cash, Short-term Securities, and Deposits
–– Core Fixed Interest
–– Enhanced Fixed Interest
–– Credit and Fixed Interest Trading Strategies
–– Property
–– Alternative Strategies
–– Australian Equities
–– Global Equities
–– Small Capitalisation Equities
–– Specialist Equities.
The appropriate level of risk for you will depend on your age, investment
timeframes, where other parts of your wealth are invested, and how
comfortable you are with the possibility of losing some of your super in
some years. To further understand the risks of super and how they
relate to you, talk to your financial planner or go to the Information on
your account Fact Sheet and Investing and your options Fact Sheet
available at amp.com.au/flexiblesuper.
You should read the important information about risks of super before
making a decision. Go to the Information Investing and your options
Fact Sheet available at amp.com.au/flexiblesuper. The material
relating to risks of super may change between the time you read
this PDS and the day when you acquire the product.
3
With LifeStages, your investment mix will be set automatically by us,
and we will change your investment mix to a less risky investment
option as you move into a new age range. LifeStages is only available in
your Super account.
We will invest your money in AMP Flexible Super based on the
investment option(s) you select. When choosing your investment
option(s), you should consider factors such as the likely investment
return, the risks of investing and your investment timeframe. If you have
not selected an investment option, then you will be automatically
invested in the Core Investment Level, in Super Easy Balanced, a
multi-sector investment option, until you select another
investment option.
Before making a decision, go to the Investing and your options Fact
Sheet, Information on your account Fact Sheet (“How we invest
your money”) and How to transact Fact Sheet (“Changing your
investment options”) available at amp.com.au/flexiblesuper.
The material relating to how we invest your money and other
information about investing and investment options may change
between the time you read this PDS and the day when you acquire
the product.
6. Fees and costs
Super Easy Balanced investment option
Aim and strategy
Did you know?
To provide moderate to higher returns primarily from capital
growth with some income over the long term by investing across
the main asset classes, with higher exposure to growth assets.
Exposure to individual asset classes will be attained through the
use of index focussed investment managers.
Small differences in both investment performance and fees and
costs can have a substantial impact on your long-term returns.
For example, total annual fees and costs of 2% of your account
balance rather than 1% could reduce your final return by up to
20% over a 30-year period (for example, reduce it from $100,000
to $80,000).
This investment option seeks to provide an index focussed solution
to diversified investing. Through a process of diversified market
analysis combined with selection of the most appropriate
investment managers for each underlying asset class, this
investment is designed to provide market tracking returns over the
suggested investment timeframe.
(Index-style investment approach)
Asset class
Range (%)
International shares
15–35
Australian shares
20–40
0–20
Direct property
n/a
Listed property
0–15
Total Growth
70
Alternative assets (defensive)
60–80
n/a
International fixed interest
0–20
Australian fixed interest
0–20
Cash
0–20
Total Defensive
You should consider whether features such as superior investment
performance or the provision of better member services justify
higher fees and costs. You may be able to negotiate to pay lower
contribution fees and management costs where applicable. Ask
the fund or your financial planner.
To find out more
Benchmark (%)
Alternative assets (growth)
30
20–40
Type of investor this option is intended to be suitable for:
Investors seeking to achieve moderate to higher returns primarily
from capital growth with some income over the long term by
investing across all asset types, with higher exposure to growth
assets. Investors are willing to accept a medium level of volatility to
achieve these returns.
The Standard Risk Measure is a guide on the expected number of
negative annual returns over 20 years. It does not consider all forms
of investment risk and does not take into account administration
fees or tax. Members should be comfortable with the potential
losses of their chosen investment option(s). See the “Standard Risk
Measure” section in the Investing and your options Fact Sheet for
more information.
Suggested minimum investment timeframe: 5 to 7 years
Standard Risk Measure: 5/ Medium to high
4
You should read the important information about how we invest
your money.
If you would like to find out more, or see the impact of fees and
costs based on your own circumstances, the Australian Securities
and Investments Commission (ASIC) website (moneysmart.gov.au)
has a superannuation calculator to help you check out different
fee options.
The calculator on the ASIC website (moneysmart.gov.au) can be
used to calculate the effect of fees and costs on your super
account balance.
The table below indicates the fees and costs for the default Super Easy
Balanced investment option in the AMP Flexible Super – Super account.
The table can be used to compare the costs of different superannuation
products. These fees and costs may be paid directly from your account
or deducted from investment returns.
Type of fee or cost
Amount
Fees when your money moves in or out of the fund
Establishment fee
Nil
Contribution fee
Nil
Withdrawal fee
Nil(i)
Termination fee
Nil
Example of annual fees and costs for the Super Easy
Balanced investment option in the AMP Flexible
Super – Super account
Type of fee or cost
Management costs(iv)
The fees and costs Until 31 October 2013, a Management Fee of
for managing your 0.65%(ii) pa of your account balance.
investment
From 1 November 2013 the Management Fee will
increase to 0.69%(ii) pa of your account balance.
Plus a Member Fee, depending on the
Investment Level that you have chosen(iii).
The Member Fee as at 1 July 2013 is:
–– $1.60 per week (Core),
–– $2.14 per week (Select), or
–– $2.68 per week (Choice).
The Member Fee will increase on 1 July each year
in line with the Consumer Price Index (CPI).
Also, in the Choice Investment Level:
Less, where eligible, a Management Fee Rebate
applied to your account balance (for more
information on Management Fee Rebates please
refer to the table below)
PLUS, for some investment options, a
Performance Based Fee may be paid for any
calendar year.
(i) If you were a member of GIO and were transferred to another AMP
product, you may transfer your Special Exit Fee to the Retirement
account. If a Special Exit Fee applies to your current AMP product,
it will be shown on your last Member Statement.
(ii) Until 31 October 2013, the Management Fee – the amount you pay
for specific investment options will range from 0.50% to 3.05% pa
of the amount you invested in the investment option each year.
From 1 November 2013 the Management Fee will increase and
will range from 0.51% to 3.09% pa of the amount you invested in
the investment option each year. The Federal Government has
introduced Stronger Super, a program of changes designed to
streamline and strengthen Australia’s superannuation system.
The Management fee is increasing to help cover the costs
associated with implementation of these changes. This increase
will apply from 1 November 2013 and is expected to end by
1 November 2018.
(iii) If you do not choose an Investment Level, the default is the Core
Investment Level.
(iv) Additional fees may apply: You and your financial planner may
agree on a Member Advice Fee for financial planning services in
relation to AMP Flexible Super.
Management Fee Rebate
(applies to the Choice Investment Level only)
Total Relationship
Balance(i)
Rebate Rate (% pa)
– on the balance
invested in Super Easy
investment options
Rebate Rate (% pa)
– on the balance
invested in premium
investment options
Under $100,000
Nil
Nil
$100,000 – $199,999
Nil
0.30
$200,000 – $499,999
Nil
0.40
$500,000 – $999,999
Nil
0.55
$1,000,000 –
$2,999,999
0.10
0.70
$3,000,000 or more
0.20
0.85
This table gives an example of how the fees and costs in the Super Easy
Balanced investment option in the Core Investment Level, can affect
your account over a one year period. You should use this table to
compare this product with other superannuation products.
Example – Super Easy Balanced
(Core Investment Level)
Balance of $50,000 with
total contributions(i) of $5,000
during the year
Contribution fees
Nil
For every $5,000 put in, you
will be charged $0.
Plus
Management
costs
0.69% pa(ii),(iii)
+
$83.20 pa(ii),(iii)
($1.60 per
week)
And, for every $50,000 you will
have in the account you will be
charged $345(ii),(iii) each year,
plus $83.20(ii),(iii) in Member
Fees regardless of your balance.
Equals
Cost of
Account
If you put in $5,000 during a
year and your balance was
$50,000, then for that year you
will be charged fees of:
$428(iv)
What it costs you will depend
on the investment option
you choose and the fees you
negotiate with your fund or
financial planner.
(i) The contribution of $5,000 is assumed to be deposited to your Super
account at the end of the year. No additional contributions can be
made to Retirement accounts
(ii) The management fee of 0.69% for Super Easy Balanced used in this
example is effective from 1 November 2013. Until 31 October 2013
the management fee for Super Easy Balanced will be 0.65% pa. Until
31 October 2013 you will be charged $325 pa plus $83.20 in Member
Fees based on a $50,000 balance. If you put in $5,000 during a year
and your balance was $50,000, then for that year you will be charged
fees of $408.
(iii) The amount you actually pay for AMP Flexible Super – Super
accounts is reduced by 15% to allow for the tax deductions passed
on to you. Note, there are no tax deductions for AMP Flexible Super
– Retirement accounts. Taking into account the deductions, the
amount you pay for Super accounts is:
Until 31 October 2013
–– Core Investment Level – 0.55% pa + $70.72
($1.36 per week) = $347
–– Select Investment Level – 0.55% pa + $94.59
($1.82 per week) = $371
–– Choice Investment Level – 0.55% pa + $118.46
($2.28 per week) = $395
From 1 November 2013 the management fee will
increase as follows:
−− Core Investment Level – 0.59% pa + $70.72
($1.36 per week) = $364
−− Select Investment Level – 0.59% pa + $94.59
($1.82 per week) = $388
−− Choice Investment Level – 0.59% pa + $118.46
($2.28 per week) = $412
(iv) Additional fees may apply: Special Exit Fee – applies if you transfer
your Special Exit Fee from an AMP product to an AMP Flexible
Super – Retirement account.
(i) The rebate rate you qualify for depends on your “Total Relationship
Balance” and the investment options you have chosen. For details on
what is included in your “Total Relationship Balance” go to the Fees
and other costs Fact Sheet available at amp.com.au/flexiblesuper.
5
Fees paid to financial planners
Type of tax
Description
How the tax is paid
You may have to pay additional fees to a financial planner if you consult
one. You may agree with your financial planner to a Member Advice Fee
to be paid for financial planning services provided to you in relation to
AMP Flexible Super. This Member Advice Fee may be:
–– a one-off dollar amount paid as a lump sum, and/or
–– an ongoing Member Advice Fee, paid monthly, which is either:
–– a fixed dollar amount, or
–– a set percentage of your account balance.
When you
withdraw
money from
super under
age 60
If you are under 60,
withdraw your money
and don’t transfer
that money directly to
another super fund,
then generally you are
subject to lump sum
tax based on the “tax
components” of your
withdrawal benefit.
Tax is payable on
assessment of your
income tax return, but
we deduct an amount
from your withdrawal
benefit as prescribed
by law. The prescribed
amount deducted may
differ from the tax
payable on assessment.
When you
withdraw
money from
super and you
are age 60
or over
No tax is payable.
–
The Member Advice Fee may be capped in the Core Investment Level.
The Statement of Advice from your financial planner details any fees for
their financial planning services.
Changing the fees
We can introduce new fees or change existing fees at any time. We will
notify you at least 30 days before we introduce new fees or increase
existing fees (other than CPI increases to the Member Fee). Some fees
have a maximum that we can charge, but other fees do not. The
Member Fee increases in line with any increase in the CPI on 1 July each
year. We can also set restrictions on your agreed Member Advice Fee.
You should read the important information about
fees and other costs and the fees for each investment option
before making a decision. Go to the Fees and other costs Fact Sheet
and Investing and your options Fact Sheet (“The fees that apply to
your investment options”) and How to transact Fact Sheet
(“Changing your investment options”) available at amp.com.au/
flexiblesuper. The material relating to fees and other costs and the
fees for each investment option may change between the time you
read this PDS and the day when you acquire the product.
7. How super is taxed
As an incentive to save for your retirement, the super system offers
attractive tax benefits.
Super account
Generally your super may be taxed in the following situations:
Type of tax
Description
How the tax is paid
When
contributions
are made
Employer, salary
sacrifice and
personal member
contributions for which
a tax deduction is
claimed are taxed at
a rate of up to 15%,
which is known as
“contributions tax”(i).
Contributions tax is
paid by us to the ATO
quarterly. We will deduct
this tax from your
account quarterly (or
earlier when you close
your account).
A maximum of 15%
tax is applied to the
investment earnings of
your super.
This tax is deducted
before we declare
investment returns
(that is, unit prices and
crediting rates are net of
this tax).
On your
earnings while
your money is
invested
6
(i) The Federal Government has proposed that from 1 July 2012,
individuals with income and certain contributions for an income year
totalling $300,000 or more will be liable for an additional tax of 15%
on the lesser of the excess over $300,000 and the contributions. This
proposal has not yet been made law, but when enacted will apply
from 1 July 2012.
Collecting your Tax File Number (TFN)
When you join AMP Flexible Super, you should provide us with your TFN.
You are not required to provide your TFN but if you don’t:
–– Any employer contributions will have the “No-TFN tax” applied at the
rate of 31.5%. This is in addition to the contributions tax you have
already paid on those contributions. This “No-TFN tax” is calculated
and deducted at the earlier of 30 June each year and when you close
your account.
–– We may have to deduct higher tax than we would otherwise have to
on your superannuation lump sum withdrawals and the income
payments we make to you.
–– We cannot accept any personal contributions and certain other types
of contributions.
Tip: Check your statement to see if we have your TFN. If we don’t,
you should give it to us to avoid us deducting extra tax from
your account.
Excess contributions taxes
If you exceed the maximum amount of contributions (called “caps”) set
by the government in any financial year for a person your age, you may
be required to pay an excess contributions tax of up to 46.5% of the
excess. If this occurs, the Australian Taxation Office will issue you with a
Release Authority and you will need to pay the tax within 21 days. This
tax may, or in some circumstances must, be paid from your Super
account balance.
The government has announced a number of changes to contribution
caps and the excess contributions tax. These changes have not yet been
made law. You should refer to treasury.gov.au for further details.
Tip: Keep an eye on contributions to all your superannuation funds
to avoid exceeding the caps. We do not monitor super
contributions made to your account against the caps.
Retirement account
Insurance
feature
Essential
Protection
Flexible
Protection
Insurance
payable for
Total and
Permanent
Disablement
3 Total and Permanent
Disablement
(TPD) cover(ii)
3 TPD benefit(ii)
Entry age
range
16 – 55
16 – 60
(as at the next 1 July)
Age cover
ceases
65
99 (but a modified TPD
definition applies after
age 65)
Sum insured
$50,000 – $250,000 (in
$1,000 increments)
(must equal Death cover
sum insured)
$75,000 minimum(i)
$5 million maximum
Insurance
payable for
Temporary
Salary
Continuance
7
3 Temporary Salary
Continuance (TSC)
benefit(ii)
Entry age
range
–
16 – 59
(as at the next 1 July)
Age cover
ceases
–
65
(i) The government has proposed changes to tax investment
earnings on assets supporting income streams over $100,000 pa
at 15% pa. This proposal has not yet been made law. You should
refer to treasury.gov.au for further details.
Sum insured
–
$1,250 per month
minimum
Limitations may apply
for benefits in excess of
$30,000 per month
You should read the important information about how super is
taxed before making a decision. Go to the Information on your
account Fact Sheet (“Tax and social security”) available at
amp.com.au/flexiblesuper. The material relating to how super is
taxed may change between the time you read this PDS and the day
when you acquire the product.
How to apply
Complete the
Insurance section of
the AMP Flexible Super
application form. AMP
Life Limited will decide
if you are eligible for
Essential Protection
based on your answers
to those few questions.
Complete the
Insurance section
of the AMP Flexible
Super application form,
including the Personal
Statement for Flexible
Protection. AMP Life
Limited will assess
your application by
considering your medical
history, likely future good
health, lifestyle, family
history, occupation and
pastimes.
If you have a Retirement account, there may be some tax benefits that
apply to your income stream. These benefits include:
All members
No lump sum tax
on rollover
When you rollover your super benefit into
your Retirement account, no tax is payable
on your benefit.
No tax on investment
earnings
Investment returns on your Retirement
account are tax-free while kept in
your account(i).
If you are under age 60
Part of each regular
income payment may be
returned tax-free
While part of each regular income
payment is taxable in your hands, some
may be free of tax. This “tax-free amount”
generally represents part of the tax‑free
component of your account.
A 15% tax offset
may apply
You may also be eligible for a 15% tax
offset (rebate) on the taxable portion of
income payments. This offset generally
applies if you’re aged between your
preservation age and 60.
If you are age 60 or over
No tax on income or
lump sum payments
All your income payments and lump sum
withdrawals are tax‑free.
8. Insurance in your super
Taking out insurance cover through AMP Flexible Super can be a tax
effective way of protecting you and your family financially. Here is an
overview of your insurance options in AMP Flexible Super:
Insurance
feature
Essential
Protection
Flexible
Protection
Insurance
payable if
you die
3 Death cover
3 Extra Death Benefit
(EDB) cover
Entry age
range
16 – 55
16 – 74
(as at the next 1 July)
Age cover
ceases
65
99
Sum insured
$50,000 – $250,000
(in $1,000 increments)
$75,000 minimum(i)
no maximum
(i) If you select both the EDB and TPD benefit, at least one benefit
must meet the minimum sum insured requirement.
(ii) Occupation eligibility rules apply.
7
How much will it cost you?
The cost of insurance depends on a number of factors, including the
cover type and amount, your age, sex, occupation, smoking status and
additional options you may want to add. Each cover type has different
premiums payable. You can obtain a tailored premium quote from your
financial planner or by calling us on 1300 360 838. If we accept your
application for insurance, we will let you know what the insurance
premium will be. We deduct the insurance premiums monthly from your
Super account.
To calculate the premium for each part of your insurance, AMP Life
Limited uses a base premium rate which is dependent on your age,
gender, smoking status and other factors. The base premium rate is
then multiplied by the amount of insurance selected to give your
base premium.
Base Premium = Base Premium Rate x Amount of insurance
The base premium is then increased or decreased with additional
premium factors, for example relating to your occupation, the state of
your health, pastimes and any optional extras you have selected. For
Flexible Protection only, we also add a flat premium amount to
determine your insurance premium.
Insurance Premium = Base Premium x Premium Factors
+ Flat Premium (Flexible Protection only)
Please note: The following factors may affect your entitlement to
insurance cover, so further information should be read before deciding
whether the insurance is appropriate:
–– The level and type of insurance cover available,
–– The range of costs of insurance cover depending on
your circumstances,
–– Eligibility for and cancellation of insurance cover, and
–– Insurance conditions and exclusions.
You should read the important information about insurance in
your super before making a decision. Go to the Insurance Fact
Sheet available at amp.com.au/flexiblesuper. The material relating
to insurance in your super may change between the time you read
this PDS and the day when you acquire the product.
9. How to open an account
To open a Super account or Retirement account in AMP Flexible Super,
you must complete an application form. There are a number of ways you
can apply:
1. Contact your financial planner.
2. C
omplete an online application form – go to
amp.com.au/flexiblesuper.
3. Contact Customer Service on 131 267, or
4. C
omplete the forms booklet you receive with this PDS, and send your
completed application and other forms to AMP.
The amount we refund or transfer may be less than the
amount invested.
We will refund an amount to you (if you are entitled to access your
super) or transfer an amount to a complying fund you nominate in
writing within one month of you telling us you have changed your mind.
Enquiries and complaints process
All aspects of AMP Flexible Super are governed by the fund’s trust deed
and insurance policies held by us, including in the event of a dispute.
You can find out additional information about your AMP Flexible Super
account, and request a copy of this PDS and any additional information
that has been referred to in this PDS, from your financial planner or AMP
Customer Service.
If you are unhappy about any aspect of your account or our service,
please contact AMP Customer Service:
Web enquiry
Phone
Mail
Fax
Internet
My Portfolio
amp.com.au/enquiry
131 267
Customer Service
AMP Life Limited
PO Box 300
PARRAMATTA NSW 2124
1300 301 267
amp.com.au/flexiblesuper
amp.com.au/myportfolio
You should read the important information about the cooling-off
period and enquiries and complaints process before making a
decision. Go to the Information on your account Fact Sheet
(“Other information on your account”) available at amp.com.au/
flexiblesuper. The material relating to the cooling-off period and
enquiries and complaints process may change between the time
you read this PDS and the day when you acquire the product.
10. Other information
You should read the important information about Tax File Numbers,
privacy, (including our collection of your personal information to
establish and manage your AMP Flexible Super account and for related
purposes such as providing you with information about other AMP
financial services), anti-money laundering and counter-terrorism
requirements, when we may transfer your superannuation without your
consent, Death benefit nominations and information about AMP Bank
Limited and other AMP companies involved in this product. Before
making a decision, go to the Information on your account Fact Sheet
(“Your beneficiaries”, “Legal arrangements”, “The relationship between
the trustee and other service providers”, “AMP and your privacy”,
“Identification requirements” and “Collection of Tax File Numbers”)
available at amp.com.au/flexiblesuper. The material relating to these
subjects may change between the time when you read this PDS and the
day when you acquire the product.
Cooling-off period
It is important to us that your AMP Flexible Super account meets your
needs, but if you change your mind about investing in this product, you
can exercise your “cooling-off” rights by contacting us. If you exercise
any right in relation to your account, you do not have these
cooling-off rights.
8 Issued by AMP Superannuation Limited ABN 31 008 414 104, AFSL No. 233060, the trustee of the AMP Retirement Trust ABN 73 310 248 809.
NS7497 07/13B
There is a limited time to do this, which is within 14 days of the
earlier of:
–– the date you receive our Welcome Letter, or
–– five business days after the date shown on our Welcome Letter.
AMP Flexible Super‰
Product Disclosure Statement and Application
form for Personal (retail) members
® Registered trademark of AMP Limited ABN 49 079 354 519.
Start your AMP Flexible Super‰ account
Before completing this form, you must read the latest
Product Disclosure Statement (PDS) enclosed at the back
of this booklet. Additional important information on this
product is contained in the Fact Sheets and (if applicable)
PDS updates, located on amp.com.au.
1. Begin by reading
How do I complete this forms booklet?
on the following page
If you have any queries, contact your financial planner or
phone Customer Service on 131 267.
Issued by AMP Superannuation Limited ABN 31 008 414 104, AFSL No. 233060, RSE Licence No. L0000550,
the trustee of the AMP Retirement Trust ABN 73 310 248 809, RSE Registration No. R1075274.
® Registered trademark of AMP Limited ABN 49 079 354 519.
1 of 2
How do I complete this forms booklet?
Setting up your account is easy, as AMP Flexible Super is a comprehensive
Super and Retirement solution. Not all of this forms booklet will need to
be completed.
The checklist below highlights the mandatory sections that everyone
needs to complete. It also helps you identify the sections that are relevant
to your situation and lets you know where to find those sections within
this application form.
Remember to
–– Go through the checklist below to confirm you’ve completed what
you need to.
–– Sign all the relevant signature boxes.
–– Return the whole booklet to your financial planner or mail to:
Customer Service, AMP Life Limited, PO Box 300, PARRAMATTA
NSW 2124.
Checklist
1. Account Type and Personal Details (page A1) – Mandatory
Start here
Fill in the forms.
Start at the Application form on
the opposite page, then follow the
prompts at the end of each section.
2. Super Account Set up (page A3)
3. Retirement Account Set up (page A10)
4. Contributions (page A18)
5. Consolidation (page A21)
6. Beneficiary Nomination (page A24) – Mandatory
7.Optional Personal Insurance (page A26) – Available with a
Super account only
8.Optional Flexible Bonus (page A27) – Available with the
Choice Investment Level only
9. Member Advice Fee (page A28) – Planner customers only
10.Ensure you have signed in all relevant signature boxes under
Agreement and Declarations (page A29) – Mandatory
11.Certified copy of your identification documents.
Identification Procedure for Retirement account only
It is a legislative requirement that proof of your identity is provided when you apply for a Retirement account.
An original or certified copy of one of the following documents must be provided:
–– Current Australian Driver’s Licence containing your photograph.
–– Australian Passport that is current or expired within the preceding two years.
–– Card issued under a State or Territory law, for the purpose of providing a person’s age, containing a photograph
of the person in whose name the card is issued.
–– Foreign government issued passport (or similar international travel document) that contains your photograph
and signature.
If you are sending proof of your identity, please send certified copies only. Do not send originals.
If you are unable to provide one of these documents, please contact your financial planner or Customer Service for further
information on other documentation you may provide to verify your identity.
Note: Documents written in a language that is not English must be accompanied by an English translation prepared by an
accredited translator.
Information on what is a certified copy can be found on page A28.
2 of 2
NS7500 07/13B
Where an agent has been appointed, the agent’s proof of authority to act on behalf of the customer (such as a Power of
Attorney) must also be provided.
AMP Flexible Super
AMP Flexible Super‰ application form
If you have any queries, contact your financial planner or
phone Customer Service on 131 267. Before completing
this form, you must read the latest Product Disclosure
Statement (and Fact Sheets) for AMP Flexible Super.
Please print in CAPITAL LETTERS and place a cross ✗
in any applicable boxes.
Office/Planner use only
Financial planner number Request ID
Plan number
1. Your account type
What account would you like to set up?
AMP Flexible Super – Super
account. Please begin with the
Personal Details section below,
and also complete Your Super
starting on page A3.
With Essential Protection
(you must also complete
page A26 of this form), or
With Flexible Protection
(you must also check page
A26 of this form, and
complete the Application
for insurance – Flexible
Protection form from page
D1), or
AMP Flexible Super –
Super account + AMP Flexible
Super – Retirement account.
If you would like to set up a
Transition to Retirement strategy
(AMP Flexible Super – Super and
Retirement accounts), please begin
with the Personal Details section
below, and also complete Your Super
starting on page A3 and Your
Retirement starting on page A10.
AMP Flexible Super – Retirement
account (including
Consolidation).2
Please begin with the Personal
Details section below, and also Your
Retirement starting on page A10.
Do you have an existing AMP
Flexible Super – Super Account
to link?1
No
Yes – Please provide
account number.
Without insurance.
Do you have an existing AMP
Flexible Super – Retirement account
to link?1
No
Yes – Please provide
account number.
1 For existing AMP Flexible Super (AFS) customers.
By linking your Super and Retirement accounts, you’ll receive one statement, pay one member fee, and your account balances across
linked accounts may be used to determine eligibility for a rebate.
Note: You cannot link AMP Flexible Super accounts with a Flexible Lifetime – Super or Flexible Lifetime – Allocated Pension for the
above purpose.
2In addition to setting up a retirement or Transition to Retirement account, this may also be used by a beneficiary dependant to invest
a Death benefit in a Beneficiary Retirement account in the AMP Retirement Trust.
Issued by AMP Superannuation Limited ABN 31 008 414 104, AFSL No. 233060, RSE Licence No. L0000550,
the trustee of the AMP Retirement Trust, ABN 73 310 248 809, RSE Registration No. R1075274.
® Registered trademark of AMP Limited ABN 49 079 354 519.
A1 of 32
2. Personal details
Your details
Correspondence address (continued)
Title
Country
Surname
Home phone
Fax number
( )
Given name(s)
Date of birth1
D D MM Y Y Y Y
Mobile number
Sex
Male Female
Communication Preference
Would you like to receive communications, including your
Annual Statement, electronically?
TFN (Tax File Number)
Yes No
See information on the collection of Tax File Numbers in the
Fact Sheet: Information on your account.
Please note that certain communications are required to be
sent by post, eg Welcome pack.
Occupation
Your email address
Industry
Provide a username for your My Portfolio account, if you do
not already have a username
Country of residence
AMP’s My Portfolio is a web facility that allows you to manage
your AMP accounts online, 24 hours a day, 7 days a week.
Country of Citizenship
1If you are applying for a AMP Flexible Super – Super account and are
between 13 and 17 years old, or under 18 years old and applying for a
Beneficiary Retirement account, you must complete the Under 18
Declaration form available from amp.com.au, or phone us for a form.
Residential address (must not be a PO box)
Address
Suburb
Family Membership – Link to an AMP Flexible Super
(employee) account
Family Membership allows you to apply to link your account to a
current employee member of an AMP Flexible Super Employersponsored plan. This link will enable your AMP Flexible Super
account balance to be counted with the Employer plan for the
purpose of determining a management fee rebate.
Family member’s account number
State
Postcode
Provide Family member’s personal details below:
Title
Country
Surname
Contact phone number
Mobile number
Given name(s)
( )
Correspondence address
Date of birth
Same as residential. If your correspondence address is the
same as your residential address, you do not need to
provide your details again.
Male Female
Type of Family member
Please indicate your relationship to the Employee member.
Please cross ✗ one box only.
Address
Suburb
D D MM Y Y Y Y
Sex
State
Postcode
Spouse
Sibling (brother/sister)
Grandparent
Father/Mother-in-law
Son/Daughter-in-law
Brother/Sister-in-law
Parent
Child
Grandchild
Interdependency relationship
(refer to the AMP Flexible
Super PDS for definition)
A2 of 32
AMP Flexible Super
Continue on this page if you’d like to:
–– start a Super account, or
–– have life insurance as part of your Super account, or
–– choose a ready-made package of super and insurance, or
–– start a Super account as part of your Transition to Retirement accounts.
Continue to Your Retirement on page A10 if you’d like to:
–– start a Retirement account, or
–– start a Beneficiary Retirement account.
Your Super
3. Super account set up
Your AMP Flexible Super – Super account offers three Investment Levels, with a different Member Fee for each level.
Choose one of the options below:
For Core Investments
For Select Investments
For Choice Investments
– complete the Core Investments section below.
– complete the Select Investments section overleaf.
– complete the Choice Investments section overleaf.
For more information on these Investment Levels, refer to the Fact Sheet: Investing and your options.
Refer to the PDS for information on Investment Levels, including fees.
4. Investment Choices (Choose either Core Investments Level or Select Investments Level or Choice Investments Level)
Core Investments
Default option: I choose to have 100% of my superannuation invested in Super Easy
Balanced. > Skip to page A9
wn Mix option: I choose to have my superannuation invested across the investment
O
options as indicated by the percentages below:
I want my account
balance to be:
Total must add
up to 100%
I want my future
contributions to go to:
Total must add
up to 100%
Investment option
Option
Code
Super Easy Balanced
EBEI
%
%
Super Easy Cash
ESC
%
%
Or
A3 of 32
Select Investments
You can invest in a maximum
of 5 of the 7 different options
available below.
Default option: I choose to have 100% of my superannuation invested in Super Easy
Balanced. > Skip to page A9
Super Easy LifeStages option: I choose to have 100% of my superannuation invested in
an investment approach that provides simplicity through a single investment choice.
> Skip to page A9
wn Mix option: I choose to have my superannuation invested across the investment
O
options as indicated in the percentages below:
Note: Fee deductions are applied proportionally across your investment options, unless you
choose to have these debited from a single investment option. This option is available in
the Select and Choice Investment Level only.
I want my
account
balance to be:
Total must add
up to 100%
I want my
future
contributions
to go to:
Total must add
up to 100%
Investment option
Option
Code
Super Easy Balanced
EBEI
%
%
Super Easy Cash
ESC
%
%
Super Easy Conservative
ECEI
%
%
Super Easy Cautious
ECAU
%
%
uper Easy Moderately
S
Conservative
EMCO
%
%
Super Easy Growth
EBEG
%
%
Super Easy High Growth
EHG
%
%
Optional:
Fee
deduction
(tick one)
Auto-rebalancing for your Super account
Auto rebalancing allows you to automatically reset the percentage amounts within your investment options back to your
nominated investment profile percentages.
This facility works by switching units between investment options to realign your investment back to your nominated
investment profile.
Would you like to have your investments automatically rebalanced to the account balance percentages
outlined in the table above?
If “Yes” – please select the frequency for auto-rebalancing:
Quarterly Yes Half-yearly No
Yearly
If “Yes” – note that all future contributions, switches or withdrawals need to match your account balance percentages.
If you provide different percentages for future contributions, you will not be eligible for auto-rebalancing.
A4 of 32
AMP Flexible Super
Choice Investments
You can invest in a maximum
of 15 of the different options
available below.
Default option: I choose to have 100% of my superannuation invested in Super Easy
Balanced. > Skip to page A9
uper Easy LifeStages option: I choose to have 100% of my superannuation invested
S
in an investment approach that provides simplicity through a single investment choice.
> Skip to page A9
MP LifeStages option: I choose to have 100% of my superannuation invested
A
in an AMP directed strategy that provides a blend of investment managers with
complementary styles. > Skip to page A9
uture Directions LifeStages option: I choose to have 100% of my superannuation
F
invested in a multi-manager investment approach through a single investment choice.
> Skip to page A9
wn Mix option: I choose to have my superannuation invested across the investment
O
options as indicated in the percentages below:
Note: Fee deduction and rebates are applied proportionally across your investment
options, unless you choose to have these debited from or credited to a single investment
option. This option is available in the Select and Choice Investment Level only.
Investment option
Option
Code
I want my
account balance
to be:
Total must add
up to 100%
I want my future
contributions to
go to:
Total must add
up to 100%
Aberdeen Emerging
Opportunities
EAEO
%
%
AHL Alpha
EMAA
%
%
AMP All Growth
EADS
%
%
AMP Australian Bond
EAAB
%
%
AMP Australian Share
EAAS
%
%
AMP Balanced Growth
EABG
%
%
AMP Capital Asian Equity
Growth
EAAJ
%
%
AMP Capital Australian
Equity Concentrated
ECEC
%
%
AMP Capital Australian
Equity Opportunities
ECAO
%
%
AMP Capital Corporate
Bond
EACO
%
%
AMP Capital Global
Infrastructure Securities
(Hedged)
EAGI
%
%
AMP Capital Global
Property Securities
ECGP
%
%
AMP Capital Multi-Asset
EAMA
%
%
AMP Conservative
ECON
%
%
AMP Equity
EAE
%
%
AMP High Growth
EAHG
%
%
AMP Listed Property Trusts
ELPT
%
%
Optional:
Fee
deduction
and rebates
(tick one)
A5 of 32
Choice Investments
continued
I want my
account balance
to be:
Total must add
up to 100%
I want my future
contributions to
go to:
Total must add
up to 100%
Investment option
Option
Code
AMP Moderate Growth
EAMG
%
%
Arnhem Australian Equity
EFAE
%
%
Arrowstreet Global Equity
EAGE
%
%
Bennelong Australian
Equities
EIAS
%
%
BlackRock Australian Equity
EBAR
Absolute Return
%
%
BlackRock Global Allocation EGLA
%
%
BlackRock Global Bond
ESIF
%
%
BlackRock Scientific Hedged
EHIS
International Share
%
%
BlackRock Scientific
International Share
EAIS
%
%
BT Australian Share
ETAS
%
%
BT Global Property
Securities
EPLP
%
%
Fidelity Global Equities
EFGE
%
%
Franklin Templeton
Multi-Sector Bond
EFMB
%
%
Future Directions Asian
Share
EFAA
%
%
Future Directions
Australian Bond
EFDA
%
%
Future Directions
Australian Share
EFAS
%
%
Future Directions
EFDS
Australian Small Companies
%
%
Future Directions Balanced
EAFD
%
%
Future Directions
Conservative
EFDC
%
%
Future Directions Emerging
EFDE
Markets
%
%
Future Directions Extended
EFDX
Markets International Share
%
%
Future Directions Geared
Australian Share
EAFS
%
%
Future Directions Growth
EFDG
%
%
Future Directions Hedged
International Share
EFHI
%
%
Future Directions High
Growth
EFDH
%
%
Future Directions
International Bond
EFDI
%
%
Optional:
Fee
deduction
and rebates
(tick one)
A6 of 32
AMP Flexible Super
Choice Investments
continued
Investment option
Option
Code
I want my
account balance
to be:
Total must add
up to 100%
I want my future
contributions to
go to:
Total must add
up to 100%
Future Directions
International Share
EFIS
%
%
Future Directions
Moderately Conservative
EFDM
%
%
Future Directions Property
EFDP
%
%
GMO International Share
EMIS
%
%
Hyperion Australian
Growth Companies
EAGC
%
%
ipac Income Generator
EIIG
%
%
K2 Australian Absolute
Return
EAEL
%
%
Kapstream Absolute Return
EKAR
Income
%
%
Lazard Global Small Cap
EGSC
%
%
Lazard Global Thematic
EGGO
%
%
Legg Mason Australian Real
EMAI
Income
%
%
Macquarie Income
Opportunities
EMIO
%
%
Macquarie International
Infrastructure Securities
EMII
%
%
Magellan Global
EMGF
%
%
Perennial Value Australian
Share
EPVS
%
%
Perennial Value Shares For
Income
ERSI
%
%
Perpetual Industrial Share
EPI
%
%
PIMCO Australian Focus
EPAF
%
%
PIMCO Diversified Fixed
Interest
EDFI
%
%
Platinum International
EPTI
%
%
Plato Australian Share
Income
EPAI
%
%
RARE Infrastructure Value
ERIV
%
%
Resolution Capital Core
Plus Property Securities
EHLP
%
%
Responsible Investment
Leaders Australian Share
EILA
%
%
Responsible Investment
Leaders Balanced
ESFB
%
%
Responsible Investment
Leaders Conservative
EILC
%
%
Optional:
Fee
deduction
and rebates
(tick one)
A7 of 32
Choice Investments
continued
Investment option
Responsible Investment
Leaders Growth
Option
Code
I want my
account balance
to be:
Total must add
up to 100%
I want my future
contributions to
go to:
Total must add
up to 100%
EILG
%
%
Responsible Investment
ERIS
Leaders International Share
%
%
Schroder Australian
Equities
ESAS
%
%
Schroder Fixed Income
ESFI
%
%
Schroder Global Active
Value
EGEV
%
%
Schroder Real Return
ESRR
%
%
Super Easy Alternative
ESEA
%
%
Super Easy Australian Fixed
EAFI
Interest
%
%
Super Easy Australian Share EASE
%
%
Super Easy Balanced
EBEI
%
%
Super Easy Cash
ESC
%
%
Super Easy Cautious
ECAU
%
%
Super Easy Conservative
ECEI
%
%
Super Easy Growth
EBEG
%
%
Super Easy High Growth
EHG
%
%
Super Easy International
Fixed Interest
EIFI
%
%
Super Easy International
Share
EISE
%
%
Super Easy Moderately
Conservative
EMCO
%
%
Super Easy Property
ESEP
%
%
T. Rowe Price Asia ex-Japan
EAEJ
%
%
T. Rowe Price Global Equity
ETPE
%
%
Templeton Global Equity
ETIS
%
%
Tyndall Australian Share
Value
EBAE
%
%
UBS Australian Small
Companies
EASC
%
%
Walter Scott Global Equity
EIEG
%
%
Optional:
Fee
deduction
and rebates
(tick one)
Term Deposits are available, see amp.com.au for information.
A8 of 32
AMP Flexible Super
Auto-rebalancing for your Super account
Auto rebalancing allows you to automatically reset the percentage amounts within your investment options back to your
nominated investment profile percentages. Auto rebalancing does not apply if you are invested in a Term Deposit.
This facility works by switching units between investment options to realign your investment back to your nominated
investment profile.
Would you like to have your investments automatically rebalanced to the account balance percentages
outlined in the table above?
If “Yes” – please select the frequency for auto-rebalancing:
Quarterly Yes Half-yearly No
Yearly
If “Yes” – note that all future contributions, switches or withdrawals need to match your account balance percentages.
If you provide different percentages for future contributions, you will not be eligible for auto-rebalancing.
5. Super account set up – next steps
This page identifies the additional information required to complete your application and finalise the set up of your account.
You only need to complete the sections below that are relevant to your application. Using the checklist at the front of the forms
booklet, identify which sections you are completing and use the page below to navigate to the pages you will need to complete.
Contribution
Will you be making or receiving super contributions into your AMP Flexible Super – Super account?
Yes No
Yes No
Yes No
Yes No
Please complete the Contributions section on page A18.
Consolidation
Will you be requesting a consolidation of existing super accounts into your AMP Flexible Super – Super account?
Please complete the Consolidation section on page A21.
Beneficiary nomination
Do you want to make a beneficiary nomination for your AMP Flexible Super – Super account?
Please complete the Beneficiaries section on page A24.
Note: If you do not make a nomination, your benefit will be paid to your estate.
Insurance
Do you want to apply for personal insurance as part of your AMP Flexible Super – Super account?
What type of insurance do you want?
Essential Protection – complete the Personal Insurance section on page A26.
Flexible Protection – check the Personal Insurance section on page A26, and complete the Application for Insurance –
Flexible Protection form on page D1.
Do you have an existing Flexible Lifetime – Super (FLS) account and want to transfer your existing insurance cover
to your AMP Flexible Super – Super account?
Yes No
Enter your Flexible Lifetime – Super (FLS) account number
Note: AMP will transfer your existing insurance cover and there is no need for you to complete any additional sections or forms.
However, you can only transfer your insurance cover if you intend to close your FLS account. Transfer of your insurance cover is
subject to acceptance by AMP Life.
A9 of 32
Your Retirement
6. Retirement account set up (including transition to retirement set up)
Investing in a Retirement account
Please select the one situation that applies to you:
A. Transition to Retirement account
I am aged between 55 and 64, have reached my
preservation age and not retired from the workforce.
B. Retirement account
I am still working.
–– 55 or over prior to 01/04/2009 and are commencing a
Transition to Retirement account, or
–– 55 or over and retired prior to 01/04/2009?
Yes – continue to next question
No – you are not eligible to apply for a
Retirement account.
Income payment instructions
Retirement – I have reached the relevant preservation age,
I have worked before but ceased employment and I never
intend to work more than ten hours per week again.
Once you have set up a Retirement account, you can draw a
regular income.
I am aged between 60 and 64 and have stopped working
since turning age 60.
Select one payment frequency from the following:
I declare that I ceased work on
Income payment frequency
Fortnightly
Half-yearly
Monthly
Yearly
Quarterly D D MM Y Y Y Y
Date of first income payment
I am aged 65 or over.
Nominate the date for your first income payment
I have ceased employment (but am not retiring) with an
employer who was contributing to this AMP plan on my
behalf.
I declare that I ceased employment with this employer on
D D MM Y Y Y Y
I have ceased employment due to permanent incapacity
or invalidity (two medical certificates required).
I wish to access my unrestricted non-preserved benefits.
C. Beneficiary Retirement account
I am using a transfer of a Death benefit from an account
in the AMP Retirement Trust.
Name or account number of deceased
Citizenship/residency test for Retirement account
Super laws require us to ascertain a customer’s citizenship/
residency status to determine eligibility for a
Retirement account.
1. Are you or have you ever been a temporary resident
in Australia?
Yes – go to question 2
No – continue to next section Income
payment instructions.
2. I f you are or have been a temporary resident, are you now
an Australian or New Zealand citizen, permanent resident or
holder of a retirement visa (subclass 405 or 410)?
Yes – continue to next section Income payment
instructions
No – go to next question 3.
3. Are you applying for a retirement account as a result of
Terminal Illness, Total and Permanent Disablement, or
because you were:
D D MM Y Y Y Y
If you do not nominate a date, we will pay you after one
payment frequency has elapsed after commencing
your account.
Note: If your account is established during the month of June,
you can choose to receive your first income payment in the
next financial year.
Regular income payment amount (gross of tax)
Note: Regular Income payment means the income payment
you will receive based on the payment frequency you have
selected above.
Select your amount from the following:
the minimum amount allowed under legislative guidelines
a nominated dollar amount (subject to minimum/
maximum1 guidelines per income payment frequency
selected above)
D D MM Y Y Y Y
the maximum1 amount allowed under legislative guidelines
1 Maximum amount applies to Transition to Retirement
accounts only.
Account to which income payments will be credited
Please provide details of the bank/building society/credit union
account you want your income credited to:
BSB
Account number
Account in the name of
Name of institution (bank/building society/credit union)
Branch location
A10 of 32
AMP Flexible Super
7. Investment Choices (Choose from Core Investments or Select Investments or Choice Investments)
Your Retirement account offers three Investment Levels, with a different Member Fee for each level. Choose one of the
options below:
For Core Investments
For Select Investments
– complete the Core Investments section below.
– complete the Select Investments section below.
For Choice Investments
– complete the Choice Investments section overleaf.
For additional information on the investment options available, please refer to the PDS and the Fact Sheet: Investing and
your options.
Refer to the PDS for more information on Investment Levels, including fees.
Core Investments
wn Mix option: I choose to have my retirement invested across both investment
O
options as indicated by the percentages below:
I want my initial
account balance
to be:
Total must add
up to 100%
I want my income
payments from:
Total must add
up to 100%
Investment option
Option
Code
Super Easy Balanced
RBEI
%
%
Super Easy Cash
RSC
%
%
Or
Select Investments
You can invest in a maximum
of 5 of the 7 different options
available below.
wn Mix option: I choose to have my retirement fund invested across the investment
O
options as indicated by the percentages below:
Note: Fee deductions are applied proportionally across your investment options, unless you
choose to have these debited from a single investment option. This option is available in
the Select and Choice Investment Level only.
I want my
initial account
balance to be:
Total must add
up to 100%
I want my
income
payments
from:
Total must add
up to 100%
Investment option
Option
Code
Super Easy Balanced
RBEI
%
%
Super Easy Cash
RSC
%
%
Super Easy Conservative
RCEI
%
%
Super Easy Cautious
RCAU
%
%
uper Easy Moderately
S
Conservative
RMCO
%
%
Super Easy Growth
RBEG
%
%
Super Easy High Growth
RHG
%
%
Optional:
Fee deduction
(tick one)
A11 of 32
Auto-rebalancing for your Retirement account
Auto rebalancing allows you to automatically reset the percentage amounts within your investment options back to your
nominated investment profile percentages. Auto rebalancing does not apply if you are invested in a Term Deposit.
This facility works by switching units between investment options to realign your investment back to your nominated
investment profile.
Would you like to have your investments automatically rebalanced to the account balance percentages
outlined in the table above?
Quarterly If “Yes” – please select the frequency for auto-rebalancing:
Yes Half-yearly No
Yearly
Or
Choice Investments
You can invest in a maximum
of 15 of the different options
available below.
wn Mix option: I choose to have my retirement invested across the investment
O
options as indicated below:
Note: Fee deduction and rebates are applied proportionally across your investment
options, unless you choose to have these debited from or credited to a single investment
option. This option is available in the Choice Investment Level only.
Investment fund
Option
Code
I want my
initial account
balance to be:
Total must add
up to 100%
I want my
income
payments
from:
Total must add
up to 100%
Aberdeen Emerging
Opportunities
RAEO
%
%
AHL Alpha
RMAA
%
%
AMP All Growth
RADS
%
%
AMP Australian Bond
RAAB
%
%
AMP Australian Share
RAAS
%
%
AMP Balanced Growth
RABG
%
%
AMP Capital Asian Equity
Growth
RAAJ
%
%
AMP Capital Australian
Equity Concentrated
RCEC
%
%
AMP Capital Australian
Equity Opportunities
RCAO
%
%
AMP Capital Corporate
Bond
RACO
%
%
AMP Capital Global
Infrastructure Securities
(Hedged)
RAGI
%
%
AMP Capital Global
Property Securities
RCGP
%
%
AMP Capital Multi-Asset
RAMA
%
%
AMP Conservative
RCON
%
%
AMP Equity
RAE
%
%
AMP High Growth
RAHG
%
%
AMP Listed Property Trusts
RLPT
%
%
Optional:
Fee
deduction
and rebates
(tick one)
A12 of 32
AMP Flexible Super
Choice Investments
continued
I want my
initial account
balance to be:
Total must add
up to 100%
I want my
income
payments
from:
Total must add
up to 100%
Investment fund
Option
Code
AMP Moderate Growth
RAMG
%
%
AMP Secure Growth (for
Retirement account only)
RASG
%
%
Arnhem Australian Equity
RFAE
%
%
Arrowstreet Global Equity
RAGE
%
%
Bennelong Australian
Equities
RIAS
%
%
BlackRock Australian Equity
RBAR
Absolute Return
%
%
BlackRock Global
Allocation
RGLA
%
%
BlackRock Global Bond
RSIF
%
%
BlackRock Scientific Hedged
RHIS
International Share
%
%
BlackRock Scientific
International Share
RAIS
%
%
BT Australian Share
RTAS
%
%
BT Global Property
Securities
RPLP
%
%
Fidelity Global Equities
RFGE
%
%
Franklin Templeton
Multi-Sector Bond
RFMB
%
%
Future Directions
Asian Share
RFAA
%
%
Future Directions
Australian Bond
RFDA
%
%
Future Directions
Australian Share
RFAS
%
%
Future Directions
Australian Small
Companies
RFDS
%
%
Future Directions Balanced
RAFD
%
%
Future Directions
Conservative
RFDC
%
%
Future Directions Emerging
RFDE
Markets
%
%
Future Directions Extended
RFDX
Markets International Share
%
%
Future Directions Geared
Australian Share
RAFS
%
%
Future Directions Growth
RFDG
%
%
Future Directions Hedged
International Share
RFHI
%
%
Optional:
Fee
deduction
and rebates
(tick one)
A13 of 32
Choice Investments
continued
Investment fund
Option
Code
I want my
initial account
balance to be:
Total must add
up to 100%
I want my
income
payments
from:
Total must add
up to 100%
Future Directions High
Growth
RFDH
%
%
Future Directions
International Bond
RFDI
%
%
Future Directions
International Share
RFIS
%
%
Future Directions
Moderately Conservative
RFDM
%
%
Future Directions Property
RFDP
%
%
GMO International Share
RMIS
%
%
Hyperion Australian
Growth Companies
RAGC
%
%
ipac Income Generator
RIIG
%
%
K2 Australian Absolute
Return
RAEL
%
%
Kapstream Absolute Return
RKAR
Income
%
%
Lazard Global Small Cap
RGSC
%
%
Lazard Global Thematic
RGGO
%
%
Legg Mason Australian Real
RMAI
Income
%
%
Macquarie Income
Opportunities
RMIO
%
%
Macquarie International
Infrastructure Securities
RMII
%
%
Magellan Global
RMGF
%
%
Perennial Value Australian
Share
RPVS
%
%
Perennial Value Shares For
Income
RRSI
%
%
Perpetual Industrial Share
RPI
%
%
PIMCO Australian Focus
RPAF
%
%
PIMCO Diversified Fixed
Interest
RDFI
%
%
Platinum International
RPTI
%
%
Plato Australian Shares
Income
RPAI
%
%
RARE Infrastructure Value
RRIV
%
%
Resolution Capital Core
Plus Property Securities
RHLP
%
%
Responsible Investment
Leaders Australian Share
RRLA
%
%
Optional:
Fee
deduction
and rebates
(tick one)
A14 of 32
AMP Flexible Super
Choice Investments
continued
Investment fund
Option
Code
I want my
initial account
balance to be:
Total must add
up to 100%
I want my
income
payments
from:
Total must add
up to 100%
Responsible Investment
Leaders Balanced
RSFB
%
%
Responsible Investment
Leaders Conservative
RRLC
%
%
Responsible Investment
Leaders Growth
RRLG
%
%
Responsible Investment
RRIS
Leaders International Share
%
%
Schroder Australian
Equities
RSAS
%
%
Schroder Fixed Income
RSFI
%
%
Schroder Global Active
Value
RGEV
%
%
Schroder Real Return
RSRR
%
%
Super Easy Alternative
RSEA
%
%
Super Easy Australian Fixed
RAFI
Interest
%
%
Super Easy Australian Share RASE
%
%
Super Easy Balanced
RBEI
%
%
Super Easy Cash
RSC
%
%
Super Easy Cautious
RCAU
%
%
Super Easy Conservative
RCEI
%
%
Super Easy Growth
RBEG
%
%
Super Easy High Growth
RHG
%
%
Super Easy International
Fixed Interest
RIFI
%
%
Super Easy International
Share
RISE
%
%
Super Easy Moderately
Conservative
RMCO
%
%
Super Easy Property
RSEP
%
%
T. Rowe Price Asia ex-Japan
RAEJ
%
%
T. Rowe Price Global Equity
RTPE
%
%
Templeton Global Equity
RTIS
%
%
Tyndall Australian Share
Value
RBAE
%
%
Term Deposits are available, see amp.com.au for information.
Optional:
Fee
deduction
and rebates
(tick one)
A15 of 32
Choice Investments
continued
Investment fund
UBS Australian Small
Companies
Choice Investments
continued
Option
Code
I want my
initial account
balance to be:
Total must add
up to 100%
%
RASC
Investment fund
Option
Code
Walter Scott Global Equity
RIEG
I want my
income
payments
from:
Total must add
up to 100%
Optional:
Fee
deduction
and rebates
(tick one)
%
I want my
income
payments
from:
Total must add
up to 100%
I want my
initial account
balance to be:
Total must add
up to 100%
%
Optional:
Fee
deduction
and rebates
(tick one)
%
Auto-rebalancing for your Retirement account
Auto rebalancing allows you to automatically reset the percentage amounts within your investment options back to your
nominated investment profile percentages. Auto rebalancing does not apply if you are invested in a Term Deposit.
This facility works by switching units between investment options to realign your investment back to your nominated
investment profile.
Would you like to have your investments automatically rebalanced to the account balance percentages
outlined in the table above?
If “Yes” – please select the frequency for auto-rebalancing:
Quarterly Yes No
Half-yearly Yearly
8. Retirement account set up (including transition to retirement set up)
Taxation
Tax File Number (TFN) Declaration – Retirement account
Refer to the instructions and privacy information on the Tax file number declaration in the Product Disclosure Statement
before quoting your TFN.
If you are age 60 or over, it is not mandatory to complete the Tax file number declaration or the Withholding declaration.
Has a Tax file number declaration been completed?
Yes No
Are you an Australian resident for tax purposes?
Yes No
Do you want to claim the tax-free threshold from this payer?
Yes No
Do you want to claim family tax benefit or the senior Australian tax offset by reducing the amount withheld
from payments made by you?
Yes No
If no, please refer to the Tax file number declaration from page B1.
The following questions are taken from the Tax file number declaration.
What is your Tax File Number?
Only provide your TFN here if you have not yet provided it anywhere in this form.
Or
Please select one of the following:
I have made a separate application/enquiry to the Tax Office 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, or
I am claiming an exemption because I am a pensioner.
A16 of 32
AMP Flexible Super
Withholding declaration
If you require additional tax to be withheld, please complete a
Withholding declaration, available online from ato.gov.au, and
submit it with this form.
The following question is taken from the
Withholding declaration.
Are you:
Has a Withholding declaration been completed?
Yes Single, or
No
Member of an illness-separated couple, or
Member of a couple
9. Retirement account set up – next steps
Retirement scenarios
Please select one of the three scenarios (A or B or C below):
For all scenarios you will need to complete the Consolidation
section on page A21 and may also need to complete the
Contributions section on page A18.
Tell us how much to transfer to the Retirement account, and
select one of the three options below:
1.
I have an existing AMP Flexible Super – Super account
and want to consolidate/contribute into this account.
Provide account number
Scenario A – Retirement with consolidation completed
My super is consolidated and I am ready to commence an
AMP Flexible Super – Retirement account with one rollover/
transfer now
Yes No
Note: If you are transferring from an AMP Flexible Super
– Super account it will remain open for future contributions.
Scenario B – Transition to Retirement
I am using this application to set up a new AMP Flexible Super
– Super account and AMP Flexible Super – Retirement account.
You must complete the Consolidation section on page A21.
Yes No
Note: Your AMP Flexible Super – Super account will remain
open for future contributions.
Type of transfer:
Full Partial
Enter amount to be transferred from your new AMP Flexible
Super – Super account (if partial transfer only)
$
.
Scenario C – Retirement including consolidation
(Also complete the Internal AMP Super Transfers
section on page A21)
I need to consolidate my super monies from one or more super
funds and/or make a contribution/re-contribution and/or claim
a tax deduction prior to commencing my AMP Flexible Super –
Retirement account
Yes No
Retirement Accounts can only receive one lump sum
amount so your super must be consolidated before
commencement. As you want to consolidate or make
contributions prior to commencing your Retirement
account, you will be set up with an AMP Flexible Super –
Super account.
I nominate the following investment strategy for my new
AMP Flexible Super – Super account:
(Please select one of the options below)
As per my nominated investment mix I have provided for
my AMP Flexible Super – Retirement account, or
Super Easy Cash investment option.
Note: If you are eligible and have selected AMP Secure
Growth as an investment option for your AMP Flexible
Super – Retirement account, then AMP will allocate the
proportion of funds allocated to Secure Growth to Super
Easy Cash investment option for your AMP Flexible Super –
Super account.
3. I have an existing Flexible Lifetime – Super (FLS) account
and want to consolidate/contribute into this account
Provide account number
Beneficiary nomination
I want to set up a beneficiary nomination for my AMP Flexible
Super – Retirement account?
No
I want to set up a beneficiary nomination for my AMP Flexible
Super – Super account?
Partial
Enter amount to be transferred from your new AMP Flexible
Super – Super account (if partial transfer only)
$
I do not have an AMP Flexible Super – Super account.
Yes Type of transfer:
Full 2.
.
Yes No
Please complete Beneficiaries on page A24.
If you don’t make a nomination, your benefit will be paid to
your estate.
Now continue to the next page: Contribute and Consolidate
A17 of 32
Contribute and Consolidate
10. Contributions
Contributing to your new AMP Flexible Super – Super account is easy. Please select at least one contribution type. Contribution
types include Employer, Personal and/or Spouse Contributions as well as Consolidation.
Employment Status if you are aged between 65 to 74
If you are 65 and over, have you worked for at least 40 hours in
a period of 30 consecutive days in the current financial year?
Yes
No – we are only able to accept certain contributions
Spouse Contributions (continued)
Regular or ongoing
$
.
Indexed for inflation
Yes Frequency: Member Contributions
Please note that we cannot accept a member contribution if
you do not quote your TFN. You can provide your TFN in the
Personal Details section on page A1.
Monthly
Half-yearly
No
Quarterly Yearly
Method of payment
Direct Debit from your nominated bank account once only
Payment notice sent to you
Amount you pay, including contributions if you are
self-employed:
Direct Debit request for Member/Spouse
Initial or one-off
$
Complete this section if you or your spouse request to make a
one-off direct debit initial contribution and/or to setup a
regular direct debit contribution.
.
Method of payment
Direct Debit from your nominated bank account1
BSB number
Account number
Bpay2
Cheque3
Account in the name of
Regular or ongoing
$
.
Indexed for inflation
Yes Frequency: Monthly
Half-yearly
Name of institution (bank/building society/credit union)
No
Quarterly Yearly
Method of payment
Direct Debit from your nominated bank account once only1
Payment notice sent to you
Please note that we cannot accept a spouse contribution if
you do not quote your TFN.
Initial or one-off
2 We will send you details in your Welcome Letter on how to make
your initial investment by Bpay.
.
3 Cheques
Method of payment
Bpay2
Cheque3
Note: Declaration for direct debit forms part of the declaration
in the Agreement and Declarations section on page A29.
1 We will deduct this amount shortly after we receive your application
(including if your financial planner sends the forms electronically).
Amount your spouse pays:
Direct Debit from your nominated bank
Preferred deduction day for direct debit –
regular contributions ONLY
(eg for the 15th of the month enter “15”)
Spouse Contributions
$
Branch location
account1
Please make payable to “AMP Life Limited – AMP Flexible Super”.
On the back of your cheque please write your full name and type of
contribution (eg personal member or superannuation guarantee).
Send your cheque to:
New Business Applications
PO Box 300
PARRAMATTA NSW 2124
A18 of 32
AMP Flexible Super
Tax Deduction on Member Contributions
Please refer to the Product Disclosure Statement (PDS),
Fact Sheets or speak to your financial planner for further
information on tax and contribution caps.
Are you eligible and do you wish to claim a tax deduction on
member contributions made in this form and previous member
contributions (if made) into your AMP Flexible Super – Super
account (or FLS account)?
Yes No
This section needs to only be completed if you made member
contributions to your AMP Super account and are eligible to
claim a deduction.
Contact your financial planner or tax adviser if you are unsure
if you are eligible to claim a tax deduction.
We cannot accept a notice to claim or vary a tax deduction
once your super has been transferred to a Retirement account,
or once those contributions have been paid out or rolled over.
This section represents a notice under section 290-170 (1) of
the Income Tax Assessment Act 1997. Please complete the
table below using dollar ($) amounts only (Nil or All is not
acceptable). Please note that the tax laws do not allow this
notice to be withdrawn or revoked; however, it may be varied.
If you do not complete this section, we will assume you do not
wish to claim your contribution that you have made personally
as a tax deduction or you have already provided a notice to us
(in another form or document) that you intend to claim a tax
deduction for the financial year not completed below.
Re-Contribution request (continued)
Note: In order to undertake a re-contribution strategy, you
must be eligible to withdraw money from your super (complete
section 6B on page A10) and make contributions back into
super (complete section 10 Contributions on page A18).
Tax deduction on Member Contributions made prior to the
withdrawal
If you wish to claim a tax deduction on a personal member
contribution made prior to the withdrawal part of this
recontribution process, please complete the Tax Deduction on
Member Contributions section above.
Tax deduction on re-contribution
If you wish to claim a tax deduction, on personal member
contributions on this recontribution, please insert the amount
below. This is not applicable, if the recontribution is made to
your spouse’s account.
Total contributions you are claiming on this recontribution only
$
Please note:
–– A claim for tax deduction cannot be submitted to the
trustee after a withdrawal (including a withdrawal which
forms part of this recontribution) has been processed on
your account.
–– To provide additional instructions please complete the
Notes section at the end of this form.
I am lodging this notice before both of the following dates:
–– the day that I lodged my income tax return for the year(s)
for which I am claiming a tax deduction, and
–– t he end of the income year after the year for which I am
claiming a tax deduction.
Note: The entire amount indicated below will be taxed as
taxable contributions and may be subject to tax. If only a
portion of the contribution is being claimed as a tax deduction,
please indicate the exact dollar ($) figure being claimed.
Total contributions you are claiming:
.
Notice for PREVIOUS financial year ($ only)
$
.
Do you wish to make a full or partial withdrawal from your
AMP Flexible Super – Super account (or FLS account) and
re-contribute back into your AMP Flexible Super – Super
account (or FLS account) before transferring to the
Retirement account?
If you’re self-employed, complete the Member Contributions
section on page A18.
Superannuation Guarantee and Award
Employer Contributions
Initial or one-off
.
Regular or ongoing
$
.
Indexed for inflation
Yes No
The amount you request your employer to contribute from
your pre-tax salary, includes salary sacrifice and additional
employer contributions.
Initial or one-off
$
.
Method of payment
No
What amount do you wish to re-contribute?
The full amount of my AMP Flexible Super – Super account
(or FLS account) as a non-concessional contribution
A part amount of
$
Please complete this section if you are an employee of your
own company.
Salary Sacrifice and Additional Employer Contributions
Re-Contribution request
Yes Employer Contributions
$
Notice for THIS financial year ($ only)
$
.
.
Direct Debit from your nominated bank account once only1
Bpay2
Cheque
1 We will deduct this amount shortly after we receive your application
(including if your financial planner sends the forms electronically).
(less tax, if any)
2 We will send you details in your Welcome Letter on how to make
your initial investment by Bpay.
A19 of 32
Employer Contributions (continued)
Employer Details (continued)
Regular or ongoing
Title
$
.
Indexed for inflation
Yes Frequency: Monthly
Half-yearly
Given names of employer contact
No
Quarterly Yearly
Surname of employer contact
Method of payment
Direct Debit from your employer’s nominated bank account
Payment notice sent to your employer
Supporting Employer Details 2
Direct Debit request for Employer Contributions
BSB number
Employer name (business or trading name)
Account number
Employer address
Account in the name of
Name of institution (bank/building society/credit union)
Branch location
Suburb
State
Postcode
Country
Preferred deduction day for direct debit –
regular contributions ONLY
Title
(eg for the 15th of the month enter “15”)
Given names of employer contact
Employer Details
Your employer is usually required to pay super contributions
every three months. If you wish to have your employer(s)
contribute to your AMP Flexible Super account, please
complete the Supporting Employer Details section below.
Surname of employer contact
We will then forward you a completed Choice form, including
an Employer Payment Instruction form. You will need to sign
this form and then provide it to your employer(s) directly or
send it back to AMP and we will provide it to your employer(s)
on your behalf.
Supporting Employer Details 3
How many employers will be contributing to your account?
If you have more than three employers, please complete the
Choice form on page F3.
Employer address
Employer name (business or trading name)
Suburb
State
Postcode
Supporting Employer Details 1
Employer name (business or trading name)
Country
Title
Employer address
Given names of employer contact
Suburb
State
Postcode
Surname of employer contact
Country
A20 of 32
AMP Flexible Super
11. Consolidation
Lost Super
Would you like AMP to search for any lost super you
might have?
Yes Tax Deduction on Member Contributions made into your
AMP Super account before we process the internal transfer
Only complete if you requested an internal transfer above.
Tax Deduction on Internal Transfer 1
No
You are under no obligation to provide your Tax File Number
(TFN), either now or later, and it is not an offence to not quote
your TFN. However, you must provide your TFN if you would
like AMP to search for your lost super.
What is your Tax File Number?
Only provide your TFN here if you have not provided it
anywhere else on this form.
Where you ask us to perform a lost super search on your behalf,
we will provide your TFN to the ATO to conduct a search on
their Lost Member Register.
The trustee can collect your TFN under the Superannuation
Industry (Supervision) Act 1993.
Internal AMP Super Transfers
This section is for internal transfers from other AMP Super
products, including for those applying for a beneficiary
retirement account as a result of a Death benefit.
How many internal transfers will there be?
Are you eligible and wish to claim a tax deduction on
contributions made into the AMP Super account?
Yes No
This section needs to only be completed if you made member
contributions to your AMP Super account, AND you have not
claimed a tax deduction in section 10 of this application form,
and are eligible to claim a deduction. Contact your financial
planner or tax adviser if you are unsure if you are eligible to
claim a tax deduction. It is important to note we cannot accept
a notice to claim a tax deduction once your super has been
transferred to a retirement account.
This section represents a notice for each year under section
290-170(1) of the Income Tax Assessment Act 1997. Please
complete the table using dollar($) amounts only (Nil or All is
not acceptable).
Note: The entire amount indicated below will be taxed as
assessable contributions and may be subject to tax. If only a
part of the contribution is being claimed as a tax deduction
please indicate the exact dollar($) figure being claimed by
financial year.
Total contributions you are claiming:
Notice for THIS financial year ($ only)
Internal Transfer 1
$
Type of transfer:
Full Notice for PREVIOUS financial year ($ only)
Partial
Transfer or Rollover amount
$
.
$
.
.
Plan/policy/membership number
Tax Deduction on Internal Transfer 2
Are you eligible and wish to claim a tax deduction on
contributions made into the AMP Super account?
If you completed this question, you must complete the Tax
Deduction question below.
Yes No
Total contributions you are claiming:
Notice for THIS financial year ($ only)
Internal Transfer 2
$
Type of transfer:
Full Notice for PREVIOUS financial year ($ only)
Partial
Transfer or Rollover amount
$
.
$
.
.
Plan/policy/membership number
If you completed this question, you must complete the
Tax Deduction question below.
A21 of 32
External Transfers
Consolidating all your existing super funds together is easy and helps you save on yearly fees. We can do most of the paperwork
for you and can contact the other funds on your behalf. You can provide us with details of your old fund(s) here and we will
forward you completed forms for you to sign and return with certified copies of your ID, if you have not elected to provide your
TFN for consolidation.
Alternatively you can complete the Request to Transfer Whole Balance of Superannuation Benefits between Funds form from
page C3 and return to us with either your TFN or a certified copy of your ID together with this application and we will contact your
old fund(s) for you. If you have more than one fund, additional transfer forms can be downloaded from amp.com.au/super/forms.
If you would like to transfer balances from other super funds into your AMP Flexible Super – Super account, please complete
this section.
How many external transfers will there be?
External Transfer 1
Fund name
Other fund name
Product name
Other product name
Australian Business Number (ABN)
Other Product Australian Business Number (ABN)
Unique Superannuation Identifier (USI)
Other Unique Superannuation Identifier (USI)
Type of transfer:
Plan/policy/membership number
Full Partial
Transfer or Rollover amount
$
.
External Transfer 2
Fund name
Other fund name
Product name
Other product name
Australian Business Number (ABN)
Other Product Australian Business Number (ABN)
Unique Superannuation Identifier (USI)
Other Unique Superannuation Identifier (USI)
Type of transfer:
Plan/policy/membership number
Full Partial
Transfer or Rollover amount
$
.
A22 of 32
AMP Flexible Super
External Transfers (continued)
External Transfer 3
Fund name
Other fund name
Product name
Other product name
Australian Business Number (ABN)
Other Product Australian Business Number (ABN)
Unique Superannuation Identifier (USI)
Other Unique Superannuation Identifier (USI)
Type of transfer:
Plan/policy/membership number
Full Partial
Transfer or Rollover amount
$
.
External Transfer 4
Fund name
Other fund name
Product name
Other product name
Australian Business Number (ABN)
Other Product Australian Business Number (ABN)
Unique Superannuation Identifier (USI)
Other Unique Superannuation Identifier (USI)
Type of transfer:
Plan/policy/membership number
Full Partial
Transfer or Rollover amount
$
.
External Transfer 5
Fund name
Other fund name
Product name
Other product name
Australian Business Number (ABN)
Other Product Australian Business Number (ABN)
Unique Superannuation Identifier (USI)
Other Unique Superannuation Identifier (USI)
Type of transfer:
Plan/policy/membership number
Full Partial
Transfer or Rollover amount
$
.
Additional Transfer or Rollover amounts from non-AMP Superannuation
$
.
Now continue to Beneficiaries on the next page
A23 of 32
Beneficiaries
12. Beneficiary nomination – super
Will you be making a Death benefit nomination for
this account?
Yes No
If you do not wish to make a nomination, you do not need to
complete this page.
If you do not make a Death benefit nomination, your benefit
will be paid into your estate.
Proportion of total benefit
%
Relationship to applicant:
Financial dependant
Spouse
Child Interdependency relationship
Full name of beneficiary
Note: Death benefit nominations are not available for
members under age 18.
For your Super account (please cross one of the options)
Date of birth
Sex
A.
Binding beneficiary nomination1
D D MM Y Y Y Y
B.
Non-binding beneficiary nomination2
Proportion of total benefit
1If you make a binding beneficiary nomination, the trustee must pay
your benefit in the event of your death to the person(s) or your legal
personal representative/estate you have nominated, provided that
your nomination is valid. For your nomination to be valid you must
ensure you have two witnesses sign the witness declarations on
page A29 of this form.
2If you make a non-binding beneficiary nomination, the trustee will
decide who will receive your benefit in the event of your death. We
will generally pay your nominated beneficiary(ies), but may decide
to pay your Death benefit differently.
Beneficiary Details
–– Your spouse (including de facto spouse).
–– Your children (including an adopted child, a step child, or
ex-nuptial child).
–– Anyone who is financially dependent on you at the time
of your death.
Female
%
Relationship to applicant:
Financial dependant
Spouse
Child Interdependency relationship
Full name of beneficiary
Date of birth
You can only nominate your legal personal representative/
estate or a person(s) who is a dependant to receive your Death
benefit. A person must be a dependant at the date of your
death to be considered by the trustee to be a beneficiary of
your Death benefit. A dependant includes:
Male Sex
D D MM Y Y Y Y
Male Female
Proportion of total benefit
%
Relationship to applicant:
Financial dependant
Spouse
Child Interdependency relationship
Full name of beneficiary
–– Anyone who has an interdependency relationship with you
at the date of your death.
I nominate the following to be paid the Total Death Benefit
from my AMP Flexible Super – Super account (you can
nominate more than one):
Legal personal representative/estate
Date of birth
Sex
D D MM Y Y Y Y
Male Female
Proportion of total benefit
%
Proportion of total benefit
Relationship to applicant:
Financial dependant
%
Spouse
Child Interdependency relationship
And/Or
I nominate the following beneficiaries to receive the specified
proportion of the benefit payable at my death:
Total
Total benefit must equal 100%
%
Full name of beneficiary
Date of birth
D D MM Y Y Y Y
Sex
Male Female
A24 of 32
AMP Flexible Super
13. Beneficiary nomination – Retirement and Transition to Retirement
If you do not make a Death benefit nomination, your benefit
will be paid into your estate. If you do not wish to make a
nomination, you do not need to complete this page.
Note: Death benefit nominations are not available for
members under age 18.
For your Retirement account (please cross one of the
options)
A.
Binding beneficiary
B.
Non-binding beneficiary nomination2
C.
Reversionary beneficiary3
Proportion of total benefit
%
Relationship to applicant:
Financial dependant
Spouse
Child Interdependency relationship
Full name of beneficiary
nomination1
1If you make a binding beneficiary nomination, the trustee must
pay your benefit in the event of your death to the person(s) or your
legal personal representative/estate you have nominated, provided
that your nomination is valid. For your nomination to be valid you
must ensure you have two witnesses sign the witness declarations
on page A29.
Date of birth
Sex
D D MM Y Y Y Y
Male Female
Proportion of total benefit
%
2If you make a non-binding beneficiary nomination, the trustee will
decide who will receive your benefit in the event of your death. We
will generally pay your nominated beneficiary(ies), but may decide
to pay your Death benefit differently.
Relationship to applicant:
Financial dependant
3A reversionary beneficiary will receive the income stream from your
retirement account on your death.
Full name of beneficiary
Spouse
Child Interdependency relationship
Beneficiary details – Binding or Non-binding Death benefit
nomination
–– If you are making a non-binding or binding Death benefit
nomination you can only nominate your legal personal
representative/estate or a person who is a “dependant” to
receive your Death benefit. A person must be a dependant
at the date of your death to be considered by the trustee to
be a beneficiary of your Death benefit.
–– A dependant includes:
Date of birth
Sex
D D MM Y Y Y Y
Male Female
Proportion of total benefit
%
Relationship to applicant:
Financial dependant
Spouse
Child Interdependency relationship
–– your spouse (including a de facto spouse)
–– your children (including an adopted child, a step child,
or ex-nuptial child)
Full name of beneficiary
–– anyone who is financially dependent on you at the time
of your death
–– anyone who has an interdependency relationship with
you at the date or time of your death
Date of birth
D D MM Y Y Y Y
Same as superannuation beneficiaries, OR
I nominate the following to be paid the Total Death Benefit
from my AMP Flexible Super – Retirement account (you can
nominate more than one):
Legal personal representative/estate
Sex
Male Female
Proportion of total benefit
%
Relationship to applicant:
Financial dependant
Spouse
Child Interdependency relationship
Proportion of total benefit
%
Total
And/Or
Total benefit must equal 100%
%
I nominate the following beneficiaries to receive the specified
proportion of the benefit payable at my death:
Full name of beneficiary
Date of birth
D D MM Y Y Y Y
Sex
Male Female
A25 of 32
Beneficiary details – Reversionary Death benefit nomination only
Only complete this section if you wish to nominate a reversionary beneficiary. If you are making a reversionary Death benefit
nomination, you can only nominate your spouse (or de facto spouse) to receive your Death benefit. This option is not available
to Beneficiary Retirement account applicants. I nominate my spouse to be paid the Total Death Benefit:
Full name of spouse
Spouse date of birth
Spouse sex
D D MM Y Y Y Y
Male Female
Your Insurance
14. Personal insurance options
Do you want to apply for personal insurance as part of this super account?
Yes No
What type of insurance do you want to apply for?
Essential Protection
Flexible Protection
You will need to:
You will need to:
–– complete the questions below.
–– complete the Application for Flexible Protection
Insurance form beginning on page D1, then
–– complete the Personal Statement available from your
financial planner or amp.com.au
Do you have an existing Flexible Lifetime – Super account (FLS) and want to transfer your existing insurance cover to your
AMP Flexible Super – Super account?
Yes No
Enter your Flexible Lifetime – Super (FLS) account number
Essential Protection
Cover Type
Do you have or have you ever had any of the following:
Death or Death and Total and Permanent Disablement (TPD)
Cover amount (up to $250,000)
$
0 0 0
What is your height (centimetres)?
What is your weight (kilograms)?
Have you smoked tobacco or any other substance or used
nicotine replacement products within the last 12 months?
Yes No
Yes No
–– Any heart disorder, diabetes or stroke.
–– Cancer, hepatitis or any other liver disorder, bowel disorder
requiring medical investigation and/or treatment or
kidney disorder.
–– AIDS, been infected with HIV, or are you carrying antibodies
to the HIV virus.
–– Do you currently have any undiagnosed condition or
symptoms for which you intend to consult any health
professional or have you been recommended to seek further
medical advice, undergo any tests or investigation in
the future?
Yes No
Additional questions for TPD cover
Health status
Do you have or have you ever had any of the following:
Yes No
–– Any neurological disorder or mental health condition,
multiple sclerosis, epilepsy, paralysis, schizophrenia, bipolar
disorder, depression or anxiety.
–– Arthritis, osteoporosis, chronic fatigue syndrome, back, neck
or any joint disorder that has required treatment by any
health professional and resulted in more than five days off
work over the previous 12 months.
–– Any persisting ear or eye disorder, hearing loss, or
impairment of sight not corrected by glasses, contact
lenses or laser vision correction surgery.
A26 of 32
AMP Flexible Super
Additional questions for TPD cover (continued)
Occupation
Do you work more than 10 hours per week in any occupation
other than home duties?
Yes No
If “Yes”, which of the following best describes your primary
occupation?
White collar
Heavy manual
Light manual Hazardous
Find out more about insurance and see examples of occupation
tables in our Fact Sheet: Insurance.
Are you primarily engaged in home duties?
Yes Are you presently restricted in any way from performing any of
the normal duties of your occupation (or normal home duties,
if applicable)?
Yes No
Sporting Activities
Do you currently, or do you intend to, participate in any
hazardous activity, motorsport, aviation or flying activity other
than as a regular fare paying passenger?
Yes No
We will contact you with information regarding your quote,
once your application has been processed. Otherwise, please
call Customer Service and we will provide you with
this information.
No
Additional information
15. Flexible Bonus
Flexible Bonus - Link to other AMP accounts
Flexible Bonus allows you to link your AMP Flexible Super –
Super account balance with other eligible AMP accounts you
hold, and with eligible AMP accounts of one other eligible
family member’s account. Depending on your account balance
and other conditions outlined in the AMP Flexible Super PDS
the linked accounts may be eligible for a Flexible Bonus in the
form of a management rebate.
Accounts eligible to be linked include:
–– AMP Flexible Super – Super account and Retirement account
–– Flexible Lifetime® – Term Pension
1. Your Family member or Dependant’s personal details
– if applicable
Title
Surname
Given name(s)
–– Flexible Lifetime® – Super
Date of birth
–– Flexible Lifetime® – Investments (Series 1)
D D MM Y Y Y Y
–– Flexible Lifetime® – Allocated Pension
Relationship to you – Please select the relationship you have
with them:
–– Flexible Lifetime® – Investments (Series 2).
Sex
Spouse
Sibling (brother/sister)
Grandparent
Father/Mother-in-law
Son/Daughter-in-law
Male Female
Parent Child Grandchild Brother/Sister-in-law Interdependency relationship
(refer to the AMP Flexible Super
PDS for definition)
2. Apply to link accounts
Complete this section if you would like to link or add accounts under Flexible Bonus.
Note: if we receive this form after the 25th of the month, the link (and eligibility for the Management Fee Rebate under the
Flexible Bonus) will not apply until the end of the following month.
Account/plan number
If application is in progress provide customer name
Owner of plan/account
You
Your family
member or
dependant
Joint
Company/
partnership/
deceased
estate/
trust/super
fund
A27 of 32
16. Member Advice Fee
Was any advice provided about the higher insurance offer –
Flexible Protection
Yes No
b.Ongoing Member Advice Fee
Super account
$
Complete this section if you have agreed a Member Advice Fee
with a financial planner who has an agreement with AMP.
or
a.A one-off amount paid from my initial investment
And/Or
Super account
$
%
per month (including GST)
pa (including GST) paid monthly
Retirement account
.
(including GST)
Or
$
or
Retirement account
$
.
.
.
%
per month (including GST)
pa (including GST) paid monthly
Note:
(including GST)
–– You cannot select both a dollar amount and a percentage
at the same time for the Ongoing Member Advice Fee.
–– These fees might not be paid while your account balance
is below $1,200. See the PDS for more information.
–– If no amount is entered in this section, no Member Advice
Fee will apply.
–– Caps may apply on the Member Advice Fee. See the PDS
for more information.
What is a certified copy?
A certified copy is a document that has been certified as a true
copy of the original document by one of the following:
–– An officer with, or authorised representative of, a holder of
an Australian financial service licence, having two or more
continuous years of service with one or more licensees.
–– Financial company officer with two or more continuous
years of service with one or more finance companies (for the
purposes of the Statutory Declaration Regulation 1993).
–– An officer with two or more continuous years of service
with one or more financial institutions (for the purposes of
the Statutory Declaration Regulation 1993).
–– A permanent employee of the Australian Postal Corporation
with two or more continuous years of service who is
employed in an office supplying postal services to
the public.
–– An agent of the Australian Postal Corporation who is in
charge of an office supplying postal services to the public.
–– A person who is enrolled on the roll of the Supreme Court
of a State or Territory, or the High Court of Australia, as a
legal practitioner (however described).
–– A judge of a court.
–– A magistrate.
–– A chief executive officer of a Commonwealth court.
–– A registrar or deputy registrar of a court.
–– An Australian police officer.
–– An Australian consular officer or an Australian diplomatic
officer (within the meaning of the Consular Fees Act 1955).
–– 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 notary public (for the purposes of the Statutory
Declaration Regulation 1993).
–– A Justice of the Peace.
A28 of 32
AMP Flexible Super
17. Agreement and Declarations
Applicant’s Agreement and Declarations
1. I confirm that I have been given and have read, or have had
the opportunity to read, the latest AMP Flexible Super
Product Disclosure Statement (PDS), as well as any updates to
that PDS.
2. I am aware I may ask my superannuation provider for
information about any fees or charges that may apply, or any
other information about the effect this transfer will have on
my insurance cover or other benefits. I have obtained or do
not require such information.
3. The information in this application form and in any other
document I provide may be used by AMP Superannuation
Limited and any other company in the AMP group for any
purpose, including for marketing purposes or in connection
with any other product or service.
4. F or Family membership or Flexible Bonus I confirm that I have
an eligible relationship with that person, and consent to the
linking of accounts. Where I have provided information about
another person, I have done so with the consent of that
person. The consent includes the sharing and disclosure of
the account name, account number, and account type of
each of the linked accounts, and I understand that
information may be disclosed to a financial planner.
5. I understand the risks of my investment choices, and that
different Member Fees and features apply depending on the
choice of my Investment Level.
6. I f I am using a financial planner, I authorise the financial
planner to complete and submit an electronic application on
my behalf.
7. If you are under 18, you should see a parent or legal guardian
before making a decision to invest in this product, and
complete the Under 18 Declaration form available from amp.
com.au or phone us for a form, and ensure it is signed by a
parent or legal guardian and submitted with this
application form.
8. I understand that the trustee will not verify that my employer
has made any contributions it may be required
or has agreed to make to my account.
9. Where I have provided instructions that involved Flexible
Lifetime – Super I have read the latest PDS, as well as
any updates.
10. By selecting yes (for complimentary Lost Super Search), I
authorise AMP Life Ltd ABN 84 079 300 379 PO Box 300
Parramatta NSW 2124 (AMP) to act as my agent in
conducting searches of Australian Tax Office (ATO) records,
using my tax file number (TFN), surname and date of birth, to
locate details of any super held on my behalf by the ATO and/
or details of any other super accounts I may have with other
institutions. I understand that AMP will notify me if the
search has been successful (and/or, where required, of an
unsuccessful search) and can assist me in consolidating my
super accounts into my AMP super account(s) should I
consent to AMP doing so at the time.
11. I consent to my tax file number being disclosed for the
purposes of consolidating my account.
Tax deduction (see page A21):
1. Please note that the tax laws do not allow this notice to
be withdrawn or revoked. However, it may be varied only
if the tax laws permit and you have not transferred your
contributions to an income stream or another fund. This
notice does not cover any contributions covered by an
earlier notice.
2. I am lodging this notice before all of the following dates:
–– The day that I lodged my income tax return for the year(s)
for which I am claiming a tax deduction.
–– The end of the income year after the year for which
I am claiming a tax deductions, and
–– I ceased to have my contribution in this
accumulation account.
Transfers and rollovers (see page A21):
1. I authorise the transfer of my benefits from my previous
superannuation fund(s) (shown on page A21 of this
application) to my AMP Flexible Super account.
2. I understand my benefit entitlements in my previous
superannuation fund(s) and the effect of a transfer (including
any fees or taxes payable) on those benefit entitlements. In
particular, if I have insurance cover with
my previous superannuation fund(s), I understand that
the transfer of my benefit may cause cancellation of that
insurance cover.
3. I understand that in certain circumstances AMP
Superannuation Limited may deduct tax from any
untaxed portion of a superannuation lump sum or
directed termination payment rolled over to my AMP Flexible
Super account.
If I request Essential Protection cover (see page A26):
Where I am applying for insurance as part of my account,
I agree and declare that:
1. I understand that I cannot receive a Terminal Illness benefit
or Total and Permanent Disablement benefit in cash or to
commence a pension unless I am eligible to access my
super benefit.
2. I have completed the insurance questionnaire and I
confirm that:
–– All information provided in the insurance questionnaire
is true and correct.
–– I have read and agree with the declarations set out in
the insurance questionnaire.
–– I have read the Privacy Information in the PDS and agree to
the various uses and exchanges of my personal
information and acknowledge my right to access personal
information held about me by the AMP group.
3. I understand that AMP Life may cancel my insurance cover if I
do not contribute or rollover funds into my account within 60
days of the insurance cover being issued.
Agreement and Declaration
Member Advice Fee and Plan Service Fee (see page A28)
I acknowledge that the arrangements for the payment of the
Member Advice Fee and any Plan Service Fee are as described
in the PDS and page A28.
Signature of applicant
✗
Date
D D MM Y Y Y Y
A29 of 32
Direct Debit Request (section Contribute and Consolidate)
For member, employer or spouse
1. I f I am applying to make a one-off initial or regular direct debit contribution arrangement, I confirm that I have read and agree
to the term of the “Direct debit service agreement” referred to in the AMP Flexible Super PDS.
2. I request AMP Life Limited (user ID000103), until further notice, to debit the amount from the account shown in section 7 of
this application, and at the frequency shown in section 6 of this application.
3. I f I am a spouse of the member I consent to you contacting and communicating with the member about my direct debit
arrangement rather than with me. I also agree that references to “you” and “your” in the direct debit service agreement in the
PDS refer to me as the spouse of the member. Where I am requesting a spouse contribution, I acknowledge that the nominated
bank account is in my name, or is a joint account in my spouse and my name, and I have authorisation to transact for
that account.
Signature of account holder
Signature of account holder
✗
✗
Date
Date
D D MM Y Y Y Y
D D MM Y Y Y Y
Employer declaration
Where I am requesting to make a direct debit contribution(s) to my employee’s AMP Flexible Super plan, I agree and
declare that:
1. I request AMP Life Limited (user ID000103), until further notice, to debit the amount from my account at the frequency as
set out above.
2. I consent to you contacting and communicating with the member about my direct debit arrangement rather than with me.
Signature of account holder
Signature of account holder
✗
✗
Date
Date
D D MM Y Y Y Y
D D MM Y Y Y Y
Witnesses Declarations – for Binding Death benefit nominations only
For a Binding Death benefit nomination, the following is to be read and signed by the two witnesses to you signing and dating
this application:
I declare that:
1. I am 18 years of age or over.
2. I am not a nominated beneficiary of this applicant and my name does not appear on page A25 of this form.
3. This form was signed and dated by the applicant in my presence.
1st witness signature
✗
2nd witness signature
✗
Name of witness
Name of witness
Date
Date
D D MM Y Y Y Y
D D MM Y Y Y Y
A30 of 32
AMP Flexible Super
18. Financial planner and office use only
Financial Planner details
Please provide your name, planner number and contact details. The planner details provided here will be used to make payment of
the Member Advice Fee or Ongoing Member Advice Fee.
AMP Flexible Super – Super account
Name
Planner number
Phone number
Email
Planner number
Phone number
Email
AMP Flexible Super – Retirement account
Name
Customer Identification Verified
Original documentation Certified copies of documentation Customer identification documentation attached
Customer Signature
The customer has received and signed the form summary.
The customer has wetsigned.
I have received signatures on the Request to Transfer Whole Balance of Superannuation Benefits between Funds form and/or
Choice forms and am forwarding them to AMP to action.
I have received signatures on the Request to Transfer Whole Balance of Superannuation Benefits between Funds form and/or
Choice forms and am forwarding them to the relevant institution.
I want AMP to create the Request to Transfer Whole Balance of Superannuation Benefits between Funds form and Choice
forms and send them to the customer for signature.
Authority number – for pre-vetted planners only
Have you received an authority number from AMP for the Statement of Advice (SoA) associated with this application?
Yes No
If “Yes” – please provide the authority number.
Notes
You may not need to complete any further forms.
If you need to complete the Tax file number declaration – please continue to form B.
If you have completed the Consolidation section of the AMP Flexible Super form, and would like to complete the Request to
Transfer Whole Balance of Superannuation Benefits between Funds form – please continue to form C.
If you would like to apply for Flexible Protection insurance – please continue to form D.
A31 of 32
A32 of 32
NS7500A 07/13B
This page has been left blank intentionally.
Instructions and form for taxpayers
Individuals
Tax file number
declaration
Information you provide in this declaration will allow your payer to
work out how much tax to withhold from payments made to you
Do not use this form if you are a beneficiary wanting to provide
your tax file number (TFN) to the trustee of a closely held trust. For
more information, visit www.ato.gov.au/trustsandtfnwithholding
You need to provide all information requested on this form.
Providing the wrong information may lead to incorrect amounts
RI}WD[EHLQJZLWKKHOGIURPSD\PHQWVPDGHWR\RX
TERMS WE USE
When we say:
Q payer, we mean the business or individual making payments
under the pay as you go (PAYG) withholding system.
Q payee, we mean the individual being paid.
WHEN SHOULD YOU USE THIS FORM?
You should complete this form before you start to receive payments
from a new payer. For example, when you receive:
Q payments for work and services as an employee,
FRPSDQ\}GLUHFWRURURIILFHKROGHU
Q payments under return-to-work schemes
Q payments under labour hire arrangements or other
VSHFLILHG}SD\PHQWV
Q benefit and compensation payments
Q super benefits.
The information you provide on this form is used to work out
WKH}DPRXQWRIWD[WREHZLWKKHOGIURPSD\PHQWVPDGHWR\RX
)RU}H[DPSOHLI\RX
Q are claiming the tax-free threshold from this payer
Q are an Australian resident for tax purposes
Q have a Higher Education Loan Program (HELP) debt
Q have a Financial Supplement debt.
You do not need to complete this form if you have
UHDFKHG}}\HDUVRIDJHDQGVWDUWHGDVXSHUEHQHILWWKDW
GRHV}QRWLQFOXGH}DQXQWD[HGHOHPHQWIRUWKDWEHQHILW
WHERE CAN YOU FIND YOUR TFN?
You will find your TFN on:
Q your income tax notice of assessment
Q certain correspondence we send you
Q a payment summary issued to you by your payer.
If you use a registered tax agent, they may also be able
WRWHOO\RX\RXU}7)1
Q
Q
If you still can’t find your TFN, you can:
phone 13 28 61EHWZHHQDPDQGSP0RQGD\WR)ULGD\
visit one of our shopfronts (phone 13 28 61 to make an
appointment).
If you phone or visit us, we need to know we’re talking to the
right person before we can discuss your tax affairs. We’ll ask
for details only you, or someone you’ve authorised would know.
$Q}DXWKRULVHGFRQWDFWLVVRPHRQHZKR\RXpYHSUHYLRXVO\WROGXV
FDQDFWRQ}\RXU}EHKDOI
DO YOU NEED TO APPLY FOR A TFN?
If you don’t have a TFN and want to provide a TFN to your payer,
you will need to complete and lodge a TFN application form. There
are a range of forms available depending on your circumstances.
For more information, see page 4.
1$7
B1 of 8
OTHER FORMS YOU MAY ALSO NEED TO COMPLETE
your benefits are being transferred. You may write to the trustee
RI}\RXU}VXSHUIXQGDQGDVNWKHPQRWWRSURYLGH\RXU7)1WRDQ\
other trustee.
In addition to this TFN declaration, you may also need to complete
and give your payer the following forms:
Q Withholding declaration 1$7 LI\RXZDQWWR
– claim entitlement to the seniors and pensioners tax offset
TXHVWLRQ RURWKHUWD[RIIVHWV TXHVWLRQ – advise your payer to adjust the amount withheld from
SD\PHQWV}PDGHWR\RX
– change information you previously provided in a Tax file
QXPEHU}GHFODUDWLRQ 1$7 tIRUH[DPSOH
- advise your payer that you have become, or ceased to be,
DQ}$XVWUDOLDQUHVLGHQWIRUWD[SXUSRVHV
- claim, or discontinue claiming, the tax-free threshold
- advise your payer of, or make changes to, your HELP
RU})LQDQFLDO6XSSOHPHQWUHSD\PHQWREOLJDWLRQV
- increase the rate or amount to be withheld
- claim or vary your entitlement to zone, overseas forces,
dependent spouse, special tax offset or seniors and
pensioners tax offset
Q Medicare levy variation declaration 1$7 LI\RXTXDOLI\IRUD
reduced rate of Medicare levy or are liable for the Medicare levy
surcharge. You can vary the amount your payer withholds from
your payments (see ‘More information’ on page 4).
For more information about privacy, see ‘Privacy of information’
RQ}SDJH}
Question 6
On what basis are you paid?
Check with your payer if you are not sure.
Question 7
Are you an Australian resident for tax purposes?
Generally, we consider you to be an Australian resident for
WD[}SXUSRVHVLI\RX
Q have always lived in Australia or you have come to Australia and
now live here permanently
Q are an overseas student doing a course that takes more than
VL[}PRQWKVWRFRPSOHWH
Q have been in Australia continuously for six months or more
DQG}IRUPRVWRIWKDWWLPH\RXZRUNHGLQWKHRQHMREDQGOLYHG
LQ}WKHVDPHSODFH
Q will be or have been in Australia for more than half of the
ILQDQFLDO}\HDU XQOHVV\RXUXVXDOKRPHLVRYHUVHDVDQG\RX
GR}QRW}LQWHQGWROLYHLQ$XVWUDOLD SECTION A: TO BE COMPLETED BY THE PAYEE
Question 1
What is your tax file number (TFN)?
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.
This question asks you to quote your TFN. If you need to find
\RXU}7)1UHIHUWRo:KHUHFDQ\RXILQG\RXU7)1"pRQSDJH
The criteria we use to determine residency are not the same as
used by the Department of Immigration and Citizenship or the
Department of Human Services.
We and your payer are authorised by the Taxation
Administration Act 1953 7$$ WRDVNIRU\RXU7)1,WLV
not an offence not to quote your TFN. However, your payer is
required to withhold the top rate of tax plus the Medicare levy
(or the top rate of tax if you are not an Australian resident for tax
purposes) from all payments made to you if you do not provide
your TFN or claim an exemption from quoting your TFN.
FOREIGN RESIDENT TAX RATES ARE DIFFERENT
A higher rate of tax applies to foreign residents’ taxable income
and foreign residents are not entitled to a tax-free threshold.
You are not entitled to claim the tax-free threshold and tax offsets
if you are not an Australian resident for tax purposes. However,
there is an exception with seniors and pensioners, zone or
overseas forces tax offsets.
You may claim an exemption from quoting your TFN.
Print X in the appropriate box if you:
Q
Q
have lodged a TFN application or enquiry form for individuals,
RU}PDGHDSKRQHRUVKRSIURQWHQTXLU\WRREWDLQ\RXU7)1
<RX}QRZKDYHGD\VWRSURYLGH\RXU7)1WR\RXUSD\HU
ZKR}PXVWZLWKKROGDWWKHVWDQGDUGUDWHGXULQJWKLVWLPH
$IWHUGD\VLI}\RXKDYHQRWJLYHQ\RXU7)1WR\RXUSD\HU
WKH\ZLOO}ZLWKKROGWKHWRSUDWHRIWD[SOXVWKH0HGLFDUHOHY\
RUWKH}WRS}UDWHRIWD[LI}\RXDUHQRWDQ$XVWUDOLDQUHVLGHQWIRU
WD[}SXUSRVHV IURPIXWXUH}SD\PHQWV
are claiming an exemption from quoting a TFN because you
DUH}XQGHU\HDUVRIDJHDQGGRQRWHDUQHQRXJKWRSD\WD[
or an applicant or recipient of certain pensions, benefits or
allowances from the
– Department of Human Services – however, you will need
to quote your TFN if you receive Austudy, Newstart, youth,
sickness or parenting allowance
– Department of Veterans’ Affairs – a service pension under
WKH}Veterans’ Entitlement Act 1986
– Military Rehabilitation and Compensation Commission.
Q
Q
Answer no to this question if you are not an Australian resident
IRUWD[SXUSRVHV<RXPXVWDOVRDQVZHUQRDWTXHVWLRQV
DQG XQOHVV\RXDUHDIRUHLJQUHVLGHQWFODLPLQJDVHQLRUV
DQG}SHQVLRQHUV]RQHRURYHUVHDVIRUFHVWD[RIIVHW Question 8
Do you want to claim the tax-free threshold from
WKLV}SD\HU"
The tax-free threshold is the amount of income you can earn each
financial year that is not taxed. By claiming the threshold, you reduce
the amount of tax that is withheld from your pay during the year. It is
DYDLODEOHRQO\WRSHRSOHZKRDUH$XVWUDOLDQUHVLGHQWVIRUWD[}SXUSRVHV
(that is, people who answered yes at question 7).
Provision of your TFN to your super fund
Your payer must quote your TFN to the super fund they pay your
contributions to on your behalf. If your super fund does not have
your TFN, you can provide it to them. This ensures:
Q your super fund can accept all types of contributions to your
account (or accounts)
Q additional tax will not be imposed on contributions as a result
RI}IDLOLQJWRSURYLGH\RXU7)1WR\RXUVXSHUIXQG
Q there will be no additional tax to be deducted when you start
drawing down your super benefits, other than the tax that
PD\}RUGLQDULO\DSSO\
Q you can trace different super accounts in your name so
WKDW}\RX}UHFHLYHDOO\RXUVXSHUZKHQ\RXUHWLUH
Under the Superannuation Industry (Supervision) Act 1993, your
super fund is authorised to collect your TFN, which will only be
used for purposes under the super laws. The trustee of your
super fund may provide your TFN to another super provider if
For more information:
visit www.ato.gov.au/residency to check your Australian
residency status for tax purposes
phone 13 28 61EHWZHHQDPDQGSP0RQGD\WR)ULGD\
The current tax-free threshold can be found at
www.ato.gov.au/taxfreethreshold
2
Answer yes if you want to claim the tax-free threshold, you are an
Australian resident for tax purposes and one of the following applies:
Q you are not currently claiming the tax-free threshold from
DQRWKHU}SD\HU
Q you are currently claiming the tax-free threshold from another
payer and your total income from all sources will be less than the
tax-free threshold.
Answer no if one of the following applies:
Q you answered no at question 7
Q you are currently claiming the tax-free threshold from another
payer and your total income from all sources will be more than
the tax-free threshold
Q you do not want to claim the tax-free threshold.
B2 of 8
You may be eligible for one or more of the following:
Q a zone tax offset if you live or work in certain remote or isolated
areas of Australia
Q an overseas forces tax offset if you serve overseas as a member
of Australia’s Defence Force or a United Nations armed force
Q a dependent spouse tax offset
Q a special tax offset for a dependent relative (invalid relative,
dependent parent, invalid spouse, carer spouse), housekeeper
RU}DGHSHQGHQWFKLOGKRXVHNHHSHU
'2<28+$9(025(7+$121(-2%253$<(5"
If you are certain that your total income for the year from all
sources will be less than the tax-free threshold, you can claim the
threshold from all of your payers.
If your total income for the year from all sources will be more than
the tax-free threshold, you can only claim the threshold from one
payer at a time. Generally, you would choose the one you expect
will pay you the most during the financial year.
If your circumstances change, you must advise your payers by
completing a Withholding declaration 1$7 If you earn more than the tax-free threshold from all sources
and you have claimed the tax-free threshold with more than one
payer at a time, you may end up with a tax debt at the end of the
financial 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 1$7} Answer yes to this question if you are eligible and choose to receive
tax offsets by reducing the amount withheld from payments made
to you from this payer. You also need to complete a Withholding
declaration 1$7 Answer no to this question if you are not eligible for the tax offsets,
choose to receive any of these tax offsets as an end-of-year lump
sum through the tax system, or are already claiming the offset from
another payer.
If you receive any taxable government payments or allowances
such as Newstart, Austudy or Youth Allowance, you are likely to be
DOUHDG\FODLPLQJWKHWD[IUHHWKUHVKROGIURPWKDW}SD\PHQW
FOREIGN RESIDENT
If you are not an Australian resident 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 about your entitlement, which payer
you should claim it from, or how to vary your withholding rate:
Q visit www.ato.gov.au/taxfreethreshold
Q refer to When you have income from two payers (NAT 7473)
RQ}www.ato.gov.au
Q phone 13 28 61EHWZHHQDPDQGSP0RQGD\WR)ULGD\
Q
Q
Question 9
Do you want to claim the seniors and pensioners
WD[}RIIVHWE\UHGXFLQJWKHDPRXQWZLWKKHOGIURP
payments made to you?
For more information about your entitlement:
visit www.ato.gov.au/taxoffsets
phone 13 28 61EHWZHHQDPDQGSP0RQGD\WR)ULGD\
Question 11
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/RDQ3URJUDP +(/3 GHEW"
The senior Australian tax offset (SATO) has been renamed the
seniors and pensioners tax offset (SAPTO). This reflects the
PHUJHU}RIWKHSHQVLRQHUWD[RIIVHWZLWKWKHPRUHJHQHURXV6$72
Answer yes if you have an accumulated HELP debt.
Answer no if you do not have an accumulated HELP debt,
or you have repaid your HELP debt in full.
CLAIM BENEFITS AND TAX OFFSETS WITH
21/<}21(3$<(5
You are not entitled to reduce your withholding amounts, or
FODLP}WKH6$372ZLWKPRUH}WKDQRQHSD\HUDWWKHVDPHWLPH
Q
Q
If you receive income from more than one source and need help
with this question, phone 1300 360 221EHWZHHQDPDQG
SP0RQGD\WR)ULGD\
How your income affects the amount of your tax offset
You must meet the eligibility conditions to receive the SAPTO.
<RXU}UHEDWHLQFRPHQRW\RXUWD[DEOHLQFRPHGHWHUPLQHVWKH
amount, if any, of SAPTO you will receive.
Answer yes if you are eligible and choose to claim the SAPTO with
this payer. To reduce the amount withheld from payments made to
you during the year by this payer, you will also need to complete
a Withholding declaration 1$7 ,I\RXUSD\HUGRHVQRWKDYH
FRSLHVRIWKHIRUPVHHo0RUHLQIRUPDWLRQ3URGXFWVpRQSDJH}
Answer no if one of the following applies:
Q you are not eligible for the SAPTO
Q you are already claiming the SAPTO with another payer
Q you are eligible but want to claim your entitlement to the tax offset
as a lump sum in your end-of-year income tax assessment.
Q
Q
You have a HELP debt if:
the Australian Government lends you money under
HECS-HELP, FEE-HELP, OS-HELP, VET FEE-HELP or SA-HELP
you have a debt from the previous Higher Education
Contribution Scheme (HECS).
For information about repaying your HELP debt:
visit www.ato.gov.au/higheredloans
phone 13 28 61EHWZHHQDPDQGSP0RQGD\WR)ULGD\
(b) Do you have an accumulated Financial
6XSSOHPHQW}GHEW"
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 your Financial Supplement debt in full.
Q
Q
For more information about your eligibility to
claim the tax offset or rebate income:
Q visit www.ato.gov.au/taxoffsets
Q phone 13 28 61EHWZHHQDPDQGSP0RQGD\WR)ULGD\
For information about repaying your Financial Supplement debt:
visit www.ato.gov.au/higheredloans
phone 13 28 61EHWZHHQDPDQGSP0RQGD\WR)ULGD\
Have you repaid this debt?
When you have repaid your accumulated HELP or Financial
Supplement debt, you need to complete a Withholding declaration
1$7 QRWLI\LQJ\RXUSD\HURIWKHFKDQJHLQ\RXUFLUFXPVWDQFHV
Question 10
Do you want to claim a zone, overseas forces,
GHSHQGHQWVSRXVHRUVSHFLDOWD[RIIVHWE\UHGXFLQJ
WKH}DPRXQWZLWKKHOGIURPSD\PHQWVPDGHWR\RX"
SIGN AND DATE THE DECLARATION
Make sure you have answered all the questions in section A then
sign and date the declaration. Give your completed declaration
WR}\RXUSD\HUWRFRPSOHWHVHFWLRQ%
CLAIM TAX OFFSETS WITH ONLY ONE PAYER
You are not entitled to claim tax offsets with more than one payer
at the same time.
3
B3 of 8
SECTION B: TO BE COMPLETED BY THE PAYER
OUR COMMITMENT TO YOU
We are committed to providing you with accurate, consistent
and clear information to help you understand your rights and
entitlements and meet your obligations.
Important information for payers. See the reverse side of the
Payer’s copy of the form.
If you follow our information in this publication and it turns out
WREH}LQFRUUHFWRULWLVPLVOHDGLQJDQG\RXPDNHDPLVWDNHDVD
result, we must still apply the law correctly. If that means you owe
us money, we must ask you to pay it but we will not charge you
D}SHQDOW\$OVRLI\RXDFWHGUHDVRQDEO\DQGLQJRRGIDLWKZHZLOO
QRW}FKDUJH\RXLQWHUHVW
MORE INFORMATION
Internet
Q
Q
For more information about residency, tax-free threshold,
HELP, Financial Supplement debt or your entitlement to
FODLP}WD[RIIVHWVYLVLWwww.ato.gov.au
If you are a permanent migrant or temporary visitor to
Australia, apply for a TFN online at www.iar.ato.gov.au
If you make an honest mistake in trying to follow our information
in this publication and you owe us money as a result, we will not
charge you a penalty. However, we will ask you to pay the money,
and we may also charge you interest. If correcting the mistake
means we owe you money, we will pay it to you. We will also pay
you any interest you are entitled to.
Phone
Q
Q
Payee – for more information, phone 13 28 61 between
DPDQGSP0RQGD\WR)ULGD\,I\RXZDQWWRYDU\
your rate of withholding, phone 1300 360 221 between
DPDQGSP0RQGD\WR)ULGD\
Payer – for more information, phone 13 28 66 between
DPDQGSP0RQGD\WR)ULGD\
If you feel that this publication does not fully cover your
circumstances, or you are unsure how it applies to you,
\RX}FDQ}VHHNIXUWKHUDVVLVWDQFHIURPXV
We regularly revise our publications to take account of any
FKDQJHV}WRWKHODZVRPDNHVXUHWKDW\RXKDYHWKHODWHVW
information. If you are unsure, you can check for more recent
information on our website at www.ato.gov.au or contact us.
If you do not speak English well and need help from the ATO,
phone the Translating and Interpreting Service on 13 14 50.
If you are deaf, or have a hearing or speech impairment, phone
the ATO through the National Relay Service (NRS) on the
numbers listed below:
Q TTY users, phone 13 36 77 and ask for the ATO
number you need (if you are calling from overseas,
SKRQH}}}})
Q Speak and Listen (speech-to-speech relay) users, phone
}} and ask for the ATO number you need (if you
are calling from overseas, phone +61 7 3815 8000)
Q internet relay users, connect to the NRS on
www.relayservice.com.au and ask for the
ATO number you need.
This publication was current at September 2012.
If you would like further information about the
National Relay Service, phone 1800 555 660 or
email helpdesk@relayservice.com.au
Only certain people and organisations can ask for your TFN.
These include employers, some Australian Government agencies,
trustees for super funds, payers under the PAYG system, higher
education and vocational education and training (VET) providers
and investment bodies such as banks. We are authorised by the
Taxation Administration Act 1953 to collect your TFN. You are
not required by law to provide your TFN. However, quoting your
7)1UHGXFHVWKHULVNRIDGPLQLVWUDWLYHHUURUV}DQGKDYLQJH[WUD
WD[}ZLWKKHOG
PRIVACY OF INFORMATION
We are authorised by the Income Tax Assessment Act 1936 and
7$$WRDVNIRULQIRUPDWLRQRQWKLVGHFODUDWLRQ:HQHHGWKLV
information to help us administer those laws.
Where we are authorised by law to do so, we may give this
information to other government agencies. These agencies could
include Department of Human Services, Australian Federal Police,
Departments of Families, Housing, Community Services and
,QGLJHQRXV$IIDLUV9HWHUDQVp$IIDLUVDQG}(GXFDWLRQ(PSOR\PHQW
and Workplace Relations.
If you phone, we need to know we’re talking to the right
SHUVRQ}EHIRUHZHFDQGLVFXVV\RXUWD[DIIDLUV:HpOODVNIRU
details only you, or someone you’ve authorised, would know.
An authorised contact is someone who you’ve previously told
us can act on your behalf.
Products
If you need more information about how the tax laws protect your
personal information, or have any concerns about how we have
handled your personal information, phone 13 28 61 between
DPDQGSP0RQGD\WR)ULGD\
We produce a number of products that may be useful to you.
You can get the following forms and publications from our
shopfronts, website at www.ato.gov.au/onlineordering or
E\}SKRQLQJ:
Q Withholding declaration 1$7
Q Medicare levy variation declaration 1$7
Q Withholding declaration – upwards variation 1$7
Q Repaying your HELP debt 1$7
Q Tax file number – application or enquiry for individuals
1$7}
Q Tax file number – application or enquiry for individuals living
outside Australia 1$7
Q Tax file number – application or enquiry for Aboriginals or
Torres Strait Islanders 1$7 WHAT TO DO IF YOU ARE CONCERNED ABOUT
PRIVACY ISSUES
If you have privacy concerns, visit www.privacy.gov.au
© AUSTRALIAN TAXATION OFFICE FOR THE
&20021:($/7+}2)}$8675$/,$
PUBLISHED BY
Australian Taxation Office
Canberra
6HSWHPEHU
You are free to copy, adapt, modify, transmit and distribute this material as
\RX}ZLVK} EXWQRWLQDQ\ZD\WKDWVXJJHVWVWKH$72RUWKH&RPPRQZHDOWK
HQGRUVHV}\RXRUDQ\RI\RXUVHUYLFHVRUSURGXFWV -6
4
B4 of 8
ORIGINAL – ATO copy
7D[ƂOHQXPEHUGHFODUDWLRQ
This declaration is NOT an application for a tax file number.
Q Use a black or blue pen and print clearly in BLOCK LETTERS.
Q Print X in the appropriate boxes.
Q Read all the instructions before you complete this declaration.
www.ato.gov.au
30920912
Section A: To be completed by the PAYEE
1 What is your tax
ƂOHQXPEHU 7)1 "
6 On what basis are you paid? (Select only one.)
OR I have made a separate application/enquiry to
the ATO for a new or existing TFN.
For more
information, see
question 1 on page 2
of the instructions.
OR I am claiming an exemption because I am under
18 years of age and do not earn enough to pay tax.
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
Full-time
employment
Part-time
employment
Labour
hire
7 Are you an Australian resident
IRU}WD[SXUSRVHV"
Superannuation
income stream
Yes
Casual
employment
You must answer no
at question 8.
No
(visit www.ato.gov.au/residency to check)
8 Do you want to claim the tax-free threshold from this payer?
Only claim the tax-free threshold from one payer at a time, unless your
total income from all sources for the financial year will be less than the
tax-free threshold.
Answer no at questions 9 and 10 unless you are a
IRUHLJQ}UHVLGHQW}FODLPLQJDVHQLRUVDQGSHQVLRQHUV
No
Yes
zone or overseas forces tax offset.
9 Do you want to claim the seniors and pensioners tax offset by
reducing the amount withheld from payments made to you?
First given name
Yes
Other given names
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?
3 If you have changed your name since you last dealt with us,
VKRZ}\RXUSUHYLRXVIDPLO\QDPH
Day
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 2 of the instructions.
Yes
Month
Year
11 (a) Do you have an accumulated Higher Education Loan
Program (HELP) debt?
Yes
4 What is your date of birth?
No
Complete a Withholding declaration (NAT 3093).
Your payer will withhold additional amounts to cover any compulsory
repayments that may be raised on your notice of assessment.
No
(b) Do you have an accumulated Financial Supplement debt?
5 What is your home address in Australia?
Yes
Your payer will withhold additional amounts to cover any compulsory
repayments that may be raised on your notice of assessment.
No
DECLARATION by payee: I declare that the information I have given is true and correct.
Signature
Date
Suburb or town
Day
State/territory
Month
Year
You MUST SIGN here
Postcode
There are penalties for deliberately making a false or misleading statement.
2QFHVHFWLRQ$LVFRPSOHWHGDQGVLJQHGJLYHLWWR\RXUSD\HUWRFRPSOHWHVHFWLRQ}%
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?
8 4
0 7 9
3 0 0
Branch number
(if applicable)
3 7 9
2 If you don’t have an ABN or withholding payer number,
have you applied for one?
Yes
Suburb or town
No
State/territory
3 What is your legal name or registered business name
(or your individual name if not in business)?
A M P
4 What is your business address?
L I F E
Postcode
5 Who is your contact person?
L I M I T E D
Business phone number
6 If you no longer make payments to this payee, print X in this box
DECLARATION by payer: I declare that the information I have given is true and correct.
Signature of payer
Date
Day
Month
There are penalties for deliberately making a false or misleading statement.
NAT 3092-09.2012
Year
Return the completed original ATO copy to:
For NSW, QLD or ACT
For WA, SA, NT, VIC or TAS
Australian Taxation Office
Australian Taxation Office
PO Box 9004
PO Box 795
PENRITH NSW 2740
ALBURY NSW 2640
IMPORTANT
See reverse side of
Payer’s copy for:
Q payer obligations
Q lodging online.
TAXPAYER-SENSITIVE (when completed)
[JS 25141]
B5 of 8
Payer’s copy
7D[ƂOHQXPEHUGHFODUDWLRQ
This declaration is NOT an application for a tax file number.
Q Use a black or blue pen and print clearly in BLOCK LETTERS.
Q Print X in the appropriate boxes.
Q Read all the instructions before you complete this declaration.
www.ato.gov.au
Section A: To be completed by the PAYEE
1 What is your tax
ƂOHQXPEHU 7)1 "
6 On what basis are you paid? (Select only one.)
OR I have made a separate application/enquiry to
the ATO for a new or existing TFN.
For more
information, see
question 1 on page 2
of the instructions.
OR I am claiming an exemption because I am under
18 years of age and do not earn enough to pay tax.
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
Full-time
employment
Part-time
employment
Labour
hire
7 Are you an Australian resident
IRU}WD[SXUSRVHV"
Superannuation
income stream
Yes
Casual
employment
You must answer no
at question 8.
No
(visit www.ato.gov.au/residency to check)
8 Do you want to claim the tax-free threshold from this payer?
Only claim the tax-free threshold from one payer at a time, unless your
total income from all sources for the financial year will be less than the
tax-free threshold.
Answer no at questions 9 and 10 unless you are a
IRUHLJQ}UHVLGHQW}FODLPLQJDVHQLRUVDQGSHQVLRQHUV
No
Yes
zone or overseas forces tax offset.
9 Do you want to claim the seniors and pensioners tax offset by
reducing the amount withheld from payments made to you?
First given name
Yes
Other given names
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?
3 If you have changed your name since you last dealt with us,
VKRZ}\RXUSUHYLRXVIDPLO\QDPH
Day
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 2 of the instructions.
Yes
Month
Year
11 (a) Do you have an accumulated Higher Education Loan
Program (HELP) debt?
Yes
4 What is your date of birth?
No
Complete a Withholding declaration (NAT 3093).
Your payer will withhold additional amounts to cover any compulsory
repayments that may be raised on your notice of assessment.
No
(b) Do you have an accumulated Financial Supplement debt?
5 What is your home address in Australia?
Yes
Your payer will withhold additional amounts to cover any compulsory
repayments that may be raised on your notice of assessment.
No
DECLARATION by payee: I declare that the information I have given is true and correct.
Signature
Date
Suburb or town
State/territory
Day
Month
Year
You MUST SIGN here
Postcode
There are penalties for deliberately making a false or misleading statement.
2QFHVHFWLRQ$LVFRPSOHWHGDQGVLJQHGJLYHLWWR\RXUSD\HUWRFRPSOHWHVHFWLRQ}%
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)
2 If you don’t have an ABN or withholding payer number,
have you applied for one?
Yes
4 What is your business address?
Suburb or town
No
State/territory
3 What is your legal name or registered business name
RU}\RXU}LQGLYLGXDO}QDPHLIQRWLQEXVLQHVV "
Postcode
5 Who is your contact person?
Business phone number
6 If you no longer make payments to this payee, print X in this box
DECLARATION by payer: I declare that the information I have given is true and correct.
Signature of payer
Date
Day
Month
There are penalties for deliberately making a false or misleading statement.
NAT 3092-09.2012
Year
Return the completed original ATO copy to:
For NSW, QLD or ACT
For WA, SA, NT, VIC or TAS
Australian Taxation Office
Australian Taxation Office
PO Box 9004
PO Box 795
PENRITH NSW 2740
ALBURY NSW 2640
IMPORTANT
See reverse side of
Payer’s copy for:
Q payer obligations
Q lodging online.
TAXPAYER-SENSITIVE (when completed)
[JS 25141]
B6 of 8
PAYER INFORMATION
The following information will help you comply with your pay as you go (PAYG) withholding obligations.
,6<285(03/2<(((17,7/('72:25.,1$8675$/,$"
It is a criminal offence to knowingly or recklessly allow someone to work, or to refer someone for work, where that
person is from overseas and is either in Australia illegally or is working in breach of their visa conditions.
People or companies convicted of these offences may face fines and/or imprisonment. To avoid penalties, ensure your
SURVSHFWLYH}HPSOR\HHKDVDYDOLGYLVDWRZRUNLQ$XVWUDOLDEHIRUH\RXHPSOR\WKHP)RUPRUHLQIRUPDWLRQDQGWRFKHFN
a visa holder’s status online, visit the Department of Immigration and Citizenship website at www.immi.gov.au
PAYER OBLIGATIONS
If you withhold amounts from payments, or are likely to withhold amounts, the payee may give you this form with section A completed.
A TFN declaration applies to payments made after the declaration is provided to you. The information provided on this form is used to
determine the amount of tax to be withheld from payments based on the PAYG withholding tax tables we publish. If the payee gives
\RX}DQRWKHUGHFODUDWLRQLWRYHUULGHVDQ\SUHYLRXVGHFODUDWLRQV
HAS YOUR PAYEE ADVISED YOU THAT THEY HAVE APPLIED FOR A TFN, OR
ENQUIRED ABOUT THEIR EXISTING TFN?
:KHUHWKHSD\HHLQGLFDWHVDWTXHVWLRQRQWKLVIRUPWKDWWKH\KDYHDSSOLHGIRUDQLQGLYLGXDO7)1RUHQTXLUHGDERXWWKHLUH[LVWLQJ7)1WKH\
KDYHGD\VWRJLYH\RXWKHLU7)1You must withhold tax for 28 days at the standard rate according to the PAYG withholding tax
tables.$IWHUGD\VLIWKHSD\HHKDVQRWJLYHQ\RXWKHLU7)1\RXPXVWWKHQZLWKKROGWKHWRSUDWHRIWD[SOXVWKH0HGLFDUHOHY\ RUWKHWRS
UDWHRIWD[LIWKH\DUHQRWDQ$XVWUDOLDQUHVLGHQWIRUWD[SXUSRVHV IURP}IXWXUH}SD\PHQWVXQOHVVZHWHOO\RXQRWWR
IF YOUR PAYEE HAS NOT GIVEN YOU A COMPLETED FORM YOU MUST:
QQRWLI\XVZLWKLQGD\VRIWKHVWDUWRIWKHZLWKKROGLQJREOLJDWLRQE\FRPSOHWLQJDVPXFKRIWKHSD\HHVHFWLRQRIWKHIRUPDV\RXFDQ
Q
3ULQW}o3$<(5pLQWKHSD\HHGHFODUDWLRQDQGORGJHWKHIRUPtVHHo/RGJLQJWKHIRUPp
withhold the top rate of tax plus the Medicare levy (or the top rate of tax if they are not an Australian resident for tax purposes) from
DQ\}SD\PHQWWRWKDWSD\HH
LODGING THE FORM
<RXQHHGWRORGJH7)1GHFODUDWLRQVZLWKXVZLWKLQGD\VDIWHUWKHIRUPLVHLWKHUVLJQHGE\WKHSD\HHRUFRPSOHWHGE\\RX LIQRW
SURYLGHG}E\WKHSD\HH <RXQHHGWRUHWDLQWKHSD\HUpVFRS\IRU\RXUUHFRUGV)RULQIRUPDWLRQDERXWVWRUDJHDQGGLVSRVDOVHHEHORZ
You may lodge the information:
Q online – lodge your TFN declaration reports using software that complies with our specifications. There
is no need to complete section B of each form as the payer information is supplied by your software.
QE\SDSHUtFRPSOHWHVHFWLRQ%DQGVHQGWKHRULJLQDOWRXVZLWKLQGD\V
For more information about lodging your TFN declaration report online, visit www.ato.gov.au/lodgetfndeclaration
PROVISION OF PAYEE’S TFN TO THE PAYEE’S SUPERANNUATION FUND
If you make a super contribution for your payee, you need to give your payee’s TFN to their super fund on the day of contribution,
RULIWKHSD\HHKDVQRW\HWTXRWHGWKHLU7)1ZLWKLQGD\VRIUHFHLYLQJWKLVIRUPIURP\RXUSD\HH
STORING AND DISPOSING OF TFN DECLARATIONS
Under the TFN guidelines in the Privacy Act 1988, you must use secure methods when storing and disposing of TFN information. You may
store electronic files of scanned forms as an alternative to storing paper forms. Scanned forms must be clear and not altered in any way.
If a payee:
Q submits a new TFN declaration 1$7 \RXPXVWUHWDLQDFRS\RIWKHHDUOLHUIRUPIRUWKHFXUUHQWDQGIROORZLQJILQDQFLDO\HDU
QKDVQRWUHFHLYHGSD\PHQWVIURP\RXIRUPRQWKV\RXPXVWUHWDLQDFRS\RIWKHODVWFRPSOHWHGIRUPIRUWKHFXUUHQWDQGIROORZLQJ
financial year.
PENALTIES
You may incur a penalty if you do not:
Q lodge TFN declarations with us
Q keep the payer copy of completed TFN declarations for your records
Q provide the payee’s TFN to their super fund where the payee quoted their TFN to you.
B7 of 8
B8 of 8
NS7500B 07/13B
This page has been left blank intentionally.
Consolidation
AMP Consolidation Instruction Sheet
Consolidate your superannuation accounts
You do not need to complete this form now. Based on the information you provide to us in the AMP Flexible Super
application form, we can pre-populate your Request to Transfer Whole Balance of Superannuation Benefits between
Funds form and return it to you to sign. Alternatively, you can complete this form now.
If you decide to complete the Request to Transfer Whole Balance of Superannuation Benefits between Funds form now,
your next steps are explained below. We have also provided you with a checklist to assist you in providing us with the
information we need to process your consolidation.
Note: Before consolidating your funds into your AMP Flexible Super account (ie your new account), you may want to speak
to your previous superannuation fund (ie your non-AMP fund) or planner to discuss any effects and/or impacts of
transferring your super benefits. Some funds may charge transfer, exit, withdrawal, and/or other fees and there may be
differences between insurance cover types and amounts and the available investment options.
If you have insurance cover with your previous super fund and wish to maintain that cover, transferring your benefit may
cause cancellation of that cover. You should be aware of all the implications before transferring your benefit.
Checklist
Have you considered AMP’s request for you to supply your Tax File Number (TFN) in this form?
Note: You are under no obligation to provide your TFN, either now or later, and it is not an offence not to provide your
TFN. For further information regarding providing your TFN please refer to the Product Disclosure Statement (PDS).
If you have not provided your TFN, have you organised certified copies of identification for each non-AMP external
rollover (if applicable)?
Have you signed the Request to Transfer Whole Balance of Superannuation Benefits between Funds form?
Once you have completed all the steps in the checklist send the documents to us at the address below.
No stamp is required.
New Business Applications
Reply Paid 62990
PARRAMATTA NSW 2124
If you have any questions regarding the completion of the above please contact our Customer Service on 131 267.
Regulated superannuation fund certification
AMP Superannuation Limited has a Registrable Superannuation Entity (RSE) Licence. The RSE Licence number is L0000550.
AMP Superannuation Limited registered the AMP Retirement Trust (ART) with the Australian Prudential Regulation
Authority (APRA). The registration number for the ART is R1075274 and the ABN is 73 310 248 809.
The ART is:
–– A resident regulated superannuation fund within the meaning of the Superannuation Industry (Supervision)
Act 1993 (SIS).
–– Not subject to a direction under section 63 of SIS, and
–– Has never previously been subject to a direction under section 63 of SIS.
AMP Superannuation Limited confirms that the ART is a complying superannuation fund under Part 3-30 of the
Income Tax Assessment Act 1997.
For and on behalf of AMP Superannuation Limited.
C1 of 8
This page has been left blank intentionally.
C2 of 8
Consolidation
Completing the Request to Transfer Whole Balance
of Superannuation Benefits between Funds form
By completing this form, you will request the transfer of the WHOLE balance of your superannuation benefits between funds.
This form CANNOT be used to transfer part of the balance of your superannuation benefits.
This form will NOT change the fund to which your employer pays your contributions. The Choice form must be used by you
to change funds.
Before completing this form
–– Read the below.
–– Check that the fund you are transferring your benefits
TO can accept this transfer.
Certified proof of identity documentation will be
required if you do not provide your Tax File Number (TFN).
When completing this form
–– Refer to these instructions where a question shows a
message like this:
–– Print clearly in BLOCK LETTERS.
After completing this form
–– Sign the authorisation.
–– If you have not provided your TFN attach the
appropriately certified proof of identity documents.
(Refer to C4 of 8 – “Completing proof of identity”)
–– Review the checklist below.
–– Send the request form to your fund.
Important information
This transfer may close your account (you will need to
check this with your FROM fund).
This form CANNOT be used to:
–– Transfer part of the balance of your
superannuation benefits.
–– Transfer benefits if you don’t know where your
superannuation is.
–– Transfer benefits from multiple funds on this one
form – a separate form must be completed for each
fund you wish to transfer superannuation from.
–– Change the fund to which your employer pays
contributions on your behalf.
–– Open a superannuation account, or
–– Transfer benefits under certain conditions or
circumstances, for example if there is a
superannuation agreement under the Family Law
Act 1975 in place.
Checklist
Have you read the important information?
Have you considered where your future employer
contributions will be paid?
Have you checked your TO fund can accept the transfer?
Have you completed all of the mandatory fields
on the form?
Have you signed and dated the form?
If you have not provided your TFN, have you attached
the certified documentation including any linking
documents if applicable? (Refer to C4 of 8 –
“Completing proof of identity”).
What happens to my future employer contributions?
Using this form to transfer your benefits will not change the
fund to which your employer pays your contributions and
may close the account you are transferring your
benefits FROM.
If you wish to change the fund into which your contributions
are being paid, you will need to speak to your employer about
choice. For the appropriate forms and information about
whether you are eligible to choose the fund to which your
employer contributions are made, contact an AMP Customer
Service Officer on 131 267 for further information.
Things you need to consider when transferring
your superannuation
When you transfer your superannuation, your entitlements
under that fund may cease. You need to consider all relevant
information before you make a decision to transfer your
superannuation. If you ask for information, your
superannuation provider must give it to you. Some of the
points you may consider are:
–– Fees – your FROM fund must give you information about
any exit or withdrawal fees. If you are not aware of the
fees that may apply, you should contact your fund for
further information before completing this form. The
fees could include administration fees as well as exit or
withdrawal fees. Your TO fund may also charge entry or
deposit fees on transfer. Differences in fees funds charge
can have a significant effect on what you will have to
retire on. For example, a 1% increase in fees may
significantly reduce your final benefit.
–– Death and disability benefits – your FROM fund may
insure you against death, illness or an accident which
leaves you unable to return to work. If you choose to
leave your current fund, you may lose any insurance
entitlements you have. Other funds may not offer
insurance, or may require you to pass a medical
examination before they cover you. When considering a
new fund, you may wish to check the costs and amount
of any cover offered.
C3 of 8
What happens if I do not quote my Tax File Number (TFN)?
You are not obligated to provide your TFN to your
superannuation fund. However, if you do not provide your TFN,
your fund may be taxed at the highest marginal tax rate plus
the Medicare levy on contributions made to your account in
the year, compared to the concessional tax rate of 15%. Your
fund may deduct this additional tax from your account.
Certified proof of identification must be provided if you do
not provide your TFN.
If your superannuation fund does not have your TFN,
you will not be able to make personal contributions to your
superannuation account. Choosing to quote your TFN will
also make it easier to keep track of your superannuation in
the future.
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 TFN may be disclosed to another superannuation
provider, when your benefits are being transferred, unless
you request in writing that your TFN is not to be disclosed
to any other trustee.
Transfers to self managed superannuation funds
You may use this form to transfer your benefits to your
own Self Managed Superannuation Fund (SMSF).
Certified proof of identification must be provided.
You should be aware that SMSFs are subject to the same rules
and restrictions as other funds, when benefits are to be paid
out. In particular, superannuation benefits in a SMSF are
required to be “preserved”, meaning they are not generally
able to be accessed until you are over age 55 and retired.
The trustee of your FROM fund may be able to request further
information from you about your status as a member, a trustee
or a director of a corporate trustee of your SMSF, if there are
multiple transfer requests to your SMSF. Penalties may apply
for providing false or misleading information.
One of the
following documents:
One of the
following documents:
–– Birth certificate or
birth extract
–– Letter from Centrelink
regarding a
Government assistance
payment
–– Citizenship certificate
issued by the
Commonwealth
–– Notice issued by
Commonwealth, State
–– Pensioner card issued
or Territory
by Centrelink that
Government or local
AND
entitles the person to
council within the past
financial benefits.
12 months that
contains your name
and residential address.
For example:
–– Tax Office Notice of
Assessment
–– Rates notice from
local council.
Have you changed your name or are you signing on behalf
of another person?
If you have changed your name or are signing on behalf of the
applicant, you will need to provide a certified linking document.
A linking document is a document that proves a relationship
exists between two (or more) names.
The following table contains information about suitable
linking documents.
Purpose
Suitable linking documents
Change of
name
Marriage certificate, deed poll or change of
name certificate from the Births, Deaths
and Marriages Registration Office.
Signed on
behalf of the
applicant
Guardianship papers or Power of Attorney.
Completing proof of identity
If you have elected not to provide your TFN, you will need to
provide documentation with this transfer request to prove
you are the person to whom the superannuation
entitlements belong.
Acceptable documents
The following documents may be used.
EITHER
One of the following documents only:
–– Driver’s licence issued under State or Territory law
–– Passport.
OR
C4 of 8
Consolidation
Certification of personal documents
All copied pages of ORIGINAL proof of identification documents
(including any linking documents) need to be certified as true
copies by any individual approved to do so (see below).
The person who is authorised to certify documents must sight
the original and the copy and make sure both documents are
identical, then make sure all pages have been certified as true
copies by writing or stamping “certified true copy” followed by
their signature, printed name, qualification (eg Justice of the
Peace, Australia Post employee, etc) and date.
The following can certify copies of the originals as true and
correct copies:
–– A permanent employee of Australia Post with five or more
years of continuous service.
–– A finance company officer with five or more years of
continuous service (with one or more finance companies).
–– An officer with, or authorised representative of, a holder of
an Australian Financial Services Licence (AFSL), having five or
more years continuous service with one or more licensees.
–– A notary public officer.
–– A police officer.
–– A registrar or deputy registrar of a court.
–– A Justice of the Peace.
–– A person enrolled on the roll of a State or Territory Supreme
Court or the High Court of Australia, as a legal practitioner.
–– An Australian consular officer or an Australian
diplomatic officer.
–– A judge of a court.
–– A magistrate, or
–– A Chief Executive Officer of a Commonwealth court.
Where do I send the form?
You can send your completed and signed form with your
certified proof of identity documents to either fund.
More information
For more information about superannuation, visit the:
–– Australian Securities and Investments Commission
website at fido.asic.gov.au, or
–– Australian Taxation Office website at
ato.gov.au/super
C5 of 8
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C6 of 8
Consolidation
Request to Transfer Whole Balance of Superannuation
Benefits between Funds form
Under the Superannuation Industry (Supervision) Act 1993
Completing this form
After completing this form
–– Read the important information pages
–– Sign the authorisation
–– Refer to instructions where indicated with a
–– S
end form and if you have not provided your TFN attach
certified proof of identity documents to either your
FROM or TO fund.
–– This form is only for whole (not part) balance transfers.
1. Personal details
Title
Contact phone number*
( )
Surname*
Residential address (must not be a PO box)
Given name(s)*
Other/previous names
Address*
Suburb*
State*
Postcode*
Date of birth*
D D MM Y Y Y Y
Previous address
TFN (Tax file number)
Under the Superannuation Industry (Supervision) Act 1993, you
are not obliged to disclose your Tax File Number, but there may
be tax consequences.
I f you know that the address held by your fund is
different to your current residential address, please give
details below.
Address*
See “What happens if I do not quote my Tax File Number?”
Gender*
Male Suburb*
State* Postcode*
Female
* Denotes mandatory field. If you do not complete all of the mandatory fields,
there may be a delay in processing your request.
IN CONFIDENCE – When completed
C7 of 8
2. Fund details
TO
Fund name*
FROM
Fund name*
AMP Retirement Trust
PO Box 300, PARRAMATTA NSW 2124
Fund phone number
Fund phone number*
( )
131 267
Membership or account number
Membership or account number*
Australian business number (ABN)
Australian business number (ABN)
7 3
Unique Superannuation Identifier (USI)
3 1 0
2 4 8
8 0 9
Unique Superannuation Identifier (USI)
AMP1248AU
You
must check with your TO fund to ensure
they can accept this transfer.
I f you have multiple account numbers with this fund,
you must complete a separate form for each account
you wish to transfer.
3. *Proof of identity
See C4 of 6 – “Completing proof of identity” (only if no TFN has been provided)
I have attached a certified copy of my Driver’s Licence or passport, OR
I have attached certified copies of both:
Birth/Citizenship Certificate or Centrelink Pensioner or Card, AND
Centrelink payment letter or Government or local council notice (<1 year old) with name and address.
4. Authorisation
See C4 of 6 – “Completing proof of identity”
By signing this request form I am making the
following statements:
–– I declare I have fully read this form and the information
completed is true and correct.
Signature*
✗
–– I am aware I may ask my superannuation provider for
information about any fees or charges that may apply,
or any other information about the effect this transfer
may have on my benefits, and do not require any
further information.
Name (Print in BLOCK LETTERS)*
–– If the TO fund is a Self Managed Superannuation Fund
(SMSF), I confirm that I am a member, trustee or director
of a corporate trustee of the SMSF.
D D MM Y Y Y Y
Date*
–– I discharge the superannuation provider of my FROM fund
of all further liability in respect of the benefits paid and
transferred to my TO fund.
* Denotes mandatory field. If you do not complete all of the mandatory fields,
there may be a delay in processing your request.
IN CONFIDENCE – When completed
C8 of 8
NS7500C 07/13B
–– I request and consent to the transfer of my superannuation
as described above and authorise AMP Life Limited to
contact my other fund to obtain any details relevant to the
transfer of my superannuation benefit to AMP.
Flexible Protection
AMP Flexible Super‰ Application for
Flexible Protection Insurance form
If you have any queries, contact your financial planner or phone
Customer Service on 131 267. Before completing this form, you must
read the PDS (and Fact Sheets) for AMP Flexible Super.
Office/Planner use only
Plan number
Request ID
1. Personal details
Client details
Correspondence address
Member number
Note: This form cannot be used to change address details.
Please use a Change of Address form if you wish to
change address.
Title
Residential address (a PO Box is not acceptable)
Surname
Suburb
State
Postcode
Given name(s)
Country
Date of birth
Sex
D D MM Y Y Y Y
Male Female
Home phone number
Fax number
( )
Mobile number
Email address
2. Existing insurance details
Note: Members with existing AMP Flexible Super or AMP Flexible Super Employer Insurance (Death cover, or Death cover and
Total and Permanent Disablement (TPD) cover) are not required to disclose the details of that cover in this section.
All other AMP Insurance cover must be disclosed.
Other than this/these applications, are you applying for, or do you have in force, any personal insurance with AMP or with
any other insurer?
Yes No
If yes, please include on page D2:
–– Any policies in force with AMP.
–– Any policies in force with other insurers.
–– Any policies that you are applying for with other insurers.
Please do not include:
–– Values of cover from this application.
Issued by AMP Superannuation Limited ABN 31 008 414 104, AFSL No. 233060, the trustee
of the AMP Retirement Trust ABN 73 310 248 809, RSE Registration No. R1075274.
® Registered trademark of AMP Limited ABN 49 079 354 519.
D1 of 6
2. Existing insurance details (continued)
Name of insurer:
Is this cover to be cancelled?4 Yes Life cover ($)
No
If “Yes” – please give policy number:
TPD cover ($)
Trauma cover ($)
Monthly disability
(income) cover ($)
Disability type
TSC1
Cover amount
IP2
Amount to cancel
BOI3
Name of insurer:
Is this cover to be cancelled?4 Yes Life cover ($)
No
If “Yes” – please give policy number:
TPD cover ($)
Trauma cover ($)
Monthly disability
(income) cover ($)
Disability type
TSC1
Cover amount
IP2
Amount to cancel
BOI3
Name of insurer:
Is this cover to be cancelled?4 Yes Life cover ($)
No
If “Yes” – please give policy number:
TPD cover ($)
Trauma cover ($)
Monthly disability
(income) cover ($)
Disability type
TSC1
Cover amount
IP2
Amount to cancel
BOI3
1 Temporary Salary Continuance cover.
2 Income Protection cover.
3 Business Overheads Insurance cover.
4 I mportant note: Your application will be considered on the understanding that if you intend to cancel any existing cover, that you will do so on
acceptance of this application. Failure to do so may render invalid a claim on your AMP plan. If this application is to replace a current AMP plan,
the plan to be replaced will cease and a new plan will start.
3. Insurance options
Note:
Insurance cover does not start until we accept the insurance risk in writing.
Have you smoked tobacco or any other substance or used nicotine replacement products within the last 12 months?
Yes No
Current occupation:
Extra Death Benefit (EDB)
$
Indexed for inflation?
Yes No
Indexed for inflation?
Yes No
TPD benefit occupation category
A Waiver benefit
Yes No
Business Safeguard benefit
Yes No
Temporary Salary Continuance
(TSC) benefit
Yes No
Total and Permanent Disablement
(TPD) benefit
$
B C
Please complete the Temporary Salary Continuance
Benefit section
D2 of 6
Flexible Protection
3. Insurance options (continued)
Temporary Salary Continuance benefit
Do you want to select the Superannuation Contribution Option?
Yes No
If you have ticked ‘yes’, please indicate your nominated
Superannuation Contribution option percentage.
Income pre-tax pa
Total maximum monthly benefit (including Superannuation
Contribution Option amount)
%
$
$
Indexed for inflation?
Yes Benefit period
2 years Waiting period
4 weeks No
to age 65
8 weeks 13 weeks 26 weeks
104 weeks (Benefit period to age 65 only)
TSC benefit occupation category
4A 3A 2A A 4B 3B 2B 1B
4. Transfers
Are you eligible for a transfer of insurance benefits from another AMP plan?
Yes No
If so, are you applying for an increase in cover or adding any new benefits?
Yes No
To find out if you are eligible to transfer your insurance benefits, call us on 131 267.
AMP policy/plan number you are transferring from
I/We as plan owner(s) of the plan above (or insured person, if a superannuation plan), request that this plan be altered as indicated,
effective from when the insurance benefits have been added.
Note: If you are transferring from an existing AMP (insurance only superannuation) plan and want to claim a tax deduction for
contributions made to that plan, it is very important that you call us before returning this form. We will send you a Notice of intent
to claim a tax deduction form to complete and return.
Signature of owner 1
✗
Signature of owner 2
✗
Date
Date
D D MM Y Y Y Y
D D MM Y Y Y Y
5. Personal Statement
Please complete the Personal Statement available from your financial planner or on amp.com.au.
6. Agreement and Declaration
1. I confirm that I have given and have read, or have had the
opportunity to read, the latest AMP Flexible Super Product
Disclosure Statement (PDS) as well as any Fact Sheets or
updates to that PDS. I am aware that there is additional
insurance information relating to the PDS available in the
AMP Flexible Super Fact Sheets. The Fact Sheets include
information on when AMP and trustee will pay the benefits.
–– Have read the Duty of Disclosure in the Personal
Statement and understand that my Duty of Disclosure
continues after completion of this form until the time
AMP advises me in writing that it has accepted the risk.
2. T
o the best of my knowledge, information and belief, the
information provided in this application and in any other
documents I provide for the purpose of this application is
accurate and complete even if the information has been
written by someone else.
–– Authorise any doctor, hospital or other health service
provider that I have or may attend to release details of
my personal medical history, including referrals to or
treatment by other practitioners, to AMP. I have been
advised by AMP of the ways this information may be
used, and to whom it may be disclosed, and approve
those purposes.
3. By completing and signing this application form and I have
completed a Personal Statement, I:
–– Will advise AMP of any change to my health or occupation
or any other matters that could be relevant to AMP, prior to
any insurance benefit being increased or added to my plan.
D3 of 6
6. Agreement and Declaration (continued)
4. I f I am transferring insurance cover from another AMP Life
(Existing plan):
a. I understand that:
–– Cover in the Existing plan ends when the AMP Flexible
Super (Flexible Protection) insurance benefit is added
to my plan.
–– My AMP Flexible Super (Flexible Protection) insured
benefits are provided on the basis that the statements
made by me are accurate and complete, and
–– Any special conditions applying to the Existing plan
will continue under the new plan.
b. I confirm that I complied with my Duty of Disclosure,
when applying for the Existing plan.
5. I understand that I cannot receive a Terminal Illness benefit
or Total and Permanent Disablement benefit (including
benefits paid under the definition for professionals, senior
managers and home duties) in cash or to commence a
pension unless I am eligible to access my super benefit.
6. I have read the Privacy Information in the PDS and agree to
the various uses and exchanges of my personal information
and acknowledge my right to access personal information
held about me by the AMP group.
I give my consent to my financial planner to provide
information to AMP, on my behalf, concerning my health,
pastimes, occupation and financial status, for the purpose of
expediting the assessment of my application for insurance.
Yes No
I give my consent to AMP to disclose to my financial planner
any personal medical information or finding that results in
my application for insurance being accepted on non-standard
or amended terms, or declined. I understand that AMP will
not provide copies of medical or other reports regarding my
application for insurance to my financial planner without first
obtaining my specific consent to do so.
Yes No
Signature of member
✗
Date
D D MM Y Y Y Y
7. Financial planner and office use only
Financial planner details
Note: If splitting fees this applies to initial risk commission only.
Name
Planner number
Phone number
Email
Split %
Servicing
planner
Insurance commission
Please indicate the insurance commission type and level to apply to insurance benefits. The commission amounts shown are
inclusive of GST.
Upfront(i)
Hybrid
Level
112.8% Initial, 11% pa Ongoing
70% initial, 16.5% pa Ongoing
22% Level Commission
90.2% Initial, 11% pa Ongoing
56% initial, 16.5% pa Ongoing
17.6% Level Commission
67.7% Initial, 11% pa Ongoing
42% initial, 16.5% pa Ongoing
13.2% Level Commission
45.1% Initial, 11% pa Ongoing
28% initial, 16.5% pa Ongoing
8.8% Level Commission
22.6% Initial, 11% pa Ongoing
14% initial, 16.5% pa Ongoing
4.4% Level Commission
0% Initial, 11% pa Ongoing
0% initial, 16.5% pa Ongoing
0% Initial, 0% pa Ongoing
Other
(i) All applications submitted using easywrite will result in a higher initial commission.
AMP will arrange medicals on your behalf. If you prefer to arrange medicals yourself, please tick the box
D4 of 6
Flexible Protection
Notes
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NS7500D 07/13B
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Flexible Protection
AMP Flexible Super‰ Flexible Protection –
Electronic Lodgement Authority form
FILE NOTE:
To be kept by Adviser
on client file
This Electronic Lodgement Authority form is only to be completed if the Application for Flexible Protection and the
Personal Statement are being lodged electronically.
1. Applicant’s Authority and Declaration
1. I have read the Duty of Disclosure notice set out on the
reverse side of this form and understand the
consequences of not complying with the duty of
disclosure.
2. I authorise my financial planner/intermediary (Adviser)
to lodge my Application for Flexible Protection and, if
applicable, the Personal Statement (together, Insurance
Application) electronically.
3. I understand that the answers I provide to my Adviser in
relation to the Insurance Application must be accurate
and complete and I must tell AMP Life if any of my
answers become inaccurate or incomplete before my
Insurance Application is accepted.
4. I understand that when providing information to my
Adviser in relation to my Insurance Application, he/she is
acting on my behalf (and not on behalf of AMP Life).
AMP Life may assume that the information my Adviser
provides to AMP Life is an accurate and complete record
of the information I provided to my Adviser.
5. I understand that my Insurance Application is subject to
acceptance by AMP Life and that cover does not start
until AMP notifies me in writing. I understand that if my
Insurance Application is accepted, I will be provided with
details of my insurance cover and a paper copy of the
Personal Statement. I undertake to check the accuracy
and completeness of the information in these
documents and notify AMP Life immediately if any of the
information is inaccurate or incomplete.
6. I understand that any benefits payable under Flexible
Protection will be paid by AMP Life to the Trustee and the
Trustee will only pay the insurance proceeds to me or a
beneficiary, as applicable, in accordance with the rules of
the Fund.
7. I consent to AMP Life disclosing to my Adviser any
personal medical information that is relevant to the
assessment of my Insurance Application. I understand
that AMP Life will not provide copies of medical or other
reports regarding my application to my Adviser without
first obtaining my consent.
Medical authority
8. I , the applicant noted below, authorise any medical
practitioner to release at any time details of my personal
and family medical history, including referrals to, or
treatment by, other medical practitioners, to AMP Life
Limited and to any other person or company acting on
AMP Life’s behalf. The purpose of this medical authority
is to allow AMP Life to assess my application for new/
additional/reinstated insurance (as applicable) and any
claim that may arise. A photocopy of this authority is
valid as the original. I understand that under privacy
legislation, I may access a copy of your report from AMP
Life. I have been informed by AMP Life of the ways this
information may be used and to whom it may be
disclosed, and approve of those purposes.
Signature of applicant
✗
Date
D D MM Y Y Y Y
Print name
Please note that by signing this form you are, among other
things, providing AMP Life with an authority to collect
information about your medical history.
2. Adviser use only
Checklist
Adviser name
The form has been signed and dated by the applicant.
I will keep this form as a file note on the client file and
provide a copy to AMP Life on request.
Plan number (insert when application is lodged)
AMP Superannuation Limited ABN 31 008 414 104, AFSL No. 233060, the trustee of the
AMP Retirement Trust ABN 73 310 248 809 (Fund). AMP Life Limited ABN 84 079 300 379,
AFSL No. 233671 (AMP Life) is the issuer of Flexible Protection. ® Registered trademark of AMP Limited ABN 49 079 354 519.
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Duty of Disclosure
Before you take out Flexible Protection or additional
cover under Employee Flexible Protection through your
superannuation, the Trustee has a duty, under the Insurance
Contracts Act 1984, to disclose to AMP Life every matter
that it knows, or could reasonably be expected to know, is
relevant to AMP Life’s decision whether to accept the risk of
the insurance and, if so, on what terms. The Trustee has the
same duty to disclose those matters to AMP Life before you
extend, vary or reinstate any insurance cover.
The duty however does not require disclosure of a matter:
–– that diminishes the risk to be undertaken by AMP Life
–– that is of common knowledge
–– that AMP Life knows or, in the ordinary course of its
business, ought to know
–– as to which compliance with the duty is waived by AMP Life.
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NS7500E 07/13B
The Trustee requires you to disclose all relevant information
in relation to your application for Flexible Protection or
additional cover under Employee Flexible Protection so that
it can comply with its duty of disclosure as set out above.
Relevant information is not limited to the questions asked
in any forms.
Choice Form
How to choose AMP Flexible Super‰ as your superannuation
choice of fund
Use this form to nominate AMP Flexible Super as your superannuation account for your employer contributions.
For Employees – What you need to do:
1. Print this whole document.
2. Complete section 2 and sign section 4 of the Choice form on page F3.
3. Then either:
a. Give your employer this document (pages F3 to F6),
OR
b. Return this document (pages F3 to F6) to AMP at the address below and they will contact your employer.
New Business Applications
Reply Paid 62990
PARRAMATTA NSW 2124
4. Follow up with your employer or check your account in My Portfolio.
Please note: It may take up to four months for your employer to pay your first contribution into your super account.
For Employers – What you need to do:
You have received this form as your employee has chosen to have their super contributions made to AMP Flexible Super,
a complying superannuation fund.
To make contributions in AMP Flexible Super see the Employer Payment Instruction form on page F5.
Complying Fund Statement from the trustee
AMP Flexible Super is a superannuation product within the AMP Retirement Trust. AMP Superannuation Limited,
in its capacity as trustee certifies that the AMP Retirement Trust:
–– Is a complying superannuation fund and is a resident regulated superannuation fund within the meaning of the
Superannuation Industry (Supervision) Act 1993 (SIS).
–– Is not subject to a direction under section 63 of SIS, and
–– Will accept contributions from an employer, provided the employee is already a member of AMP Flexible Super.
Any questions?
If you have any questions about completing this form, please contact Customer Service on 131 267.
Issued by AMP Superannuation Limited ABN 31 008 414 104, AFSL No 233060,
the trustee of the AMP Retirement Trust ABN 73 310 248 809.
® Registered trademark of AMP Limited ABN 49 079 354 519.
F1 of 6
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F2 of 6
Choice Form
AMP Flexible Super‰
Choice form
Employee: Use this form to choose AMP Flexible Super as your choice of superannuation fund.
1. Choice of Fund
I request that all my future superannuation contributions be paid to:
My own choice of superannuation fund ✗
2. Your details
Employee surname
Employee given names
Employee identification number (if applicable)
Tax File Number (TFN)
Make sure your superannuation fund knows your TFN. You can check just by looking at your latest statement from them.
It helps you keep track of your money, allows you to pay extra contributions, and makes sure the money gets taxed at the
special low rate.
3. Details of my chosen superannuation fund
Product name
Fund name
AMP Flexible Super
AMP Retirement Trust
Fund address
Reply Paid 62990
Suburb
PARRAMATTA
State
NSW
Account number (we will send you this in your Welcome pack)
Surname
Superannuation fund’s Australian Business Number (ABN)
(if applicable)
Given names
7 3
3 1 0
2 4 8
8 0 9
Postcode
2124
Daytime phone number
Unique Superannuation Identifier (USI)
AMP1248AU
4. Appropriate documentation (place an ✗ in the box if you have attached the required information)
✗ I have attached:
a. A letter from the trustee stating that this is a
complying fund (page F1).
b. Written evidence from the fund stating that they will
accept contributions from my employer (page F1), and
c. Details about how my employer can make
contributions to this fund (Employer Payment
Instruction form page F5).
Your employer is not required to accept your Choice of Fund
if you have not provided the appropriate documents.
Signature of applicant
✗
Date
D D MM Y Y Y Y
Please keep a copy for your own records.
Issued by AMP Superannuation Limited ABN 31 008 414 104, AFSL No 233060,
the trustee of the AMP Retirement Trust ABN 73 310 248 809.
® Registered trademark of AMP Limited ABN 49 079 354 519.
F3 of 6
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F4 of 6
Choice Form
AMP Flexible Super‰
Employer Payment Instruction form
Employers: Use this form to set up the employer contributions for your employee’s AMP Flexible Super – Super account.
Payment options
There are three options for employers to make contributions to an employee’s AMP Flexible Super – Super account.
1. Bpay
Use the following information to pay your employee contributions by Bpay®.
You can make contributions (if eligible) using Bpay.
Please use the applicable Biller Code below and the employee’s Customer Reference Number (CRN), available from
your respective employees or from AMP by calling 131 267.
Customer Reference Number (CRN)
Contribution Type
Biller Code
Super Guarantee (SG) and Award
879072
Salary Sacrifice and Additional Employer
443721
Member
879080
2. Direct debit
If you wish to set up an employer direct debit arrangement from either your bank account or credit card, please complete
the Employer Direct Debit Arrangements and Change of Contact Details form which can be found on
amp.com.au/employerforms, or by calling 131 267.
3. Cheque
Use the following information to pay your employee contributions by cheque.
Cheques should be made payable to: AMP Life Limited.
If paying by cheque, please include the employee Plan Number (found in section 3 of the AMP Flexible Super Choice form
on page F3), contribution type (below) and mail to:
Customer Service
AMP Life Limited
Locked Bag 5400
PARRAMATTA NSW 2124
Contribution Type:
Super Guarantee (SG) and Award
Salary Sacrifice and Additional Employer
Member
Issued by AMP Superannuation Limited ABN 31 008 414 104, AFSL No 233060,
the trustee of the AMP Retirement Trust ABN 73 310 248 809.
® Registered trademark of AMP Limited ABN 49 079 354 519.
Bpay® Registered to Bpay Pty Ltd ABN 69 079 137 518.
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NS7500F 07/13B
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Contact us
Fax
amp.com.au/flexiblesuper
amp.com.au/myportfolio
amp.com.au/enquiry
131 267
AMP Life Limited
PO Box 300
Parramatta NSW 2124
1300 301 267
Unique Superannuation Identifier (USI)
AMP1316AU – AMP Flexible Super – Retirement
AMP1248AU – AMP Flexible Super – Super
NS7500 07/13B
Internet
My Portfolio
Web enquiry
Phone
Mail