make
AmP Superannuation Limited AbN 31 008 414 104, AFSL No. 233060
33 Alfred Street Sydney NSW 2000
NS5271 11/10
Rating applies to Core and
Select investment levels
PRODUCT DISCLOSURE STATEMENT - SUPER & RETIREMENT ACCOUNT
ISSUED 13 NovEmbEr 2010
Issued by AmP Superannuation Limited AbN 31 008 414 104, AFS Licence No 233060, the Trustee of AmP Superannuation Savings Trust, AbN 76 514 770 399.
registered trade mark of AmP Life Limited AbN 84 079 300 379.

Super is a tax-effective way of saving for your retirement. By putting in place a suitable super strategy you can increase the likelihood of doing the things you want to do when you retire.
This is the Product Disclosure Statement (PDS) for AMP Flexible Super
AMP Superannuation Limited (ASL) is the issuer of AMP Flexible Super. AMP Flexible Super is an account offered in a superannuation fund known as the AMP
Superannuation Savings Trust (the fund). ASL is the trustee of the fund.
The purpose of AMP Flexible Super is to help you save for your retirement, to allow you to draw an income in retirement, and to provide you with insurance options.
The section of this PDS headed “What to consider before investing” contains a summary description of the key risks of the product. The rest of this PDS contains a summary description of the key features of the product.
Please see the back cover of this PDS for contact details.
How and why you should read this PDS
This PDS is an important document which will help you decide whether AMP Flexible Super suits your needs.
For prospective employer-sponsored members, the PDS is in two parts:
Part 1: this document and all relevant Fact Sheets
Part 2: Member Benefits Schedule sent to you as part of your welcome pack.
For other prospective members, the PDS is just this document.
It is important that you read this entire PDS including Fact Sheets before applying for AMP Flexible Super as it provides helpful information about its key features, benefits and options - including fees and insurance. Fact Sheets are available online at www.amp.com.au, or ask us for a free printed copy using the contact details on the back of this PDS.
You’ll find more detailed information on particular topics in our Fact Sheets which are referred to by this symbol throughout this PDS. Sometimes we will also refer you to a particular section heading in a Fact Sheet.
Important information
No other company in the AMP group is responsible for any statements or representations made in this PDS or the Fact Sheets, unless otherwise expressly stated.
Investments in the fund and the investment options are not deposits or liabilities of AMP Bank or any other AMP group company. Your investment in the fund and the investment options are subject to investment risks, which could include delays in repayment and loss of income and capital invested. Neither ASL nor any other AMP group company guarantees the performance of the fund or any investment option, the repayment of capital or (except where specifically stated in this PDS or the Fact
Sheets) any particular investment option.
This offer is available only to people receiving it (including electronically) within Australia. The information contained in this PDS and the Fact Sheets is of a general nature only. It is not based on your personal objectives, financial situation and needs. You should consider whether the information in this PDS and the Fact Sheets is appropriate for you in accordance with your objectives, financial situation and needs. To obtain advice or more information about the product offered in this PDS and the
Fact Sheets, you should speak to a financial planner who is an Australian financial services licensee or an authorised representative.
In this PDS unless specified otherwise:
“AMP Life” means AMP Life Limited (ABN 84 079 300 379, AFSL No. 233671).
“AMP Capital” means AMP Capital Investors Limited (ABN 59 001 777 591, AFSL No. 232497).
“we”, “us”, “our”, “ASL” and the “Trustee” mean AMP Superannuation Limited.
“Plan” refers to your AMP Flexible Super plan.
“you” refers to the member of the plan. If you are an employer sponsor, it refers to your employee.
Updating you of changes to this PDS, the Fact Sheets and the product
Information in this PDS/Fact Sheets may change from time to time. Where the change is not materially adverse, we will issue updated information that you can access by:
Visiting amp.com.au/pdsupdates
Asking your financial planner (if applicable)
Calling us on 131 267 to request a free printed copy.
If the change is materially adverse, we will issue a supplementary PDS.
This product is subject to the terms and conditions described in this PDS and the Fact Sheets. We reserve the right to change these terms and conditions from time to time.
Information for former GIO members who are transferring to an AMP Flexible Super - Retirement account
A Special Exit Fee may apply to former GIo members currently invested in Flexible Lifetime - Super, Flexible Lifetime - Allocated Pension, AmP multifund Flexible Income
Plan and AmP Deferred Annuity who are opening an AmP Flexible Super - retirement account. Any applicable Special Exit Fee will be transferred to the retirement account and will apply on any lump sum withdrawals from that account.

1. Read this PDS and the other important information referred to in the PDS, such as the Fact Sheets. The Fact
Sheets are available online at www.amp.com.au
2. Once you are ready to invest, there are a number of ways you can complete your application:
Contact your financial planner.
Complete an online application form for AMP Flexible
Super. Just visit us at www.amp.com.au/flexiblesuper
Contact Customer Service on 131 267 .
Complete the forms booklet at the back of the PDS.
3. If your application is accepted by AMP, you, your spouse and/or your employer can then start to make contributions into your AMP Flexible Super account, or you can begin to receive regular income payments from your Retirement account.
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It is recommended you consult a financial planner before you invest. If there is any part of this PDS or the Fact Sheets that you do not understand, please ask your financial planner or call us on 131 267 .
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AMP is one of Australia’s largest superannuation providers.
Over 160 years experience with helping Australians make the most of tomorrow.
More than $111 billion in assets under management, as at
30 June 2010.
One product solution to see you from your working life into retirement - without the need to change from a Super to a
Retirement product.
Access to a range of features - such as life insurance, or a wider range of investment options - when the time is right for you.
Flexible options putting you in control of your super by adding or removing options at your convenience, which includes an entry-level, low-cost super account.
Access to self-education tools and other benefits. See amp.com.au
for more information about your AMP benefits.
Only pay for the features and services you, or your employer, have agreed to.
No establishment fees, and no fees on contributions, withdrawals*, or for closing your account.
Access to Management Fee Rebates.
* Except for former GIO members.
4 easy ways to join (see page 1): Choose to apply through a financial planner, online, by calling Customer Service or by completing the paper forms attached.
View and manage your account online through My portfolio at any time.
Complimentary super consolidation service taking the hassle out of rolling over super accounts.
Keep your super in one place - with our consolidation and choice of funds service.

m en t
Core
Re
Su
1. At the start of your working life, the core level Super account in AMP Flexible
Super can provide a low-cost, easy to set up Super account, with simple investment options.
em en t
Re
Core
Su
Life
Insurance
2. If you’re ready to give your family - and your income - better protection, it’s a simple thing to add extra features, such as a life insurance component.
Wider
Investments m en t
Core
Re
Su
Life
Insurance
3. If you prefer a more hands on approach to investing, you can apply for our more sophisticated options with our Select or
Choice levels. You can upgrade from the
Core level at any time.
Wider
Investments em tir en t
Re
Core r
Su
4. Once you reach preservation age
(currently age 55) and retire, you can withdraw money from your
Super account as you need it. Or, if you would like to draw a regular tax effective income, you can activate your
Retirement account and receive an income, even while you’re still working.
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AMP Flexible Super is one product that can be set up in 3 ways, depending on your age and financial priorities:
AMP Flexible Super
Super account
Transition to Retirement:
Super account + Retirement account
Retirement account
Are you a very “hands on” investor who likes a wide investment choice, or are you more comfortable being “hands off”? We cater for a variety of investment styles with 3 different investment levels for you to choose from.
Simple choices
Core Investments C Select Investments S
Sophisticated choices
Choice Investments Ch
You have the option to protect yourself and the people closest to you by adding a level of life insurance cover. Premiums are paid directly from your Super account, making it a convenient and possibly more tax-effective option for you. There are two alternatives:
Essential Protection EP
Basic cover with lower premiums
Flexible Protection FP
Higher benefits available and more flexible features

If you prefer an easier way to set up your account, choose one of the two packaged solutions that offer a ready-made combination of investments and life insurance:
Core package:
Core Investments C
+
Essential Protection EP
Choice package:
Choice Investments Ch
+
Flexible Protection FP
If you’re like most people, more than one super account has been created for you over your working life.
AMP can help you take control and bring your super together:
Our free consolidation service will chase your existing super funds and do most of the paperwork for you.
We’ll even look for any “lost” super you may have and add it to your AMP Flexible Super account.
You can become a member of AMP Flexible Super either as:
A personal member by applying for membership either online or with the application forms enclosed with this PDS
(you must be at least 13 years of age)
An employer sponsored member by being nominated for membership by your employer.
Employers can set up an employer plan in AMP Flexible Super. An employer plan in AMP Flexible Super can make it easy for an employer to make superannuation contributions for their employees, and can provide employees with additional benefits such as rebates on fees and insurance options.
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For more information on employer plans, see the Fact Sheet:
Employer plans
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You can change the set up of your AMP Flexible Super account at any stage of your life.
Here are some examples:
6 m e nt
Core t
Re
Su
Craig, 26
Goes to the gym 3-4 times per week.
Renting a flat in the inner city.
Working in IT.
Earns $50,000 per year.
Craig’s current AMP Flexible Super mix:
Core package: Core Investment level plus
Essential Protection insurance.
Wider
Investments m e nt
Core t
Re
Su
Life
Insurance
Ella, 31
Married with two children.
Paying off a mortgage.
Working full-time as an office manager.
Earns $80,000 per year.
Sister had a minor car accident recently, so Ella has decided to increase her insurance cover.
Ella’s current AMP Flexible Super mix:
Choice package: Choice Investment level plus
Flexible Protection insurance.

And before that, if you’re between the ages of 55 and 65, we can help you make a smoother transition to retirement by activating your Retirement account so you can draw a regular income from your Super.
Wider
Investments m e nt
Core t
Re
Su
Life
Insurance
Wendy, 56
Married, children have left home.
Owns home and paying off an investment property.
Working four days a week in an executive role, and starting her Transition to Retirement strategy.
Earns $110,000 per year.
Wendy’s current AMP Flexible Super mix:
Select Investment level for both her Super account and her Retirement account, with
Flexible Protection insurance linked to her
Super account.
Note: These examples are for illustrative purposes only.
Wider
Investments t m en t
Core
Re er
Su
Alistair, 64
Married, with four children and a new grandchild.
Owns home.
Recently retired from his job teaching at TAFE.
Alistair’s current AMP Flexible Super mix:
Choice Investment level for Retirement.
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For more information on how to arrange for your employer contributions to be made to your Super account, see the
Fact Sheet: How to
Transact . Look for the heading: Choosing your super fund.
In most cases your employer is required to contribute to a super fund for you.
You are usually able to choose the fund your employer will contribute to. If you are opening a Super account as a personal member, you can ask your employer to make contributions to this account.
You can also help build up your super savings more quickly by:
Making salary sacrifice contributions to your Super account.
Making additional personal contribution.
Taking advantage of the Government co-contribution (see page 9).
Arranging spouse contributions to be made into your account.
Consolidating your super into the one account (see page 10).
Finding your lost super (see page 11).
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Check out AMP’s super strategies to make the most of your super at amp.com.au/super
Start your
AMP Flexible Super account
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 any supplements) for AMP Flexible Super.
Issued by AMP Superannuation Limited ABN 31 008 414 104,
AFSL No. 233060, RSE Licence No. L0000550, the trustee of the AMP
Superannuation Savings Trust, ABN 76 514 770 399, RSE Registration
No. R1001648
1 Begin by reading How do I complete this forms booklet?
on the following page >
This section will help you answer the questions in the Your Super section of the forms booklet.
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For more information on contribution restrictions, see the
Fact Sheet: How to
Transact . Look for the heading: Money in.
We can accept a variety of contributions into your Super account:
TYPE oF CoNTRIBUTIoN
Member contributions
Spouse contributions
Employer contributions
Superannuation Guarantee (SG)
Award/workplace agreement
Salary sacrifice
Additional employer
Government co-contributions
Overseas transfers (including UK transfers)
Directed termination payments
Transfers/rollovers











There are limits on the contributions we can accept into your Super account, depending on your age, as well as who makes the contribution, how much you are working and other factors.
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Fact Sheets are available at www.amp.com.au/flexiblesuper
The government caps the amount of contributions that can be made to your super each year before additional tax becomes payable. If you exceed the caps, you could be required to pay tax of up to 46.5% on the excess contributions.
Contributions counted towards the caps include contributions made to all of your super accounts, including those with other super funds.
Important: We do not monitor your super contributions against the caps. It is up to you to keep an eye on all your contributions to avoid exceeding the caps. There are adverse tax consequences if you do exceed them.
There are two types of Contribution Caps: the Concessional contributions cap and the Non-concessional contributions cap. The following table summarises the types of contributions which are covered by each cap, and the amount of the relevant cap.
TYPE oF CAP
Concessional contributions cap
CoNTRIBUTIoNS THAT CoUNT ToWARDS
THIS CAP*
Employer contributions (including
Superannuation Guarantee and salary sacrifice contributions).
Defined benefit “notional” contributions.
Personal member contributions you claimed as a tax deduction, and
Certain allocations of surplus.
AGE & AMoUNT
Under 50
50 or over
$25,000 ^ pa
$50,000 pa
(under transitional arrangements)
Non-concessional contributions cap
Member contributions (personal after-tax contributions).
Spouse contributions (including for same sex couples).
Tax-free part of overseas transfers, and
Excess concessional contributions.
Under 65
65 - 74
Over 75
$150,000 pa or
$450,000 # over
3 years
$150,000 # pa
Non-concessional contributions are not accepted
* This is not an exhaustive list.
^ This amount is indexed annually, but only in $5,000 increments (rounded down).
# This amount is a multiple of the Concessional Contributions Cap.
If you make personal contributions to your Super account the Federal Government currently provides a matching co-contribution of up to $1 for each $1 of eligible member contributions, up to a maximum co-contribution of $1,000 per year. The amount of government co-contribution depends on your income.
You are entitled to the maximum co-contribution if your annual income is up to $31,920 (for the 2010/2011 income year, and indexed annually from 1 July 2012). The amount of the co-contribution then reduces until it stops if your income reaches $61,920.
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For more information on the contribution caps and the excess contribution taxes, see the Fact Sheet:
Information on your account . Look for the heading: Tax and social security.
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For more information on whether you could be eligible for a Government co-contribution, see the Fact Sheet: How to transact . Look for the heading: Money in.
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For information on direct debit, see the
Fact Sheet: How to transact . Look for the heading: Direct debit service agreement.
You, your spouse or your employer can make contributions using the following payment methods:
METHoD oF PAYMENT DESCRIPTIoN
B PAY ® (Reference details will be provided in your Welcome Pack and are also accessible via My portfolio)
Regular direct debit
You, your spouse and your employer can use B PAY to make a payment at any time.
B PAY biller codes:
Member contributions: 879080
Spouse contributions: 879098
SG and Award contributions: 879072
Salary sacrifice and additional employer contributions: 443721.
You or your spouse can arrange for a direct debit to be made monthly, quarterly, half-yearly or yearly from your or your spouse’s nominated bank account.
Credit Card
Ad hoc direct debit
Cheque
From 3 December 2010, you or your spouse can make regular or ad hoc (one-off) contributions to your superannuation account via credit card. Regular contributions may be set up via a Direct Debit form available on amp.com.au/forms . Ad hoc contributions may also be made by contacting us on 131 267.
Acceptable credit cards are Visa or MasterCard only. Contributions made by credit card, using a credit or debit card will incur a processing fee of 0.88% (including
GST) of the contribution amount. This processing fee will be applied by AMP Life
Limited (as the merchant) each time you make a contribution and does not form part of your contribution or account balance. AMP may change this fee amount at any time and will advise you via a PDS Update available on www.amp.com.au
You or your spouse can make ad hoc (one off) contributions online via
My portfolio whenever it suits.
You can send us a cheque payable to “AMP Life Limited - Flexible Super” together with your member number and the contribution type to:
Customer Service
AMP Limited
PO Box 300
PARRAMATTA NSW 2124.
eSuper (for AMP
Flexible Super employer sponsors only)
If you are an employer, AMP’s eSuper is an online service that helps you easily manage your super contributions for your employees.
® Registered to B PAY Pty Ltd ABN 69 079 137 518.
If you have more than one super account in various superannuation funds, you could benefit by consolidating your super into a single account. Consolidating your super into your Super account in AMP
Flexible Super isn’t difficult or confusing. Our complimentary Super Consolidation Service makes it as hasslefree for you as possible by doing most of the paperwork for you and contacting your existing super funds to make sure your super is where you want it.
You can request to consolidate your super online through My portfolio, or by calling us on 131 267.
Potential to save on fees - if you have more than one superannuation account with various funds, you are probably paying more in fees than you need to. You could reduce the amount of fees you pay by reducing the number of accounts you have and increasing the balance of your chosen fund at the same time.
Potential to grow - with compounding returns the money you save in fees could really help your super balance to grow.
Reduce the likelihood of ending up with lost super.
Important : Before consolidating, you need to consider how your old superannuation accounts compare to
AMP Flexible Super, and what effect consolidating will have on your insurance cover. If you are unsure, speak with your financial planner or contact AMP.

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For more information about the things you need to consider before consolidating and to understand more about the benefits of consolidating your super, go to amp.com.au/consolidate
If you think you may have lost track of some of your super accounts, but can’t remember the details, we can conduct a lost super search on your behalf. Just let us know if you want to do this and provide us with your
Tax File Number.
We may from time to time search for lost super on your behalf. To do this, we will send personal information such as your full name, date of birth, address and tax file number (if held) to the Australian Taxation Office (ATO).
If any lost super is found for you, then we will send you a letter with the relevant information. If no match is made, we will not contact you.
If you would like to opt out of this feature, please let us know by email or phone. If emailing askamp@amp.com.au please use the title “Opt out - SuperSearch” and provide your full name and account number.
To get the ball rolling complete the consolidation and/or lost super sections, either during your application or later via My portfolio (amp.com.au/myportfolio). Alternatively, you can complete the form at the back of this PDS.
Start your
AMP Flexible Super account
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 any supplements) for AMP Flexible Super.
Issued by AMP Superannuation Limited ABN 31 008 414 104,
AFSL No. 233060, RSE Licence No. L0000550, the trustee of the AMP
Superannuation Savings Trust, ABN 76 514 770 399, RSE Registration
No. R1001648
1 Begin by reading How do I complete this forms booklet?
on the following page >
This section will help you answer the Contribute and Consolidate questions in the AMP Flexible Super section of the forms booklet.
You can take out insurance cover through your Super account. You may be able to take out death, total and permanent disablement, or temporary salary continuance cover.
The after-tax cost of insurance through super can be lower than the same cover outside of super because of the tax advantages of paying for premiums out of Concessional contributions made to the Super account.
See page 30 for more information on the insurance options.
If you are an employer sponsored member you can have an unlimited number of people with whom you have an eligible relationship join AMP Flexible Super as a Personal member and apply for Family membership.
By applying for Family membership you and your Family members may be entitled to a greater management fee rebate.
If you are a Personal super member, you may be eligible to link a family member for Flexible bonus. See page 26 for more information.
Because super enjoys tax advantages, the law restricts when you can access your super money. These restrictions are known as the “preservation rules”.
Generally this means that you can only access your money after you reach your preservation age and retire
(with some exceptions).
Once you have satisfied the preservation rules, you can start drawing from your Super account. If you want to receive a regular income you can open a Retirement account. This can be a better way of accessing your super, compared to making withdrawals from a Super account.
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For information on
Family membership, see the Fact Sheet:
Information on your account.
Look for the heading: Family membership.
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For information on the preservation rules and when you can access your super money, see the
Fact Sheet: How to transact . Look for the heading: Money out.
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To minimise your member fees and maximise your potential to receive management fee rebates you can apply to link your Super and
Retirement accounts.
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For more information on Retirement accounts, see the Fact
Sheet: Information on your account . Look for the heading: Account details (Retirement accounts only) .
Once you are able to access your accumulated 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.
When you activate a Retirement account, you can continue to decide how your money is invested.
Drawing an income though a Retirement account can be a tax effective way of providing for your retirement.
Some benefits of a Retirement account include:
The investment earnings within your account are tax free .
There is no PAYG tax deducted from your income payments once you are 60 or over.
A 15% tax offset is applied on the taxable portion of income payments if you’re between your preservation age and 60.
If you have reached your preservation age and are still working, you can access your super in the form of an account based income stream from a Transition to Retirement account.
What account can I use?
TYPE oF ACCoUNT
Transition to Retirement account
Retirement account
SUITABLE FoR
If you are between your preservation age and 64, and you have not retired.
If you are 65 or older
If you are not retired but you ceased an employment arrangement when 60 or over
If you have reached your preservation age and retired.
The Retirement account offers flexible payment options so you can determine the date and frequency of your income payments.
You can choose to receive your income fortnightly, monthly, quarterly or annually. You can also choose the amount of the income payments you will receive from your Retirement account, as long as you receive at least a minimum amount.
Retirement accounts are required by law to pay you a minimum income amount each financial year based on your account balance on 1 July in that year (or your starting account balance if you commence your Retirement account in that year). The minimum amounts are as follows:
AGE
Under 65
65 to 74
75 to 79
80 to 84
85 to 89
90 to 94
95 or over
% oF RETIREMENT ACCoUNT BALANCE*
4%
5%
6%
7%
9%
11%
14%
* For the 2010/2011 financial year, these percentages have been reduced by half from those shown in the table above.
Where you commence a Retirement account in the month of June, you don’t need to take any income payment until the new financial year, unless you want to.

There is no maximum annual income payment from the Retirement account, unless you invest in a Transition to Retirement account. You can receive income payments from your Transition to Retirement account each financial year of up to a maximum of 10% of your account balance on 1 July in that year (or your starting account balance if you commence your account in that year).
Where you start a Retirement account during the financial year:
the minimum amount is pro-rated for the rest of the year
for Transition to Retirement accounts the maximum is not pro-rated.
By law, your Retirement account can only accept a single lump sum of super money. If you have amounts in several super accounts that you want to consolidate, or if you want to make extra contributions to your super before starting your Retirement account, you can do this in your Super account.
If you don’t have an active Super account in AMP Flexible Super, we can activate one for you so that you can bring your super together before starting a Retirement account. You can select your investment level, however, if you don’t make a selection, your Super account will be invested in the Super Easy Cash investment option.
To check if you are eligible to invest in the AMP Secure Growth investment option, and for special conditions that apply, you should refer to the Fact Sheet: Investing and your options .
Note: If we receive your request to:
commence a Retirement account
make an additional income payment or withdrawal, or
adjust your income payment arrangements.
5 business days prior to 30 June, your request may not be processed until after 1 July of that calendar year.
If this occurs the transaction will take place in the next financial year after your request was made.
Start your
AMP Flexible Super account
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 any supplements) for AMP Flexible Super.
Issued by AMP Superannuation Limited ABN 31 008 414 104,
AFSL No. 233060, RSE Licence No. L0000550, the trustee of the AMP
Superannuation Savings Trust, ABN 76 514 770 399, RSE Registration
No. R1001648
1 Begin by reading How do I complete this forms booklet?
on the following page >
This section will help you answer the Your Retirement questions in the AMP Flexible Super section of the forms booklet. i
For more information on nominating your beneficiaries, see the Fact Sheet:
Information on your account.
Look for the heading: Your beneficiaries .
The Retirement account provides a range of beneficiary nomination options for estate planning purposes.
If you are the beneficiary of a death benefit payable from the AMP Superannuation Savings Trust (which includes AMP Flexible Super), you may be eligible to open a Retirement account. We will contact you.
The Pension Refresh Facility helps you build your retirement savings by streamlining the process of consolidating your Super and Retirement accounts in an efficient way. Because you are not able to contribute additional amounts to a Retirement account we have designed the Pension Refresh Facility. If you want to increase your Retirement account balance, you can use the Pension Refresh Facility to consolidate your Super account and Retirement account into a new Retirement account. You can also add other super money you may have or extra contributions at this stage. This facility is generally used as part of a “pension refresh strategy” or for one final consolidation of funds, before retirement.
You need to have both a Super account and a Retirement account (or a Transition to Retirement account) to use this facility. You can use this facility by completing the Pension Refresh form available from your financial planner or us.
It is recommended you seek financial advice before using this facility, as there are likely to be financial, taxation and social security implications from moving between superannuation and pension arrangements.
® Registered trademark of AMP Life Limited ABN 84 079 300 379 i
For information on Beneficiary
Retirement accounts, see the Fact Sheet:
Information on your account.
Look for the heading: Account details (Retirement accounts only).
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For more information on the Pension
Refresh Facility, see the Fact Sheet: How to transact.
Look for the heading: Pension
Refresh Facility.
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For information on the risks of investing, see the Fact Sheet:
Investing and your options . Look for the heading: Risks of investing.
Your investment goals.
Will your investment goals require a high return or will a moderate, stable return be enough?
Your timeframe.
The amount of time you intend to invest for is a key factor when making your investment decisions. You will generally find that investment options with higher volatility in the short term tend to have higher returns in the long term, and vice versa.
Remember also that you will usually not be able to access your super until you retire.
Your attitude to risk.
Your attitude to risk is one of the most important factors to consider before investing. To achieve higher returns you need to be prepared to accept a higher risk of losing the value of your super. This is because investments that offer higher returns are generally more volatile than those producing lower returns.
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 risks you need to consider.
Investment risk means not only that your returns might be variable, or volatile, but that you might also lose part or all of your investment. Your capital and investment returns are not guaranteed (unless expressly stated for particular investment options). This means you may experience negative investment returns. You will usually find that the investments with higher expected returns tend to also have higher investment risks.
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To better understand your attitude to investment risk why not try our “What investor style am I?” tool at amp.com.au/calculators

Other risks associated with investing in super include:
You may not be able to access your super, including any insurance proceeds, when you need it because of preservation rules.
Laws (such as taxation laws) affecting super may change, which may affect the amount of your benefit and when you can access it.
Processing of transactions may be delayed in some circumstances. See below for more information about the risks of delays.
When applying for insurance cover, if you don’t comply with your duty to provide us with certain information (referred to as your Duty of Disclosure), the insurer may not pay if you make an insurance claim, or it may only pay part of your claim.
If you are invested in a Retirement account your investment may not be sufficient to provide an income for the rest of your life.
We may delay switches between investment options or withdrawals from your account if:
There are delays by investment managers or banks in processing our request - for example, if the investment manager delays issuing unit prices or the bank or investment manager suspends transactions.
Switches or withdrawals would adversely affect the interests of, or if we do not consider it in the best interest of, customers in the relevant investment options offered through AMP Flexible Super as a whole.
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.
The delays or suspensions of payments could be for weeks, months or even years. We are not responsible for any losses caused by these delays.
If a delay or suspension of switches and withdrawals from an investment option occurs, it could affect a number of transactions and features of this product. Possible consequences include:
Switches and withdrawals, including rollovers, transfers, pension payments and the payment of insurance cover may occur in more than one payment or be delayed.
On death, any transfer of your investments to the Super Easy Cash investment option (which would normally occur automatically) may be delayed.
You can take steps to manage the risks of investing in AMP Flexible Super by:
Obtaining professional advice to determine whether the investment option(s) suit your investment objectives, financial situation and particular needs.
Carefully reading all the information in the PDS and Fact Sheets (including any updates) before investing.
Regularly reviewing your investments in light of your investment objectives, financial situation and particular needs.
15

16
TIP
If you are an employer sponsored member, your employer will nominate an initial default Investment level and investment option on your behalf.
Refer to the Member
Benefit Schedule you received when you were accepted for membership for your investment details.
i
For more information on changing your investment option, see the Fact Sheet:
How to transact .
Look for the heading:
Changing your investment options.
i
For more information on
LifeStages, including the underlying investment options selected, see the Fact
Sheet: Investing and your options . Look for the heading:
Approaches to investing
LifeStages.
Alternatively, you can contact your financial planner, or call us on
131 267 .
Different fees and features apply based on these levels. If you choose the Select or Choice level, you should consider whether the associated features continue to meet your needs - especially if you choose investment options that are available under the Core Investment level.
Depending on which Investment level you choose, you can have a choice of over 70 investment options managed by leading Australian and international fund managers.
You can change your Investment level, or options, at any time either through My portfolio, by completing the
Changing your investment levels, options and fee mandate form on www.amp.com.au/forms , or by contacting your financial planner.
A simple-to-set-up investment approach with lower fees.
A more “hands on” approach, with more sophisticated features.
Core Investments C
Simple choices.
Member fee: $1.50 per week*.
Invest in a cash investment option or balanced investment option, or a mix of both.
Select Investments S
More choices.
Member fee: $2.00 per week*.
Choose up to 5 of 7 options, including a range of multi-sector investment options and a cash investment option.
Choose the Super Easy
LifeStages strategy.
Option to auto-rebalance every 3, 6 or 12 months.
Nominate one investment option for deduction of fees only using the Deduction and Rebate profile facility.
Choice Investments Ch
Expert choices.
Member fee: $2.50 per week*.
Choose up to 15 of over 70 multi-sector and single sector options, covering a spectrum of defensive to higher growth options.
Choose Super Easy LifeStages,
AMP LifeStages or Future
Directions LifeStages strategies to connect with
AMP’s investment expertise.
Option to auto-rebalance every 3, 6 or 12 months.
Nominate one investment option for deduction of fees and crediting of rebates using the Deduction and Rebate profile facility.
* This fee will increase on 1 July each year in line with the Consumer Price Index (CPI).
No you don’t. If you don’t want to make a choice, your investment will be automatically invested into our default Investment level - Core and the default investment option - Super Easy Balanced.
If you choose Select or Choice Investments as your Investment level, you can select the LifeStages strategy.
With LifeStages, your investment mix will be set automatically by us, and will be readjusted periodically throughout your life. LifeStages is only available for Super accounts and it changes your investment to a more conservative investment option as you move into a new age range.
There are 3 LifeStages strategies available:
Super Easy LifeStages - a passive approach through the Super Easy multi-sector investment options
(available in Select and Choice Investments)

AMP LifeStages - a single manager approach through the AMP Capital multi-sector investment options
(available only in Choice Investments)
Future Directions LifeStages - a multi-manager approach through the Future Directions multi-sector investment options (available only in Choice Investments).
Craig, 26 student loans.
as his situation changes.
Ella, 31 for higher returns.
Alistair, 64
Alistair and his financial planner worked together and chose the Choice investment level which worked well with Alistair’s retirement strategy. Having access to a wider range of investment options helped him to achieve his desired level of diversification and comfort with his retirement portfolio.
Note: These examples are for illustrative purposes only.
17

18
When you invest through AMP Flexible Super, we invest your money based on the investment option(s) you have selected. However, if you have not selected an investment option (for example, you are investing through an employer sponsored arrangement), then you will be automatically invested in the Core Investment level, in the
Super Easy Balanced (multi-sector) investment option until you select another investment option. If you are an employer sponsored member and your employer has arranged an alternative default investment arrangement, you will be initially invested in your employer’s default investment level and default investment option.
You can transfer your money to a different investment level or option at any time. Just review the choices available in the PDS and complete a request online via My portfolio (or use our Changing your investment levels, options and fee mandate form ).
Multi-sector (or diversified) investment options have their assets spread over various asset classes to provide pre-selected portfolios considered appropriate to typical investor profiles.
The investment levels are Core Investments C , Select Investments S , or Choice Investments Ch .
INVESTMENT CATEGoRY/oPTIoN NAME MANAGEMENT FEE
(% PA) 1
PERFoRMANCE
BASED FEE AND
ESTIMATE
(% PA) 2
AVAILABLE
IN THE
FoLLoWING
INVESTMENT
LEVELS
CoNSERVATIVE
Who are these options suitable for?
Investors seeking stability of capital and who are prepared to accept lower returns to achieve this objective. Returns are primarily from income as well as some capital growth over the short to medium term, by investing mainly in defensive assets with some exposure to growth assets. A low level of volatility can be expected from time to time.
AMP Conservative 1.35 + 0.03* Yes/0.00
Ch
Future Directions Conservative 1.35
Yes/0.03
Ch
Responsible Investment Leaders
Conservative
Super Easy Conservative
1.55
No
Ch
0.60
No
S Ch
CAUTIoUS
Who is this option suitable for?
Investors seeking stability of capital and who are prepared to accept modest returns to achieve this objective. Returns are primarily from income and as well as some capital growth over the short to medium term, achieved by investing mainly in defensive assets and some exposure to a diversified range of growth assets. A low level of volatility is expected from time to time.
Super Easy Cautious 0.62
No
S Ch
MoDERATELY CoNSERVATIVE
Who are these options suitable for?
Investors seeking to achieve moderate returns from a balance of income and capital growth over the medium to long term by investing in a diversified mix of growth and defensive assets. Capital stability is still a priority, however, investors are willing to accept some risk and low levels of volatility to achieve these returns.
AMP Moderate Growth 1.40 + 0.03* Yes/0.00
Ch
Future Directions Moderately Conservative 1.40
Yes/0.06
Ch
Super Easy Moderately Conservative 0.63
No
S Ch
Please refer to notes on page 22.

INVESTMENT CATEGoRY/oPTIoN NAME MANAGEMENT FEE
(% PA) 1
PERFoRMANCE
BASED FEE AND
ESTIMATE
(% PA) 2
AVAILABLE
IN THE
FoLLoWING
INVESTMENT
LEVELS
BALANCED
Who are these options suitable for?
Investors whose main objective is 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.
AMP Balanced Growth 1.45 + 0.07* Yes/0.00
Ch
Future Directions Balanced
Responsible Investment Leaders Balanced
1.45
1.65
Yes/0.09
Yes/0.00
Ch
Ch
Super Easy Balanced 0.65
No
C S Ch
MoDERATELY AGGRESSIVE
Who are these options suitable for?
Investors seeking to achieve moderate to high returns predominantly from capital growth by investing across all asset types, but with a substantially higher exposure to growth assets. Investors are prepared to accept higher volatility and medium risks to achieve these returns.
AMP High Growth 1.50 + 0.08
* Yes/0.00
Ch
Future Directions Growth 1.50
Yes/0.09
Ch
Responsible Investment Leaders Growth 1.70
Future Directions High Growth 1.55
No
Yes/0.11
Ch
Super Easy Growth 0.68
No
S Ch
AGGRESSIVE
Who are these options suitable for?
Investors seeking to achieve high returns from capital growth over the long term by investing in growth assets. Capital stability is not a concern as investors are prepared to accept high volatility to pursue potentially greater long-term returns. Investment choices are diverse but carry with them a higher level of risk.
AMP All Growth 1.55 + 0.04* Yes/0.00
Ch
Ch
Super Easy High Growth 0.70
No
S Ch
The following secure investment is restricted to the Retirement account only:
INVESTMENT CATEGoRY/oPTIoN NAME MANAGEMENT FEE
(% PA) 1
PERFoRMANCE
BASED FEE AND
ESTIMATE
(% PA) 2
AVAILABLE
IN THE
FoLLoWING
INVESTMENT
LEVELS
SECURE
Who is this option suitable for? Investors seeking some capital security whilst having exposure to a mix of growth and defensive assets. Returns (after fees and before tax) may exceed inflation over the longer term, but with lower returns and less variability of returns compared to other investments with the same exposure to bonds, cash, shares and property. Investors are protected from capital losses at specified times, and subject to conditions.
AMP Secure Growth 1.55
Yes/0.06
Ch (Retirement account only)
Please refer to notes on page 22.
19

20
Single-sector investment options have their assets invested in a single asset class (usually in addition to the cash asset class). You can construct an investment portfolio to match your investor profile and your personal situation using “single sector” investment options.
The investment levels are Core Investments C , Select Investments S , or Choice Investments Ch
INVESTMENT CATEGoRY/ oPTIoN NAME
MANAGEMENT
FEE (% PA) 1
PERFoRMANCE
BASED FEE AND
ESTIMATE
(% PA) 2
INVESTMENT
STYLE 3
AVAILABLE
IN THE
FoLLoWING
INVESTMENT
LEVELS
CASH, SHoRT-TERM SECURITIES, DEPoSITS
Who are these options suitable for?
Investors seeking stable returns and capital stability by generally investing in bank deposits, bank bills, corporate bills, and Commonwealth and State Government securities.
Super Easy Cash up to 0.50
No n/a C S Ch
Super Easy Term Deposits up to 0.50
No n/a
FIXED INTEREST: CoRE FIXED INTEREST
Who are these options suitable for?
Investors seeking income-based returns above inflation and cash over the short to medium term by investing in Australian and/or global fixed interest securities (including sovereign and corporate bonds and asset-backed securities). Investors are prepared for infrequent capital losses over the short term.
Ch
Super Easy Australian Fixed Interest 0.80
No Index-style Ch
Super Easy International Fixed Interest 0.80
No Index-style Ch
FIXED INTEREST: ENHANCED FIXED INTEREST
Who are these options suitable for?
Investors seeking an income based return above inflation and cash over the short to medium term through exposure to Australian and global fixed interest markets (including sovereign and corporate bonds, asset-backed securities, interest rate and credit derivatives, and some exposure to high yield credit, emerging market debt, and hybrids). Investors are prepared for some capital losses over the short term.
AMP Australian Bond
BlackRock Global Bond
1.40
1.50
Future Directions Australian Bond 1.40
No
No
Yes/0.00
Active
Active
Multi-manager
Ch
Ch
Ch
Future Directions International
Bond
1.40
Yes/0.00
Multi-manager Ch
Schroder Fixed Income 1.50
No Active Ch
FIXED INTEREST: CREDIT & FIXED INTEREST TRADING STRATEGIES
Who are these options suitable for?
Investors seeking higher income based returns over the medium term through investment in traditional and non-traditional fixed interest markets (both domestic and global credit-based securities) where interest rate, credit and currency derivatives may be used extensively.
Investors are prepared for capital losses over the short term.
AMP Capital Corporate Bond 1.60
No Active Ch
Macquarie Income Opportunities 1.60
Yes/0.00
Opportunistic Ch
PRoPERTY
Who are these options suitable for?
Investors seeking moderate investment return from income and capital growth through exposure to property related securities or in a combination of direct property and property related securities. Investors are prepared for capital losses over the short term.
AMP Global Property Securities
AMP Listed Property Trusts
1.60
1.60
No
No
Growth
Value
Ch
Ch
Future Directions Property 1.80
Yes/0.00
Multi-manager Ch
Perennial Global Listed Property 1.75
No Active Ch
SG Hiscock Listed Property 1.65
No Value Ch
Super Easy Property 1.00
No Index-style Ch
ALTERNATIVE STRATEGIES
Who are these options suitable for?
Investors seeking returns above inflation and cash over the medium term by investing in skill based strategies or alternative assets which captures traditional and non traditional risk. Returns may be from skill based strategies and/or returns unrelated to the returns from traditional investment markets with the potential for positive returns in both rising and falling markets. Investors expect returns to be unrelated to capital markets. Investors are prepared for capital losses over the short term.
BlackRock Asset Allocation Alpha 1.95
H3 Commodities 2.55
Yes/0.00
Yes/0.00
Active
Opportunistic
Ch
Ch
Macquarie International
Infrastructure Securities
RARE Infrastructure Value
2.05
2.00
Yes/0.00
Yes/0.00
Active
Active
Ch
Ch
Please refer to notes on page 22.

INVESTMENT CATEGoRY/ oPTIoN NAME
MANAGEMENT
FEE (% PA) 1
PERFoRMANCE
BASED FEE AND
ESTIMATE
(% PA) 2
INVESTMENT
STYLE 3
AVAILABLE
IN THE
FoLLoWING
INVESTMENT
LEVELS
EqUITIES
AUSTRALIAN EqUITIES
Who are these options suitable for?
Investors seeking higher returns from capital investment growth over the long term, through exposure to the Australian share market and who can accept volatile capital values.
Investors are prepared for capital losses over the shorter term.
AMP Australian Share
AMP Equity
Arnhem Australian Equity
Ausbil Australian Active Equity
Bennelong Australian Equities
BT Australian Share
1.60
1.60
1.65
1.80
1.75
1.65
No
No
No
No
No
No
No
Multi-style
Growth
Growth
Core
Core
Core
Growth
Ch
Ch
Ch
Ch
Ch
Ch
Ch Colonial First State Australian
Share
Future Directions Australian
Share
1.65
1.60
Perennial Value Australian Share 1.65
Yes/0.12
No
Multi-manager
Value
Ch
Perennial Value Shares For Income 1.70
Perpetual Industrial Share
Responsible Investment Leaders
Australian Share
1.80
1.85
No
No
No
Value
Value
Ch
Ch
Ch
Ch
Schroder Australian Equities
Super Easy Australian Share
Tyndall Australian Share Value
1.65
1.00
1.65
No
No
No
Responsible investing/
Multi-manager
Growth/
Quality
Index-style
Value
Ch
Ch
Ch
GLoBAL EqUITIES
Who are these options suitable for?
Investors seeking potentially higher returns from capital investment growth over the long term through exposure to the global share market (may be hedged or unhedged to the Australian dollar). Investors can accept volatile capital values and are prepared for capital losses over the shorter term.
Arrowstreet Global Equity 2.10
1.85
No
No
Core/
Quantitative
Style neutral
Ch
Ch BlackRock Scientific Hedged
International Share
BlackRock Scientific International
Share
Fidelity Global Equities
1.85
1.65
1.60
No
Yes/0.00
Yes/0.08
Style neutral
Core
Multi-manager
Ch
Ch
Ch Future Directions Hedged
International Share
Future Directions International
Share
GMO International Share
1.60
1.75
Yes/0.03
No
Multi-manager Ch
Ch
Responsible Investment Leaders
International Share
1.85
No
Value/
Momentum
Responsible investing/
Multi-manager
Ch
Value Schroder Global Active Value
Super Easy International Share
T. Rowe Price Global Equity
Templeton Global Equity
Walter Scott Global Equity
1.65
1.00
2.00
1.80
2.05
No
No
No
No
No
Index-style
Growth
Value
Growth
Ch
Ch
Ch
Ch
Ch
Please refer to notes on page 22.
21

22 i
For information on the investment option menu, see the
Fact Sheet: Investing and your options .
INVESTMENT CATEGoRY
/ oPTIoN NAME
MANAGEMENT
FEE (% PA) 1
PERFoRMANCE
BASED FEE &
ESTIMATE
(% PA) 2
INVESTMENT
STYLE 3
AVAILABLE
IN THE
FoLLoWING
INVESTMENT
LEVELS
SMALL CAPITALISATIoN EqUITIES
Who are these options suitable for?
Investors seeking higher returns from capital investment growth over the long term through exposure to the small capitalisation segment of the Australian and/or global share markets and who can accept volatile capital values. Investors are prepared for capital losses over the short term. Exposure to Global Small Capitalisation equities may be hedged or unhedged to the Australian dollar.
Future Directions Australian
Small Companies
2.05
Yes/0.26
Multimanager
Ch
UBS Australian Small Companies 1.75
Yes/0.00
Core/
Style neutral
Ch
SPECIALIST EqUITIES
Who are these options suitable for?
Investors seeking higher returns from capital investment growth over the long term through exposure to single sectors of the broad market or to emerging markets or groups of emerging markets, or specialist equity approaches such as long short, gearing or buy/write investing, or currency, and who can accept volatile capital values. Investors are prepared for capital losses over the short term.
Aberdeen Emerging
Opportunities
2.20
AMP Capital Asian Equity Growth 1.95
No
Yes/0.00
Growth
Growth
Ch
Ch
Future Directions Asian Share 2.20
No Ch
Future Directions Emerging
Markets
Future Directions Extended
Markets International Share
Future Directions Geared
Australian Share 4
K2 Australian Absolute Return
2.15
2.15
1.70
3.05
Yes/0.00
Yes/0.00
Yes/0.31
Yes/0.00
Multimanager
Multimanager
Multimanager
Multimanager
Opportunistic
Ch
Ch
Ch
Ch
Lazard Global Thematic
Platinum International
1.65
2.85
No
No
Thematic
Stock selection
Growth
Ch
Ch
T.Rowe Price Asia ex-Japan 2.25
No Ch
Notes:
1. Management Fees apply based on the balance held in each investment option. Management Fee Rebates may also apply. Please refer to page 25. For Super accounts the fees you actually pay are reduced by 15% to allow for the tax deduction passed on to you.
2. Performance Based Fee (PBF) estimates for each applicable investment option assume the following:
For the underlying investment managers of an investment option that have had performance-based incentives, we have used the actual PBF payable for the year ended 31 December 2009.
For the Macquarie International Infrastructure Securities investment option, we have used the actual PBF payable for the year ended 30 June 2010.
For other investment managers that have since or are likely to have performance-based incentives, we have used the PBF that would have been payable for the year ended 31 December 2009 had these PBF arrangements existed.
For any new underlying investment managers of an investment option, we have assumed performance is in line with the relevant benchmark and therefore no PBF is payable.
The use of an estimate for the calculation of the PBF is not an indication of future performance and should not be relied on as such.
The actual rate of return of an investment option and therefore the PBF payable will vary from these estimates. If the investment performance of a particular asset sector is better than the set benchmark, the amount of fees paid could be much higher.
3. For information about the investment styles for the single-sector investment options, please refer to Fact Sheet: Investing and your options.
4. For Future Directions Geared Australian Share, the Management Fee is payable on gross assets under management.
Refer to Fact Sheet: Investing and your options.
* These “other costs” are almost entirely the costs of managing direct investment options, primarily in the “alternative assets” asset class but also in the “direct property” asset class. They are not fixed and will vary depending on the actual mix of assets of the investment options at any point in time. These costs were paid for the investment options during the year 31 December 2009.
Start your
AMP Flexible Super account
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 any supplements) for AMP Flexible Super.
Issued by AMP Superannuation Limited ABN 31 008 414 104,
AFSL No. 233060, RSE Licence No. L0000550, the trustee of the AMP
Superannuation Savings Trust, ABN 76 514 770 399, RSE Registration
No. R1001648
1
Begin by reading
How do I complete this forms booklet?
on the following page >
This section will help you answer the Investment Choices questions in the AMP Flexible Super section of the forms booklet.

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).
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.
If you would like to find out more, or see the impact of fees based on your own circumstances, the Australian Securities and Investment Commission (ASIC) website (fido.asic.gov.au) has a superannuation calculator to help you check out different fee options.
This section shows fees and other costs that you may be charged. These fees and costs may be deducted from your account, from the returns on your investment or from the fund assets as a whole.
Taxes and insurance premiums are set out in other sections of this PDS and the Fact Sheets.
You should read all the information about fees and costs because it is important to understand their impact on your investment.
Fees and costs for particular investment options are set out on pages 18 to 22.
HoW AND WHEN PAID TYPE oF FEE oR CoST AMoUNT
FEES WHEN YoUR MoNEY MoVES IN oR oUT oF YoUR ACCoUNT
Establishment fee
The fee to open your account.
Nil
Contribution fee
The fee on each amount contributed to your account - either by you, your spouse or your employer.
Nil
Withdrawal fee
The fee on each amount you take out of your account.
Termination fee
The fee to close your account.
Nil.
If you were a member of GIO, and were transferred to AMP, a withdrawal fee
(Special Exit Fee) may apply. This will be shown on your last Member Statement.
Nil -
-
-
The fee is deducted from your account whenever you make a lump sum withdrawal from your Retirement account.
23

24 i
For information on fees and costs, see the Fact Sheet: Fees and other costs . Look out for the headings:
Taxation and fees
Former GIO members
AMP Secure
Growth
Performance
Based Fees
Small account protection
(for Super accounts only), which applies if your account balance is less than $1,000.
TYPE oF FEE oR CoST
MANAGEMENT CoSTS
The fees and costs for managing your account.
AMoUNT HoW AND WHEN PAID
Management costs consist of:
Management Fee
The amount you pay for specific investment options ranges:
Between 0.50% and 0.65% for investment options in the Core Investment level.
Between 0.50% and 0.70% for investment options in the Select Investment level.
Between 0.50% and 3.05% for investment options in the Choice Investment level.
See pages 18 to 22 for details of the management fees which apply to each investment option.
PLUS
Performance based fees manager.
(for some Choice investment level options).
Up to 25% of the outperformance over the benchmark index for the relevant investment
See pages 18 to 22 for estimated performance based fees for each investment option.
This fee is deducted daily from the assets of each investment option and is reflected in the unit price or crediting rate, which applies to that investment option.
It is not deducted directly from your account.
Performance Based Fees are deducted from the assets of the relevant investment option and are reflected in the unit price or crediting rate when these targets are met.
They are not deducted directly from your account.
LESS
Management Fee Rebate
(applies to Choice investment level only).
ToTAL
RELATIoNSHIP
BALANCE
REBATE RATE
(% pa) - on the balance invested in
Super Easy investment options
Under $100,000 Nil
Nil $100,000 -
$199,999
$200,000 -
$499,999
$500,000 -
$999,999
Nil
Nil
$1,000,000 -
$2,999,999
$3,000,000 or more
0.10
0.20
REBATE RATE
(% pa) - on the balance invested in
Premium investment options
Nil
0.30
0.40
0.55
0.70
0.85
The Rebate is applied to your account balance based on the applicable Rebate Rate (converted to an equivalent monthly rate). See the additional explanation section on page 25 for more information.
The rebate is paid directly into your account, usually within
7 business days after the end of each month.
If you withdraw your money before the end of the month or before the rebate is paid
(in the next month) so that you no longer meet the minimum relationship balance requirements, no Management
Fee Rebate may be payable to you for that month.
You may qualify for another rebate under Flexible Bonus.
See the additional explanation section on page 26 for more information.

TYPE oF FEE oR CoST AMoUNT HoW AND WHEN PAID
MANAGEMENT CoSTS CoNTINUED
PLUS
Member Fee
Depending on the Investment level that you have chosen, the applicable Member Fee is:
$1.50 per week for Core Investment level
$2.00 per week for Select Investment level
$2.50 per week for Choice Investment level.
This fee will increase on 1 July each year in line with the Consumer Price Index (CPI).
The Member Fee is paid from your account, usually within
7 business days of the end of each month.
The Member Fee is paid:
From a unitised investment option, by cashing units in that option, or
From a crediting rate investment option, by decreasing your account balance in that option.
If you have an active Super account and a Retirement account, you will pay only one Member Fee, based on the higher Investment level (core, select or choice) of the two accounts, and it will be deducted from your
Retirement account.
SERVICING FEES 1
Investment switching fee
The fee for changing investment options.
Nil -
1. You and your financial planner (or your employer and a financial planner) may agree on a Member Advice Fee or Plan Service Fee for financial planning services in relation to AMP Flexible Super. See page 27.
The Management Fee Rebate means we reduce your management fees by paying part of them back into your account. To be eligible for a Management Fee Rebate you need to select the Choice Investment level in either your Super or Retirement account. The amount of any Management Fee Rebate you get depends on the rebate rates you qualify for and your account balance. The rebate rates you qualify for depends on your “total relationship balance” and the investment options you have chosen.
Your “total relationship balance” is described in this table:
TYPE oF MEMBER
Employer sponsored member
Personal member who is linked to an employer sponsored member under Family membership
Personal member who is not linked to an employer sponsored member under
Family membership
ToTAL RELATIoNSHIP BALANCE
The size of the employer plan, which is the sum of all:
Employer sponsored members’ Super accounts and (if linked) Retirement accounts.
Personal members’ Super and Retirement accounts, if those members are linked to employer sponsored members in the plan under Family membership.
The sum of the member’s Super and Retirement accounts. If you are a personal super member, you may be eligible to link a family member for flexible bonus. See page 26 for more information.
25

26 i
For more information on rebates, see the
Fact Sheet: Fees and other costs . Look for the headings:
Management Fee
Rebate
Flexible bonus i
For more information on Family membership and the definition of
“interdependency relationship”, see the Fact Sheet:
Information on your account . Look for the heading: Family
Membership.
The rebate rates also depend on the investment options you have chosen. There are 2 categories of investment options, “Super Easy” investment options (those with “Super Easy” in their name) and “Premium” investment options (all other options). The different rates that apply for these two categories are specified in the fees and costs table, from page 23. If you switch from a Super Easy investment option into a Premium investment option, you may not be eligible for the higher rebate rate at the end of the month in which you switched.
Once the rebate rates you qualify for have been determined, they are applied to the investment option balances within your AMP Flexible Super account, to produce the amount of your rebate. For Super accounts, this rebate amount is reduced by 15% to allow for the tax deduction which has already been included in the original fee.
The rebate is paid directly into your account by issuing you with additional units (or for crediting rate options other than Super Easy Term Deposit, by crediting an amount to your account balance in the option) usually within 7 business days after the end of each month. We allocate the units and/or the credits in proportion to the balance of each investment option (excluding Super Easy Term Deposit). However, if you have nominated a single investment option under the Deductions and Rebate Profile, we allocate the units or credits
(as applicable) to that investment option.
Flexible bonus is a feature of the Management Fee Rebate that allows you and one Family member you choose to link your AMP products together. By applying to link your AMP products, you and your Family member may be able to benefit from a higher Management Fee Rebate, as the aggregate account balance across your products is used to determine the level of Management Fee Rebate that applies.
To be eligible for a Flexible bonus you need to select the Choice Investment level in either your Super or
Retirement account.
The following AMP products are eligible to be linked under Flexible bonus:
AMP Flexible Super
Flexible Lifetime - Super
Flexible Lifetime - Allocated Pension
Flexible Lifetime - Term Pension
Flexible Lifetime - Investments (Series 1)
Flexible Lifetime - Investments (Series 2).
Your entitlement to Flexible bonus is described in this table:
TYPE oF MEMBER
Employer sponsored member
Personal member who is linked to an employer sponsored member under Family membership.
Personal member who is not linked to an employer sponsored member under Family membership.
ToTAL RELATIoNSHIP BALANCE
You are not eligible for any additional rebates in respect of your AMP Flexible
Super account.
However, you may be entitled to additional rebates in respect of your Flexible
Lifetime products that are linked under Flexible bonus. The current rebate tiers and rates for those products will apply. The rebate rate for linked products is determined by the total of linked account balances at the end of the month. Any Management Fee Rebate you have already received for that month will be taken into account when determining the additional amount of
Management Fee Rebate you are entitled to under the Flexible bonus.
Under Flexible bonus, the applicable account balances will not be limited to your Super and Retirement accounts in AMP Flexible Super. Instead, they will include your accounts in other eligible AMP products as well as those of your
Family member who is linked under Flexible bonus. The current rebate tiers and rates for AMP Flexible Super and the other products will apply. The rebate rate for linked products is determined by the total of linked account balances at the end of the month. Any Management Fee Rebate you have already received for that month will be taken into account when determining the additional amount of Management Fee Rebate you are entitled to under the
Flexible bonus.

Any rebate payable under Flexible bonus is paid in the same way as any rebate that is payable under the main rebate arrangements described on page 25, except that payment occurs on the 15th day of each month. If you close your account after the end of the month, but before the 15th day of the next month, no rebate under
Flexible bonus will be payable for the previous month.
You can apply to link your account with another person for the Flexible bonus or Family membership for the purpose of determining a Management Fee Rebate if they are:
your Spouse, Parent, Sibling (brother/sister), Child, Grandparent, Grandchild, Father/Mother-in-law,
Brother/Sister-in-law, Son/Daughter-in-law, or
someone with whom you have an “interdependency relationship”.
If you have nominated a single investment option under the Deductions and Rebate Profile, the Member Fee and Management Fee Rebates are generally paid from that investment option.
Otherwise, the Member Fee and Management Fee Rebates are paid proportionately to each investment option
(excluding Super Easy Term Deposits), according to the proportion of your total account balance invested in each option.
If you have nominated an investment option, any Member Fee and Management Fee Rebate you are entitled to receive will also be paid by:
Issuing additional units in that option (for unitised investment options), or
Increasing your account balance in that option, (for a crediting rate investment option).
If you have not nominated an investment option, we will allocate the units in the investment options in which you are invested (or for crediting rate options, increase your account balance in the option), in proportion to the balance of each investment option (excluding Super Easy Term Deposit).
Transaction and operational costs may apply to investment options. Estimates of these costs are reflected in the unit price or crediting rate.
We can introduce new fees or change existing fees at any time. However, we will notify you at least 30 days before we increase existing fees (other than the CPI increases to the Member Fee) or introduce new fees. Some fees have a maximum that we can charge, but other fees do not.
We can also set restrictions on the Member Advice Fee and Plan Service Fee to which you or your employer agree.
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.
If you invest in the Core Investment Level, the Member Advice Fee may be capped. The current caps (inclusive of GST) are:
$440 for the one-off dollar amount at the initial opening of your account, and $220 for an existing account
(the caps will not apply if you have Flexible Protection or have received advice relating to upgrading your insurance), and
$55 each year or 0.22% pa of your account balance for the Ongoing Member Advice Fee.
If you are an Employer Sponsored member, your employer may agree with a financial planner to a Plan Service
Fee to be paid for financial planning services provided in respect of some or all members of the AMP Flexible
Super plan.
This Plan Service Fee is an ongoing fee, paid monthly, which may be either:
a fixed dollar amount, or
a set percentage of your account balance.
If you are invested in the Core Investment Level, the Plan Service Fee is capped. The current caps (inclusive of
GST) are $55 each year or 0.22% pa of your account balance.
i
For more information on rebates and transaction and operational costs , see the Fact Sheet:
Fees and other costs ,
Look for the headings:
Transaction and operational costs.
i
For more information on how we can change fees and the maximums which apply, see the Fact
Sheet: Fees and other costs , Look for the heading: Changing the fees.
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28 i
For more information on fees and costs, see the Fact Sheet: Fees and other costs . Look out for the heading:
Advice and Service fees.
The Plan Service Fee no longer applies when we process a notification from your employer stating that you have ceased employment, or if we have not received any contributions from your employer for at least 12 months.
The Member Advice Fee and Plan Service Fee must only be for services provided in respect of your
AMP Flexible Super account and must not be used to pay for any other products or financial planning advice targeted at broader non-super savings and investment opportunities.
You can change any Ongoing Member Advice Fee by agreement with your financial planner and completing a Changing your advice and service fees form. Your employer can change any Plan Service Fee by agreement in writing with the financial planner.
You can cancel any Ongoing Member Advice Fee or Plan Service Fee by completing a Changing your advice and service fees form available at www.amp.com.au.
For your Super account, any Member Advice Fee and Plan Service Fee agreed with a financial planner will only be paid from the date your Super account balance first reaches $1,200 or more. If your account balance is
$1,000 or less, or a payment of the above fee(s) would result in your account balance decreasing to $1,000 or less, no payment will apply. For your Retirement account, no minimum applies.
No commission is payable on Essential Protection insurance.
The standard commission on Flexible Protection insurance cover is up to:
112.8% of the first year’s insurance premiums (which your planner may have to repay if you don’t keep up your insurance for at least one year) and 11% of insurance premiums for that year and each subsequent year, or
55% of the first year’s insurance premiums (which your planner may have to repay if you don’t keep up your insurance for at least one year) and 16.5% of insurance premiums for that year and each subsequent year, or
22% pa of insurance premiums.
This commission is not in addition to your insurance premium.
You and your financial planner agree on one of these options for standard commission on insurance.
The above amounts are inclusive of 10% GST. If your financial planner is registered for GST purposes they will pay this 10% to the Australian Taxation Office.
If your personal statement is completed using AMP’s easywrite automated underwriting for insurance, AMP
Life pays commission up to:
130% of the first year’s personal insurance premium and 11% of insurance premiums for that year and each subsequent year (if the first of the standard commission on insurance options above is used), or
70% commission of the first year’s personal insurance premium and 16.5% of insurance premiums for that year and each subsequent year (if the second of the standard commission on insurance options above is used).
The above amounts are inclusive of 10% GST.
No commission is payable on Employee Essential Protection insurance.
For Employee Flexible Protection, AMP Life will normally pay the standard commission to the plan’s financial planner. This is paid out of the insurance premiums.
The standard commission is agreed between the employer and the plan’s financial planner. It can be up to
22% pa of the insurance premiums paid by employee and Family membership members. Your insurance premium reflects the cost of the agreed standard commission.
The above amount is inclusive of 10% GST. If your financial planner is registered for GST purposes they will pay this 10% to the Australian Taxation Office.
You and your financial planner can agree to an alternative to the standard initial commission and ongoing commission on insurance premiums.
If a lower commission on insurance is agreed the cost of your insurance will be reduced.

Your employer and the employer plan’s financial planner may agree to an alternative to the standard commission on insurance that applies to your employer plan.
The commission on insurance that is agreed will be reflected in the cost of your insurance.
Contact details for your financial planner (if applicable) are on your Welcome Letter, or Member Benefit Schedule, or accessible via My portfolio.
Where a tax deduction is available to AMP Life in respect of the expense paid, the actual amount of fees charged to your account will be reduced by 15%.
The fees described in the “Fees and other costs” section of this PDS and the Fact Sheet: Fees and other costs include, if applicable, GST.
These tables give an example of how the fees and costs in a balanced investment option for this product can affect your Super account or Retirement account over a one year period. You should use this table to compare this product with other super products.
EXAMPLE - SUPER EASY BALANCED
(CoRE INVESTMENT LEVEL)
BALANCE oF $50,000 WITH ToTAL
CoNTRIBUTIoNS oF $5,000 DURING THE YEAR
Contribution fees
Plus Management costs
Equals Cost of Account
Nil
0.65% pa + $78
($1.50 per week) 1
For every $5,000 put in, you will be charged $0.
And, for every $50,000 you have in the account you will be charged $325 each year, plus $78 in Member
Fees regardless of your 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:
$403
What it costs you will depend on the investment option you choose and the fees you negotiate with your fund or financial planner .
Note: The $403 shown in the above table does not include the management costs charged on the additional $5,000 investment.
The management costs would be $435.50 if you had invested the $5,000 for a full 12 months.
1. The amount you actually pay for Super accounts is reduced by 15% to allow for the tax deduction passed on to you. Taking into account the deduction, the amount you pay is:
Core Investment level - 0.55% pa + $66 ($1.28 per week) = $343
Select Investment level - 0.55% pa + $88 ($1.70 per week) = $365
Choice Investment level - 0.55% pa + $110 ($2.13 per week) = $387.
EXAMPLE - SUPER EASY BALANCED
(CoRE INVESTMENT LEVEL)
Plus Management costs
Equals Cost of Account
0.65% pa + $78
($1.50 per week) 2
BALANCE oF $50,000 1
And, for every $50,000 you have in the account you will be charged $325 each year, plus $78 in Member
Fees regardless of your 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:
$403
What it costs you will depend on the investment option you choose and the fees you negotiate with your fund or financial planner .
1. No additional contributions are permitted to the Retirement account once it has commenced. This example assumes the balance of your investment in the Super Easy Balanced investment option remains at $50,000 throughout the year.
2. This fee is based on the Core option. If you were in either of the other Investment levels your fees would be:
Select Investment level - 0.65% pa + $104 ($2.00 per week) = $429
Choice Investment level - 0.65% pa + $130 ($2.50 per week) = $455.
29

30 i
For more information about each of these insurance benefits, see the Fact Sheet:
Insurance.
i
For more information about interim accident cover conditions, see the
Fact Sheet: Insurance .
Look for the headings:
Essential
Protection
Employee Flexible
Protection.
AMP Flexible Super provides 4 insurance types:
Personal members' insurance
Essential Protection
Flexible Protection
Employer sponsored members' insurance
Employee Essential Protection
Employee Flexible Protection.
An overview of your personal member insurance options:
INSURANCE FEATURES
Insurance payable if you die
Entry age range
Expiry age
Sum insured
ESSENTIAL PRoTECTIoN EP

Death cover
16-55
65
$50,000 - $250,000 in $1,000 increments
FLEXIBLE PRoTECTIoN FP

Extra Death Benefit (EDB)
16-74 (as at the next 1 July)
99
$75,000 minimum
(If you select both EDB and TPD Benefit together, at least one of the benefits must be $75,000 or more.)
No maximum



Indexation feature ✗
Terminal illness benefit 
Guaranteed future insurability feature
✗
Interim Accident cover ✗
Business Safeguard
Benefit (extra cost option)
Entry age range
✗
-
-
Expiry age
Waiver Benefit (extra cost option)
Entry age range
Expiry age
✗
-
-


(Available if EDB sum insured is at least $500,000)
16-60 (as at the next 1 July)
65

16-60 (as at the next 1 July)
65
Insurance payable for total and permanent disablement
Entry age range
Expiry age

Total and Permanent
Disablement (TPD) cover
(Only available if you have also selected Death cover)
16-55
65

TPD Benefit
Sum insured
Indexation feature ✗
Guaranteed future insurability feature
✗
Interim Accident cover ✗
$50,000 - $250,000 in $1,000 increments
(Must equal Death cover sum insured)
16-60 (as at the next 1 July)
99
(a modified TPD definition applies after age 65.
Please refer to the Fact Sheet: Insurance, look for the heading Flexible Protection)
$75,000 minimum
(If you select both EDB and TPD Benefit together, at least one of the benefits must be $75,000 or more)
$3 million maximum




INSURANCE FEATURES ESSENTIAL PRoTECTIoN EP
Occupational eligibility You must be working at least 10 hours per week in an occupation that we classify as “white collar”
(including full time home duties) or
“light manual” or “heavy manual”.
(Refer to the occupation table in the Fact Sheet: Insurance, look for the heading Essential Protection.)
Business Safeguard
Benefit (extra cost option)
✗
Entry age range
Expiry age
Waiver Benefit (extra cost option)
Entry age range
Expiry age
-
-
-
-
✗
FLEXIBLE PRoTECTIoN FP
You must be working at least 10 hours per week in an occupation that we insure.
(We will let you know if we insure your occupation after you apply, or you can speak to your financial planner.)

(Available if TPD Benefit sum insured is at least
$500,000)
16-55 (as at the next 1 July)
65

16-60 (as at the next 1 July)
65
Insurance payable for temporary salary continuance
Entry age range
Expiry age
Sum insured
-
-
-
✗ 
Temporary Salary Continuance
(TSC) Benefit
16-59 (as at the next 1 July)
65
$1,250 per month minimum
Up to 75% of the first $320,000 of your annual income, plus
Up to 50% of the next $240,000 of your income, plus
Up to 15% of amounts over $560,000 1


Indexation feature
Guaranteed future insurability
Interim Accident cover -
-
Occupational eligibility -
-
Application process

You must be working at least 20 hours per week in an occupation that we insure.
(We will let you know if we insure your occupation after you apply, or you can speak to your financial planner)
We will decide if you are eligible for Essential Protection based on your answers to the questions contained in the insurance section of the AMP Flexible Super application form.
When you complete the application process we will provide you with a premium quote based on the information you have provided.
Insurance quotes are valid for 30 days.
We will also let you know if we cannot offer you cover.
In assessing your application for insurance we will consider your medical history, your likely future good health, lifestyle and family history.
We will also consider the information you provide about your occupation and pastimes.
We will let you know if we cannot offer you cover.
Speak to your financial planner or call AMP on
133 888 to obtain a Flexible Protection premium quote.
Insurance quotes are valid for 30 days.
1. Limitations may apply for benefits in excess of $30,000 per month.
When applying for insurance, you have a legal duty to answer the questions in the application form and questionnaire truthfully. Not doing so may result in any claim being declined or the amount we would otherwise pay being reduced.
i
For more information about the insurance options available, see the Fact Sheet:
Insurance . Look for the headings:
Essential
Protection
Flexible Protection.
31

32
Start your
AMP Flexible Super account
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 any supplements) for AMP Flexible Super.
Issued by AMP Superannuation Limited ABN 31 008 414 104,
AFSL No. 233060, RSE Licence No. L0000550, the trustee of the AMP
Superannuation Savings Trust, ABN 76 514 770 399, RSE Registration
No. R1001648
1 Begin by reading How do I complete this forms booklet?
on the following page >
This section will help you answer the Insurance questions in the AMP
Flexible Super and Flexible Protection sections of the forms booklet.
(Refer back to pages 6-7 for more information.)
Craig, 26
Craig’s employer doesn’t offer insurance so he has decided to apply for Essential Protection :
Death cover of $100,000
Total & Permanent Disablement Benefit of $100,000
Non-smoker
Lives in New South Wales.
Cost will be approximately $8.25
a month deducted from his Super account.
Ella, 31
Ella has also taken out an optional level of insurance that will protect her income in the case of accident or illness.
Ella has decided to apply for Flexible Protection :
Extra Death Benefit of $750,000
Total & Permanent Disablement Benefit of $500,000
Temporary Salary Continuance Benefit of $4,688 per month
Non-smoker
Lives in Queensland
2 years TSC benefit period
13 week TSC waiting period.
Cost will be approximately $91.29
a month deducted from her Super account.
Wendy, 56
Wendy is nearing retirement and her family has grown up.
Wendy has decided to apply for Flexible Protection :
Extra Death Benefit of $200,000
Total & Permanent Disablement Benefit of $200,000
Non-smoker
Lives in Victoria.
Cost will be approximately $157.85
a month deducted from her Super account.
Note: These examples are for illustrative purposes only.

For employer sponsored members, the insurance cover available in your employer plan has been chosen by your employer.
Employee Essential Protection is available if AMP Flexible Super is the default super plan or the only other employer super plan that the employer uses for its employees.
Employee Flexible Protection is available if AMP Flexible Super is your employer’s default plan, or if at least
75% of employee members in the employer plan have the default insurance for their plan or have insurance for higher amounts.
Both Employee Essential Protection and Employee Flexible Protection allow employers to arrange for automatic insurance cover for all existing and new employees joining their employer plan.
Alternatively, if your employer plan does not have any insurance cover as a default or if you would like to upgrade your insurance cover, you may decide to apply for Essential Protection or Flexible Protection at any time after you become an employer sponsored member. You can apply either online or by contacting your financial planner.
Premium discounts based on the size of the employer plan only apply to Employer Flexible Protection premiums.
Note: A default super plan is typically the plan to which the employer pays Superannuation Guarantee (SG) contributions for those of their employees who do not choose their own Superannuation product upon commencing employment. However, employees can choose to become a member of the default plan.
oPTIoNS EMPLoYEE ESSENTIAL PRoTECTIoN EEP EMPLoYEE FLEXIBLE PRoTECTIoN EFP
Employee Essential Protection provides
Death cover and Total and Permanent
Disablement (TPD) cover according to a scale that depends on your age and occupation
Employee Flexible Protection provides Death cover, TPD cover and Temporary Salary
Continuance (TSC) cover up to:

Death cover: No maximum
TPD cover: $3 million
TSC cover: $25,000 per month (for benefit period “to age 65”) or $30,000 per month
(for benefit period up to 2 years).
Death cover
Total and
Permanent
Disablement
(TPD) cover
Temporary Salary
Continuance cover
Minimum sum insured
Entry age
-


(only available with Death cover)
The sum insured is fixed and varies by age and occupation
Minimum: 16 (current age)
Maximum: 64 (current age)

(only available with Death cover)

(only available with Death cover)
No minimum
Minimum: Death and TPD cover - 12 (current age)
TSC cover - 15 (current age)
Maximum: Death cover - 69 (current age)
TPD and TSC cover - 64 (current age)
Expiry age 65 Death cover: 70
TPD and TSC cover: 65
Detached members (see page 35 for more information)
Death cover: 99
TPD cover: 99 1
TSC cover: 65
1. A modified TPD definition applies after age 65. Please refer to the full TPD definition in the insurance definition section of the
Employee Flexible Protection Fact Sheet.
i
For more information about Employer
Sponsored Member insurance options available see the Fact
Sheet: Insurance . Look out for the headings:
Employee Essential
Protection
Employee Flexible
Protection.
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34 i
For more information about Active
Employment see the
Fact Sheet: Insurance.
Look out for the heading Insurance
Definitions.
If you are an employee who has been nominated for Employee Essential Protection cover by your employer you will automatically receive Death and TPD cover without having to provide information on the state of your health or pastimes, subject to meeting the Employee Essential Protection employee eligibility rules discussed in the Fact Sheets, including being Actively Employed on the day cover commences.
The type of insurance cover available in an employer plan under Employee Flexible Protection is the type of cover chosen by your employer. This can be Death/TPD, Death/TSC or Death/TPD/TSC. If you are an employee who has been nominated for Employee Flexible Protection cover by your employer you will automatically receive the cover available for your employer plan, up to the Automatic Acceptance Limit, without having to provide information on the state of your health, subject to meeting the Employee Flexible Protection employee eligibility rules discussed in the Fact Sheets, including being Actively Employed on the day cover commences.
You are Actively Employed if:
you are employed (including being on paid leave except for leave caused by an illness or injury) by an employer to carry out identifiable duties, on a full-time, part-time or casual basis, and
you are capable of performing (without restriction by accident, injury or illness) your full and normal duties on a full-time basis (for at least 30 hours per week) even though actual employment may be on a full-time, part-time or casual basis.
“Actively Employed” has a corresponding meaning. See the Insurance Fact Sheet for more information.
Limited Cover applies to you if you were not in Active Employment at the time your Employee Essential
Protection or Employee Flexible Protection cover started or you have previously been paid a TPD benefit from
AMP Flexible Super, another superannuation fund or insurance policy.
Limited Cover provides the same cover as Employee Essential Protection or Employee Flexible Protection, but with certain exclusions. While Limited Cover applies you are not covered for any pre-existing conditions. You will only be covered for claims that arise from a sickness that first became apparent, or was diagnosed, or an injury that first occurred on or after the date your cover started.
During the first 12 months of Limited Cover, no insurance is paid:
under Death cover if your death or terminal illness is caused by suicide, or your wilful and intentional self-inflicted illness or injury, or
under TPD cover if disablement is caused by you, either directly or indirectly, by an intentional or deliberate act.
If you were not in Active Employment at the time your Employee Essential Protection or Employee Flexible
Protection insurance started, Limited Cover generally applies for 2 years provided you are a member for that period. Provided you are in Active Employment at the end of this 2 year period, Limited Cover will stop and full Employee Essential Protection or Employee Flexible Protection cover will apply. If you are not in Active
Employment at the end of the 2 year period, Limited Cover will continue to apply until you are in Active
Employment.
If you have Limited Cover because you were previously paid a TPD Benefit, Limited Cover will apply for the life of your membership in AMP Flexible Super.

When you leave your employer and are detached from the employer plan, your cover under Employee Essential
Protection continues unchanged.
When you leave your employer and are detached from the employer plan, your cover under Employee Flexible
Protection continues with the following changes:
any employer plan premium discounts will cease and your premium may increase,
your Death cover will continue until your 99th birthday,
your TPD cover will continue until your 99th birthday, a modified TPD definition will apply after age 65 (see the full TPD definition in the Fact Sheet: Insurance ),
your insurance will be converted to a fixed amount equal to the amount of cover you had on the day you were detached. This amount will be increased at each 1 July. For Death and TPD cover the increase is the higher of 5% and the annual change in the Consumer Price Index (CPI). For TSC cover the increase is the annual change in CPI and it continues until you turn 64.
The table below provides you with some general information:
24 hour worldwide coverage
Making a claim
Claiming a TPD benefit and you die before the claim is accepted
You will be covered for Death, TPD or TSC no matter where in the world you are, at any time.
We aim to be proactive in our claims management. Our claim requirements vary depending on the type of, and reason for, the claim you are making. We pride ourselves on providing a supportive claims service and are committed to paying genuine claims.
This includes the provision of a Claims Concierge Service and a specially trained and empathetic claims team.
The 4 steps of the claims process:
Step 1 - Notifying AMP of your intention to claim.
Step 2 - You complete and return the claim paperwork.
Step 3 - AMP assesses your claim.
Step 4 - We assist you with your claim payment.
To notify us of your intention to claim a benefit, you or an authorised representative acting on your behalf can contact our Claims team on the following numbers:
Death claims 1300 373 654
Disability claims 1300 366 214
Upon this notification we will send claim forms for you to complete and return to us.
These forms will be specific to the benefit type under which you are claiming. Our initial claims requirements will be outlined in our letter to you, this may include information about your health.
In addition, we will advise you of the direct contact details of our claims representative for your future reference.
We will pay the costs of obtaining information from medical advisers we choose. In all other cases, you must pay the costs of providing information in support of your claim.
For TPD and TSC claims, if you are an employee who has been nominated for insurance cover by your employer, you must tell us within 7 months of your disablement starting.
Otherwise AMP Life may reduce the benefit it pays if it has been prejudiced by your delay.
If you die while your TPD claim is being considered, AMP Life will consider eligibility to claim under Death cover instead. Except where your TPD benefit insured amount is higher than your EDB insured amount, if Death cover is paid, your TPD claim will be cancelled. AMP Flexible Super insurance cover will not pay both the insured TPD benefit and the insured death benefit. Only the higher benefit amount will be paid.
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For more information see the Fact Sheet:
How to Transact .
Look for the heading
Leaving your employer.
i
For more information about TPD claims see the Fact Sheet: How to Transact . Look out for the heading
Accessing your money.
35

36 i
For more information about insurance cover and for insurance definitions, see the
Fact Sheet: Insurance .
Look for the headings:
Insurance benefits explained, and
Insurance definitions.
i
For more information about how insurance premiums are calculated for each type of cover, see the
Fact Sheet: Insurance .
Look for the heading:
Your insurance premiums under each type of cover.
Payment of Death and TPD claims
Taxation
Automatic cover for
Employee members
Government duties on insurance premiums
Duty of disclosure
If you die, then your balance, as at the date we receive notification at an AMP processing centre, will be transferred to the Super Easy Cash investment option.
For TPD claims, you cannot receive an insurance benefit payment in cash unless you are eligible to access your super and have satisfied a condition of release.
Instead, we will invest the benefit amount into your account in the Super Easy Cash investment option until it can be paid to you.
Note: If you lodge a TPD claim more than 2 years after you permanently stopped working, you may be unable to make a complaint to the Superannuation Complaints Tribunal (SCT) in the event of your TPD claim being declined because of time limits imposed by the SCT.
You may have to pay tax on insurance benefits we pay you. We will deduct any tax that we are required to deduct before we pay you.
An AMP Flexible Super employer should tell us if they are aware of anything affecting their employees as a group (other than the information about their ages, occupations and claims experience that they have already given us) that is relevant to the insurer’s decision whether to accept the risk of the insurance and, if so, on what terms. However, the AMP Flexible Super employer does not need to tell us about the health of individual employees. If employees do not qualify for automatic acceptance or their cover exceeds the automatic acceptance level, AMP Life will advise employees of their duty of disclosure when it collects information about their health from them.
In addition to the premiums for any insurance cover, Government stamp duty or a similar tax may also be payable (stamp duty is either incorporated into the base premium rates or is an additional charge). Any additional stamp duty on insurance premiums will be deducted from your account when your insurance premium is deducted, or paid. Your
Member Statement will show the amount of any additional stamp duty or tax deducted.
If a State or Territory Government stamp duty or tax applies to you, it will be based on the State or Territory we record as your residential address. As stamp duty and tax differ between States/Territories, it is important that you inform us of any changes to your address.
Additional stamp duty charges currently vary between 1.5% and 11% of the cost of premiums, depending on the insurance benefits and the State or Territory we record as your residential address. Additional stamp duty charges can change without notice (up and down) as governments introduce a new stamp duty or revise an existing one or as we change our address records. AMP may also change the way we recover stamp duty, from incorporating it into the base premium rates to making it an additional charge.
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.
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. However, for Essential Protection, the duty of disclosure is limited to the questions asked.
The cost of insurance depends on a number of factors, such as the insurance amount you have applied for
(which will increase each year if the indexation feature has been selected) and additional options you may want to add.

As an incentive to save for your retirement, the super system offers attractive tax benefits.
Generally, your super may be taxed:
when contributions are made
on your earnings while your money is invested (maximum 15%)
when you withdraw money from super under age 60.
Contributions to your account can be taxed in 3 main ways, as outlined below. While the first type of tax always applies, you can ensure the other 2 taxes do not impact your account.
TYPE oF TAX
Tax on contributions
Penalty tax for not providing your tax file number (known as “no-TFN tax”)
Excess
Contributions
Taxes
DESCRIPTIoN WHEN IS IT
DEDUCTED?
-
HoW CAN YoU MAKE
SURE THE TAX DoES
NoT APPLY?
Employer contributions, salary sacrifice contributions and personal member contributions for which a tax deduction is claimed are taxed at a rate of 15%.
We will deduct this tax from your account at the time shown. This tax is often referred to as “contributions tax”.
Insurance premiums for death and disability cover paid as part of your super are generally tax deductible to the
Trustee. Providing that we expect full value for this tax deduction in a tax year, the value of this benefit will be shown as a reduction in the allowance we make for contributions tax to be deducted from your account or as a credit where possible.
A further tax charge of 31.5% applies to the contributions described above if you do not give us your Tax File Number.
Unlike the standard tax charge above, there is no reduction for premiums for death or disability cover.
If you exceed the contributions caps set by Government, you could be required to pay an Excess Contributions Tax of up to
46.5% on the excess.
Quarterly (or earlier when you close your account).
The earlier of 30 June each year and when you close your account
This tax is payable by you personally and is in addition to contributions tax and income tax.
Advise us of your Tax
File Number.
If you are charged, this tax may be refunded if you supply your Tax
File Number within 4 financial years from when the contribution is made.
Make sure that your contributions are within your current contribution caps limits.
( Note: Caps currently vary with your age.
See page 9 for the contributions caps).
No contributions tax is payable on your after-tax personal member contributions for which you do not claim a tax deduction or contributions your spouse makes to your account.
TIP
If you are self-employed, you might be able to claim your personal member contributions as a tax deduction.
i
For information about the consequences of not providing your
Tax File Number refer to the Fact Sheet:
Information on your account . Look for the heading Collection of
Tax File Numbers.
37

38 i
For information on tax, including tax on withdrawals, see the Fact Sheet:
Information on your account . Look for the heading: Tax and social security.
i
For information on tax and social security issues, see Fact Sheet:
Information on your account . Look for the heading: Tax and social security.
If the Family member is the employee member’s spouse and the spouse is a low-income earner, then a tax offset may be available if an employee member contributes to their spouse’s account.
If you have a Retirement account or Transition to 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
No tax on investment earnings
When you rollover your superannuation benefit into your Retirement account, no tax is payable on your benefit.
Tax may be payable on rollovers from a public sector super scheme, and the taxable component of “directed termination payments” from employers.
Investment returns on your Retirement account are tax-free while kept in your account.
UNDER 60
Part of each regular income payment may be returned tax-free
A 15% tax offset may apply
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 investment.
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. It may also apply if the payment is made as a result of the death of another person or your disability.
60 oR oVER
No tax on income or lump sum payments All your income payments and lump sum withdrawals are tax free.
SoCIAL SECURITY
Super account
Retirement account (including Transition to Retirement income streams)
Amounts in your Super account are generally income and assets test exempt if you are under Centrelink/DVA
Age Pension age.
Assets test
100% of your Retirement account is counted as an asset under the assets test.
Income test
Regular income payments from your Retirement account, less an amount representing the return of your investment (non-assessable portion) are included under the income test. Contact Centrelink or your financial planner for more information.
Important : This tax and social security information is of a general nature only. Tax and social security laws are complex and can change. We recommend you discuss your own circumstances with your financial planner or tax adviser before you decide to invest.

You can nominate one or more beneficiaries to receive your benefit in the event of your death.
It’s recommended you discuss your nomination with your financial planner.
It’s important to us that your account meets your needs so if you change your mind regarding this product within 14 days of:
the date you receive our Welcome Letter, or
5 business days after the date shown on our Welcome Letter (whichever is earlier), we will cancel your account and refund an amount to you (if you are entitled to access your superannuation benefit) or transfer an amount to a complying fund you nominate in writing within one month of you telling us you have changed your mind.*
We will refund to you or transfer to another complying fund the amount you invested:
plus or minus any movement in the unit price, or positive or negative earnings on your account
less administration costs and taxes incurred by us.
If you have switched investment options or exercised any other right in relation to your account, you do not have these “cooling off” rights.
* If you are an employer, we will only transfer the amount of your employer contributions (including any salary sacrifice contributions, and less any amounts listed above) to the fund you have nominated. If your employee has made any contributions to your plan, they must provide us with details of another fund to which they want us to transfer the amount of their contributions (less any amounts listed above).
Statements, annual reports and other correspondence will be sent to you based on your communications preference, ie electronically, either through email or to your My portfolio account (where possible) or via post.
AMP Flexible Super is part of a super fund known as the AMP Superannuation Savings Trust (SST).
A trust deed established the SST and it contains:
your rights and obligations relating to AMP Flexible Super, and
our rights and obligations as the Trustee - for example, the right to charge fees, the right to be indemnified, the right to terminate the trust and the limits on our liability.
As a Trustee, our rights and obligations are also governed by laws affecting super as well as general trust law.
We may amend the trust deed with the consent of AMP Life Limited.
We invest all the assets of the SST in group superannuation policies held with AMP Life. By investing in a specific investment option, you do not receive any entitlement to the assets underlying that investment option. Insurance cover is also provided under these policies.
You can phone us on 131 267 to get a copy of the trust deed or the policy documents.
We engage companies within and outside the AMP group to provide services in relation to AMP Flexible Super.
The companies in the AMP group we use are AMP Life Limited (AFSL No. 233671), AMP Capital Investors Limited
(AFSL No. 232497) and AMP Bank Limited (AFSL No. 234517).
i
For information on nominating your beneficiaries, see the Fact Sheet:
Information on your account . Look for the heading: Your beneficiaries .
i
For information about how we keep you informed, see the Fact
Sheet: Information on your account . Look for the headings:
Keeping you informed
My portfolio - online information about your account.
39

40 i
For more important information about your account, see the Fact Sheet:
Information on your account , including under the headings:
AMP and your privacy
Family law and your super
Your beneficiaries
Collection of Tax
File Numbers
Additional identification requirements
The relationship between the
Trustee and other service providers.
i
For more important information about your account, see the
Fact Sheet: How to transact.
, Look for the heading:
Direct Debit service agreement
(the terms that will apply to any direct debit that you, your spouse or your employer set up to make contributions).
Our main purpose in collecting personal information from you is so we can establish and manage your account.
We may also use this information for related purposes - for example, providing you with ongoing information about AMP’s financial services that may be useful for your financial needs.
These may include investment, retirement, financial planning, banking, credit, life and general insurance products and enhanced customer services, that may be made available by us, other members of the AMP group, or by your financial planner.
We usually disclose information of this kind:
To other members of the AMP group.
To your financial planner or broker (if any).
To external service suppliers who supply administrative, financial or other services to assist the AMP group in providing financial services.
If you are part of an employer sponsored plan, to the employer and the financial planner or broker responsible for the plan.
To anyone you have authorised or if required by law.
Under the National Privacy Principles, you may generally access personal information about you held by the
AMP group. Also, you may let us know if you think any of it is inaccurate, incomplete or out of date.
The AMP Privacy Policy Statement sets out the AMP group’s policy on management of personal information.
You may obtain a copy by contacting us on 131 267 or visiting our website at www.amp.com.au.
Additional information about the operation or management of your AMP Flexible Super account or of the SST is available from your financial planner or AMP Customer Service can help you. Please see the back of this PDS for contact details.
If you are unhappy about any aspect of your account or our service, please contact AMP Customer Service.
We will try to resolve your complaint as quickly as possible. If we cannot resolve it immediately, we will keep you informed about our progress.
Where we cannot resolve your complaint within 90 days or if you are unhappy with our decision, you may be able to lodge a complaint with the Superannuation Complaints Tribunal (SCT). The SCT is an independent body established by the Government to review certain decisions of superannuation trustees.
Website: sct.gov.au
Phone: 1300 884 114
Or write to: Locked Bag 3060
MELBOURNE VIC 3001
Time limits apply to certain complaints to the SCT, for example in respect of total and permanent disablement claims. If you have a complaint, you should contact the SCT immediately to find out if a time limit applies.

Super is a tax-effective way of saving for your retirement. By putting in place a suitable super strategy you can increase the likelihood of doing the things you want to do when you retire.
This is the Product Disclosure Statement (PDS) for AMP Flexible Super
AMP Superannuation Limited (ASL) is the issuer of AMP Flexible Super. AMP Flexible Super is an account offered in a superannuation fund known as the AMP
Superannuation Savings Trust (the fund). ASL is the trustee of the fund.
The purpose of AMP Flexible Super is to help you save for your retirement, to allow you to draw an income in retirement, and to provide you with insurance options.
The section of this PDS headed “What to consider before investing” contains a summary description of the key risks of the product. The rest of this PDS contains a summary description of the key features of the product.
Please see the back cover of this PDS for contact details.
How and why you should read this PDS
This PDS is an important document which will help you decide whether AMP Flexible Super suits your needs.
For prospective employer-sponsored members, the PDS is in two parts:
Part 1: this document and all relevant Fact Sheets
Part 2: Member Benefits Schedule sent to you as part of your welcome pack.
For other prospective members, the PDS is just this document.
It is important that you read this entire PDS including Fact Sheets before applying for AMP Flexible Super as it provides helpful information about its key features, benefits and options - including fees and insurance. Fact Sheets are available online at www.amp.com.au, or ask us for a free printed copy using the contact details on the back of this PDS.
You’ll find more detailed information on particular topics in our Fact Sheets which are referred to by this symbol throughout this PDS. Sometimes we will also refer you to a particular section heading in a Fact Sheet.
Important information
No other company in the AMP group is responsible for any statements or representations made in this PDS or the Fact Sheets, unless otherwise expressly stated.
Investments in the fund and the investment options are not deposits or liabilities of AMP Bank or any other AMP group company. Your investment in the fund and the investment options are subject to investment risks, which could include delays in repayment and loss of income and capital invested. Neither ASL nor any other AMP group company guarantees the performance of the fund or any investment option, the repayment of capital or (except where specifically stated in this PDS or the Fact
Sheets) any particular investment option.
This offer is available only to people receiving it (including electronically) within Australia. The information contained in this PDS and the Fact Sheets is of a general nature only. It is not based on your personal objectives, financial situation and needs. You should consider whether the information in this PDS and the Fact Sheets is appropriate for you in accordance with your objectives, financial situation and needs. To obtain advice or more information about the product offered in this PDS and the
Fact Sheets, you should speak to a financial planner who is an Australian financial services licensee or an authorised representative.
In this PDS unless specified otherwise:
“AMP Life” means AMP Life Limited (ABN 84 079 300 379, AFSL No. 233671).
“AMP Capital” means AMP Capital Investors Limited (ABN 59 001 777 591, AFSL No. 232497).
“we”, “us”, “our”, “ASL” and the “Trustee” mean AMP Superannuation Limited.
“Plan” refers to your AMP Flexible Super plan.
“you” refers to the member of the plan. If you are an employer sponsor, it refers to your employee.
Updating you of changes to this PDS, the Fact Sheets and the product
Information in this PDS/Fact Sheets may change from time to time. Where the change is not materially adverse, we will issue updated information that you can access by:
Visiting amp.com.au/pdsupdates
Asking your financial planner (if applicable)
Calling us on 131 267 to request a free printed copy.
If the change is materially adverse, we will issue a supplementary PDS.
This product is subject to the terms and conditions described in this PDS and the Fact Sheets. We reserve the right to change these terms and conditions from time to time.
Information for former GIO members who are transferring to an AMP Flexible Super - Retirement account
A Special Exit Fee may apply to former GIo members currently invested in Flexible Lifetime - Super, Flexible Lifetime - Allocated Pension, AmP multifund Flexible Income
Plan and AmP Deferred Annuity who are opening an AmP Flexible Super - retirement account. Any applicable Special Exit Fee will be transferred to the retirement account and will apply on any lump sum withdrawals from that account.

make
AmP Superannuation Limited AbN 31 008 414 104, AFSL No. 233060
33 Alfred Street Sydney NSW 2000
NS5271 11/10
Rating applies to Core and
Select investment levels
PRODUCT DISCLOSURE STATEMENT - SUPER & RETIREMENT ACCOUNT
ISSUED 13 NovEmbEr 2010
Issued by AmP Superannuation Limited AbN 31 008 414 104, AFS Licence No 233060, the Trustee of AmP Superannuation Savings Trust, AbN 76 514 770 399.
registered trade mark of AmP Life Limited AbN 84 079 300 379.

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 any supplements) for AMP Flexible Super.
1
Issued by AMP Superannuation Limited ABN 31 008 414 104, AFSL No. 233060, RSE Licence No. L0000550, the trustee of the AMP Superannuation Savings Trust, ABN 76 514 770 399, RSE Registration No. R1001648
® Registered trade mark of AMP Life Limited ABN 84 079 300 379.
153256 1110 NS5272.indd 1
NS5272 11/10
9/11/10 4:40 PM

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.
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.
1. Account Type and Personal Details (page A1) - Mandatory
2. Super Account Set up (page A3)
3. Retirement Account Set up (page A8)
4. Contributions (page A15)
5. Consolidation (page A18)
6. Beneficiary Nomination (page A20) - Mandatory
7. Optional Personal Insurance (page A22) - Available with a Super account only
8. Optional Flexible Bonus (page A23) - Available with the Choice investment level only
9. Member Advice Fee (page A23) - Planner customers only
10. Ensure you have signed in all relevant signature boxes under
Agreement and Declarations (page A24) - Mandatory
11. Certified copy of your identification documents.
Fill in the forms.
Start at the Your Details section on the opposite page, then follow the prompts at the end of each section.
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 preceeding 2 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.
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.
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 A24.
153256 1110 NS5272.indd 2 9/11/10 4:40 PM

Please staple all relevant material together
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 any supplements) for AMP Flexible Super.
Mark boxes with (
8
) where appropriate, otherwise use block letters.
Leave a box between words.
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 A4.
With Essential Protection (you must also complete page A22 of this form), or
With Flexible Protection (you must also check page A22 of this form, and complete the Application for insurance -
Flexible Protection form from page D1), or
Without insurance.
Do you have an existing AMP Flexible Super -
Retirement Account to link?^
No Yes. Please provide account no.
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 A4 and Your Retirement starting on page A8.
AMP Flexible Super - Retirement Account
(including consolidation).
# Please begin with the Personal Details section below, and also
Your Retirement starting on page A8.
Do you have an existing AMP Flexible Super -
Super Account to link?^
No Yes. Please provide account no.
^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.
# In 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 Superannuation Savings Trust.
Title Surname
Given names
Date of birth*
Occupation
Industry
Country of Residence
Country of Citizenship
Sex
Male Female
Tax File Number See information on the collection of
Tax File Numbers in the Fact Sheet:
Information on your account.
Address
Unit No.
Street No.
Suburb
Country
Street name
State Postcode
*If 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 NS4631 available from www.amp.com.au, or phone us for a form.
Issued by AMP Superannuation Limited ABN 31 008 414 104, AFSL No. 233060, RSE Licence No. L0000550, the trustee of the AMP Superannuation Savings Trust, ABN 76 514 770 399, RSE Registration No. R1001648.
NS5272A (11/10)
A1 of 28
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Same as residential. If your correspondence address is the same as your residential address, you do not need to provide your details again.
Unit No.
Suburb
Country
Home phone
Street No.
Street name
Fax number
State Postcode
Mobile phone number
Would you like to receive communications, including your Annual Statement, electronically?
Please note that certain communications are required to be sent by post, eg Welcome pack.
Your email address
Yes No
Provide a username for your My portfolio account, if you do not already have a username
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.
Family Membership allows you to apply to link your account to a current employee member of an AMP Flexible Super Employer-sponsored 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
Provide family member’s personal details below:
Title Surname
Given names
Date of birth Sex
Male Female
Type of family member
Please indicate your relationship to the employee member. Please cross one box only.
Spouse Parent Sibling (brother/sister)
Grandparent
Son/Daughter-in-law
Child
Grandchild Father/Mother-in-law Brother/Sister-in-law
Interdependency relationship (Refer to the AMP Flexible Super PDS for definition)
A2 of 28
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Your AMP Flexible Super - Super account offers 3 investment levels, with a different Member Fee for each level. Choose one of the options below:
For Core Investments
For Select Investments
C
S
- complete the Core Investments section below.
- complete the Select Investments section below.
For Choice Investments Ch - complete the Choice Investments section overleaf.
For more information on these Investment levels, see page 16 of the AMP Flexible Super PDS.
Refer to the PDS for information on investment levels, including fees.
Core Investments C Default option: I choose to have 100% of my superannuation invested in Super Easy Balanced.
> Skip to page A7
Own Mix option: I choose to have my superannuation invested across both investment options as indicated by the percentages below:
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%
Super Easy Balanced EBEI
% %
Super Easy Cash ESC
% %
OR
Select Investments S
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 A7
Super Easy Lifestages option: I choose to have 100% of my superannuation invested in an investment approach that provides the simplicity of a single investment manager.
> Skip to page A7
Own Mix option: I choose to have my superannuation invested across the investment 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.
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%
Optional:
Fee deduction
(tick one)
Super Easy Balanced EBEI
Super Easy Cash ESC
%
%
%
%
Super Easy Conservative
Super Easy Cautious
Super Easy Moderately
Conservative
Super Easy Growth
ECEI
ECAU
EMCO
EBEG
%
%
%
%
%
%
%
%
Super Easy High Growth EHG
% %
OR
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 re-align 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? Yes No
If “yes”, please select the frequency for auto-rebalancing: Quarterly Half-yearly 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.
A3 of 28
Continued overleaf >
153256 1110 NS5272.indd 3 9/11/10 4:40 PM

Choice Investments Ch
You can invest in a maximum of 15 of the different options available below.
153256 1110 NS5272.indd 4
Default option: I choose to have 100% of my superannuation invested in Super Easy Balanced.
> Skip to page A7
Super Easy Lifestages option: I choose to have 100% of my superannuation invested in an investment approach that provides the simplicity of a single investment manager.
> Skip to page A7
AMP L ifestages option: I choose to have 100% of my superannuation invested in an AMP directed strategy that provides a blend of investment managers with complementary styles.
> Skip to page A7
Future Directions LifeStages option : I choose to have 100% of my superannuation invested in a multi-sector investment approach through a single manager. > Skip to page A7
Own Mix option: I choose to have my superannuation invested across the investment 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%
Optional:
Fee deduction and rebates
(tick one)
Aberdeen Emerging
Opportunities
EAEO
% %
AMP All Growth EADS
% %
AMP Australian Bond EAAB
% %
AMP Australian Share EAAS
% %
AMP Balanced Growth EABG
% %
AMP Capital Asian Equity
Growth
AMP Capital Corporate
Bond
AMP Capital Global
Property Securities
EAAJ
EACO
ECGP
%
%
%
%
%
%
AMP Conservative ECON
% %
AMP Equity EAE
% %
AMP High Growth EAHG
% %
AMP Listed Property Trusts ELPT
% %
AMP Moderate Growth EAMG
% %
Arnhem Australian Equity EFAE
% %
Arrowstreet Global Equity EAGE
% %
Ausbil Australian Active
Equity
Bennelong Australian
Equities
BlackRock Asset Allocation
Alpha
EAAE
EIAS
EBRA
%
%
%
%
%
%
BlackRock Global Bond ESIF
% %
BlackRock Scientific Hedged
International Share
BlackRock Scientific
International Share
EHIS
EAIS
%
%
%
%
BT Australian Share ETAS
% %
Colonial First State
Australian Share
ECAS
% %
Fidelity Global Equities EFGE
% %
Future Directions Asian
Share
Future Directions
Australian Bond
Future Directions Australian
Share
EFAA
EFDA
EFAS
%
%
%
%
%
%
Continued overleaf >
A4 of 28
9/11/10 4:40 PM

Choice Investments Ch continued
153256 1110 NS5272.indd 5
Investment option
Future Directions Australian
Small Companies
Future Directions Balanced
Future Directions Conservative
Future Directions Emerging
Markets
Future Directions Extended
Markets International Share
Future Directions Geared
Australian Share
Future Directions Growth
Future Directions Hedged
International Share
Future Directions High Growth
Future Directions International
Bond
Future Directions International
Share
Future Directions Moderately
Conservative
Future Directions Property
GMO International Share
H3 Commodities
K2 Australian Absolute Return
Lazard Global Thematic
Macquarie Income
Opportunities
Macquarie International
Infrastructure Securities
Perennial Global Listed
Property
Perennial Value Australian
Share
Perennial Value Shares For
Income
Perpetual Industrial Share
Platinum International
RARE Infrastructure Value
Responsible Investment
Leaders Australian Share
Responsible Investment
Leaders Balanced
Responsible Investment
Leaders Conservative
Responsible Investment
Leaders Growth
Responsible Investment
Leaders International Share
Schroder Australian Equities
Schroder Fixed Income
Schroder Global Active Value
SG Hiscock Listed Property
Super Easy Australian Fixed
Interest
Option
Code
I want my account balance to be :
Total must add up to 100%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
ESFI
EGEV
EHLP
EAFI
EILC
EILG
ERIS
ESAS
EPVS
ERSI
EPI
EPTI
EGGO
EMIO
EMII
EPLP
ERIV
EILA
ESFB
EFDP
EMIS
EGBC
EAEL
EFDH
EFDI
EFIS
EFDM
EFDX
EAFS
EFDG
EFHI
EFDS
EAFD
EFDC
EFDE
I want my future contributions to go to:
Total must add up to 100%
Optional:
Fee deduction and rebates
(tick one)
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
Continued overleaf >
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
A5 of 28
9/11/10 4:40 PM

Choice Investments Ch continued
Investment option
Super Easy Australian Share
Super Easy Balanced
Super Easy Cash
Super Easy Cautious
Super Easy Conservative
Super Easy Growth
Super Easy High Growth
Super Easy International Fixed
Interest
Super Easy International Share
Super Easy Moderately
Conservative
Super Easy Property
T. Rowe Price Asia ex-Japan
T. Rowe Price Global Equity
Templeton Global Equity
Tyndall Australian Share Value
UBS Australian Small
Companies
Walter Scott Global Equity
ETIS
EBAE
EASC
EIEG
EBEG
EHG
EIFI
EISE
EMCO
ESEP
EAEJ
ETPE
EASE
EBEI
ESC
ECAU
ECEI
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%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
Optional:
Fee deduction and rebates
(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 re-align 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? Yes No
If “yes”, please select the frequency for auto-rebalancing: Quarterly Half-yearly 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.
153256 1110 NS5272.indd 6
A6 of 28
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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.
Will you be making or receiving super contributions into your AMP Flexible Super - Super account?
Please complete the Contribution s section on page A15.
Will you be requesting a consolidation of existing super accounts into your AMP Flexible Super - Super account?
Please complete the Consolidation section on page A18.
Do you want to make a beneficiary nomination for your AMP Flexible Super - Super account?
Please complete the Beneficiaries section on page A20.
Note: If you do not make a nomination, your benefit will be paid to your estate.
Yes No
Yes No
Yes No
Do you want to apply for personal insurance as part of your AMP Flexible Super - Super account?
What type of insurance do you want?
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
Essential Protection - Complete the Personal Insurance section on page A22.
Flexible Protection - Check the Personal Insurance section on page A22, and complete the Application for Insurance - Flexible Protection from page D1.
Yes
No
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.
153256 1110 NS5272.indd 7
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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.
C. Beneficiary Retirement account
I am using a transfer of a death benefit from an account in the AMP Superannuation Savings Trust.
Name or account number of deceased
B. Retirement account
I have reached my preservation age and have retired from the workforce
I am aged 60 to 64 and have ceased employment
I am aged 65 or older and not retired
I have ceased employment due to permanent incapacity or invalidity (2 medical certificates required).
I retired from the workforce or ceased employment on
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) If 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:
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.
Once you have set up a Retirement account, you can draw a regular income.
Select one payment frequency from the following: Fortnightly Monthly Quarterly Half-yearly Yearly
Nominate the date for your first income payment
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.
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/maximum^ guidelines per income payment frequency selected above)
the maximum^ amount allowed under legislative guidelines
^ Maximum amount applies to Transition to Retirement accounts only.
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
A8 of 28
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Your Retirement account offers three investment levels, with a different Member Fee for each level. Choose one of the options below:
For Core Investments C - complete the Core Investments section below.
For Select Investments S - complete the Select Investments section below.
For Choice Investments Ch - 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 C
Own Mix option: I choose to have my retirement invested across both investment options as indicated by the percentages below:
Investment option 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%
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.
S
Own Mix option: I choose to have my retirement fund invested across the investment 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.
Investment option 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%
Optional:
Fee deduction
(tick one)
Super Easy Balanced RBEI
% %
Super Easy Cash RSC
% %
Super Easy Conservative RCEI
% %
Super Easy Cautious
Super Easy Moderately
Conservative
Super Easy Growth
RCAU
RMCO
RBEG
%
%
%
%
% %
Super Easy High Growth RHG
% %
OR
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.
This facility works by switching units between investment options to re-align 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? Yes No
If “yes”, please select the frequency for auto-rebalancing: Quarterly Half-yearly Yearly
Continued overleaf >
A9 of 28
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Choice Investments Ch
You can invest in a maximum of 15 of the different options available below.
153256 1110 NS5272.indd 10
Arrowstreet Global Equity
Ausbil Australian Active
Equity
Bennelong Australian
Equities
BlackRock Asset Allocation
Alpha
BlackRock Global Bond
BlackRock Scientific Hedged
International Share
BlackRock Scientific
International Share
BT Australian Share
Colonial First State
Australian Share
Fidelity Global Equities
Future Directions Asian
Share
Future Directions
Australian Bond
Future Directions
Australian Share
Future Directions Australian
Small Companies
Future Directions
Balanced
Future Directions
Conservative
Future Directions
Emerging Markets
Own Mix option: I choose to have my retirement invested across the investment 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%
Optional:
Fee deduction and rebates
(tick one)
Aberdeen Emerging
Opportunities
AMP All Growth
RAEO
RADS
%
%
%
%
AMP Australian Bond
AMP Australian Share
RAAB
RAAS
%
%
%
%
AMP Balanced Growth
AMP Capital Asian Equity
Growth
AMP Capital Corporate
Bond
AMP Capital Global
Property Securities
AMP Conservative
AMP Equity
AMP High Growth
AMP Listed Property Trusts
AMP Moderate Growth
AMP Secure Growth (for retirement account only)
Arnhem Australian Equity
RABG
RAAJ
RACO
RCGP
RCON
RAE
RAHG
RLPT
RAMG
RASG
RFAE
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
RAGE
RAAE
RIAS
RBRA
RSIF
RHIS
RAIS
RTAS
RCAS
RFGE
RFAA
RFDA
RFAS
RFDS
RAFD
RFDC
RFDE
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
Continued overleaf >
A10 of 28
9/11/10 4:40 PM

Choice Investments Ch continued
Investment option 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%
Optional:
Fee deduction and rebates
(tick one)
Future Directions
Extended Markets
International Share
Future Directions Geared
Australian Share
Future Directions Growth
Future Directions Hedged
International Share
Future Directions High
Growth
Future Directions
International Bond
Future Directions
International Share
Future Directions
Moderately Conservative
Future Directions Property
GMO International Share
H3 Commodities
K2 Australian Absolute
Return
Lazard Global Thematic
Macquarie Income
Opportunities
Macquarie International
Infrastructure Securities
Perennial Global Listed
Property
Perennial Value Australian
Share
Perennial Value Shares For
Income
Perpetual Industrial Share
Platinum International
RARE Infrastructure Value
Responsible Investment
Leaders Australian Share
Responsible Investment
Leaders Balanced
Responsible Investment
Leaders Conservative
Responsible Investment
Leaders Growth
Responsible Investment
Leaders International Share
Schroder Australian
Equities
Schroder Fixed Income
Schroder Global Active
Value
SG Hiscock Listed Property
Super Easy Australian
Fixed Interest
Super Easy Australian
Share
RFDX
RAFS
RFDG
RFHI
RFDH
RFDI
RRIV
RRLA
RSFB
RRLC
RRLG
RRIS
RPVS
RRSI
RPI
RPTI
RFIS
RFDM
RFDP
RMIS
RGBC
RAEL
RGGO
RMIO
RMII
RPLP
RSAS
RSFI
RGEV
RHLP
RAFI
RASE
% %
Continued overleaf >
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
%
A11 of 28
153256 1110 NS5272.indd 11 9/11/10 4:41 PM

Choice Investments Ch continued
Investment option
Super Easy Balanced
Super Easy Cash
Super Easy Cautious
Super Easy Conservative
Super Easy Growth
Super Easy High
Growth
Super Easy International
Fixed Interest
Super Easy International
Share
Super Easy Moderately
Conservative
Super Easy Property
T. Rowe Price Asia ex-Japan
T. Rowe Price Global
Equity
Templeton Global
Equity
Tyndall Australian Share
Value
UBS Australian Small
Companies
Walter Scott Global
Equity
RTPE
RTIS
RBAE
RASC
RIEG
RHG
RIFI
RISE
RMCO
RSEP
RBEI
RSC
RCAU
RCEI
RBEG
Option
Code
RAEJ
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%
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.
This facility works by switching units between investment options to re-align 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? Yes No
If “yes”, please select the frequency for auto-rebalancing: Quarterly Half-yearly Yearly
153256 1110 NS5272.indd 12
A12 of 28
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Refer to the instructions and Privacy information on the TFN declaration form in the Product Disclosure Statement before quoting your
Tax File Number.
If you are age 60 or over, it is not mandatory to complete the Tax File Number declaration or the Withholding declaration.
Yes No Has a Tax File Number declaration been completed?
If no, please refer to the Tax File Number declaration form from page B1.
The following questions are taken from the Tax File Number declaration form.
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 Tax File Number, 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.
Are you an Australian resident for tax purposes?
Do you want to claim the tax-free threshold from this payer?
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
Yes No
Yes No
If you require additional tax to be withheld, please complete a withholding declaration form, available online from ato.gov.au, and submit it with this form.
Has a Withholding declaration form been completed? Yes No
The following question is taken from the Withholding declaration form.
Are you:
Single, or
Member of an illness-separated couple, or
Member of a couple
153256 1110 NS5272.indd 13
A13 of 28
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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 A18 and may also need to complete the Contributions section on page A15.
My super is consolidated and I am ready to commence an AMP Flexible Super - Retirement account with one rollover/transfer now
Note: If you are transferring from an AMP Flexible Super - Super account it will remain open for future contributions.
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 A18.
Note: Your AMP Flexible Super - Super account will remain open for future contributions.
Type of transfer:
Yes No
Yes No
Full Partial
Enter amount to be transferred from your new AMP Flexible Super - Super account
(if partial transfer only)
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
Type of transfer:
Yes No
Full Partial
Enter amount to be transferred from your new AMP Flexible Super - Super account
(if partial transfer only)
Tell us how much to transfer to the Retirement account, and select one of the 3 options below:
1. I have an existing AMP Flexible Super - Super account and want to consolidate/contribute into this account.
Provide account number
2. I do not have an AMP Flexible Super - Super account.
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
I want to set up a beneficiary nomination for my AMP Flexible Super - Retirement account?
I want to set up a beneficiary nomination for my AMP Flexible Super - Super account?
Please complete Beneficiaries on page A20.
If you don’t make a nomination, your benefit will be paid to your estate.
Yes No
Yes No
A14 of 28
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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.
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
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.
Amount you pay, including contributions if you are self-employed:
Initial or one off Regular or ongoing
Method of payment
Indexed for inflation Yes No
Frequency: Monthly Quarterly Half-yearly Yearly
Direct Debit from your nominated bank account once only* Method of payment
B PAY ^ Direct Debit from your nominated bank account
Cheque # Payment notice sent to you
Please note that we cannot accept a spouse contribution if you do not quote your TFN.
Amount your spouse pays:
Initial or one off Regular or ongoing
Method of payment
Indexed for inflation Yes No
Frequency: Monthly Quarterly Half-yearly Yearly
Direct Debit from your nominated bank account once only* Method of payment
B PAY ^ Direct Debit from your nominated bank account
Cheque # Payment notice sent to you
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.
BSB
Account number Account in the name of
Name of institution (bank/building society/credit union)
Branch location
Preferred deduction day for direct debit - regular contributions ONLY
(eg: for the 15th of the month enter 15th)
Note: declaration for direct debit forms part of the declaration in the Agreement and Declarations section on page A24.
* We will deduct this amount shortly after we receive your application (including if your financial planner sends the forms electronically).
^ We will send you details in your Welcome Letter on how to make your initial investment by B PAY .
# Cheques
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
A15 of 28
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Please refer to the 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)
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.
Yes No
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.
Notice for THIS financial year ($ only) Notice for PREVIOUS financial year ($ only)
Total contributions you are claiming
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?
Yes 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
(less tax, if any)
Are you eligible and wish to claim a tax deduction on the re-contribution nominated above? Yes No
This section needs to only be completed if you made member contributions as a result of requesting a re-contribution on this form and you 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.
Notice for THIS re-contribution only ($ only)
Total contributions you are claiming
Note: To provide additional instructions, please complete the Notes section at the end of this form.
Please complete this section if you are an employee of your own company.
If you’re self-employed, complete the Member Contributions section on page A15.
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 Regular or ongoing
Method of payment
Indexed for inflation Yes No
Frequency: Monthly Quarterly Half-yearly Yearly
Direct Debit from your nominated bank account once only* Method of payment
B
PAY
^ Direct Debit from your employer’s nominated bank account
Cheque Payment notice sent to your employer
*We will deduct this amount shortly after we receive your application (including if your financial planner sends the forms electronically).
^We will send you details in your Welcome Letter on how to make your initial investment by B PAY .
A16 of 28
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BSB Account number
Account in the name of
Account in the name of
Name of institution (bank/building society/credit union)
Branch location
Preferred deduction day for direct debit - regular contributions ONLY
(eg for the 15th of the month enter 15th)
Your employer is usually required to pay super contributions every 3 months. If you wish to have your employer(s) contribute to your AMP
Flexible Super account, please complete the Supporting Employer Details section below.
We will then forward you a completed Choice of Fund 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.
How many employers will be contributing to your account? If you have more than 3 employers, please complete the Employer Choice of Fund form, available from amp.com.au/super/forms.
Employer name (business or trading name)
Employer address
Suburb
Country
Given names of employer contact Surname of employer contact
State Postcode
Title
Employer name
Employer address
Suburb
Country
Given names of employer contact Surname of employer contact
State Postcode
Title
Employer name
Employer address
Suburb
Country
Given names of employer contact Surname of employer contact
State Postcode
Title
A17 of 28
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Would you like AMP to search for any lost super you might have? Yes 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 .
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?
Type of transfer: Transfer or Rollover amount Plan/policy/membership number
Full Partial
If you completed this question, you must complete the Tax Deduction question below.
Type of transfer: Transfer or Rollover amount Plan/policy/membership number
Full Partial
If you completed this question, you must complete the Tax Deduction question below.
Only complete if you requested an internal transfer above.
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 4 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.
Notice for THIS financial year ($ only) Notice for PREVIOUS financial year ($ only)
Total contributions you are claiming
Are you eligible and wish to claim a tax deduction on contributions made into the AMP Super account?
Notice for THIS financial year ($ only)
Yes
Notice for PREVIOUS financial year ($ only)
No
Total contributions you are claiming
A18 of 28
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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.
Alternatively you can complete the Request to transfer whole balance of superannuation benefits between funds form from page C1 and return to us with 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?
Fund name
Product name
Type of transfer: Transfer or Rollover amount
Other fund name
Other product name
Plan/policy/membership number
Full Partial
Fund name
Product name
Type of transfer:
Full Partial
Fund name
Transfer or Rollover amount
Other fund name
Other product name
Plan/policy/membership number
Product name
Type of transfer:
Full Partial
Fund name
Transfer or Rollover amount
Other fund name
Other product name
Plan/policy/membership number
Product name
Transfer or Rollover amount
Other fund name
Other product name
Plan/policy/membership number Type of transfer:
Full Partial
Fund name
Product name
Type of transfer:
Full Partial
Transfer or Rollover amount
Other fund name
Other product name
Plan/policy/membership number
Additional Transfer or Rollover amounts from non-AMP Superannuation
A19 of 28
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Will you be making a death benefit nomination for this account?
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.
Note: Death benefit nominations are not available for members under age 18.
Yes No
A) Binding beneficiary nomination* B) Non-binding beneficiary nomination†
* If 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 2 witnesses sign the witness declaration in Agreement and Declarations on page A24 of this form.
† If 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.
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:
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.
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):
Proportion of total benefit
Legal personal representative/estate
I nominate the following beneficiaries to receive the specified proportion of the benefit payable at my death:
Full name of beneficiary
%
Date of birth Sex Proportion of total benefit
Male Female
Spouse Child Financial dependant Interdependency relationship
%
Relationship to applicant:
Full name of beneficiary
Date of birth* Sex Proportion of total benefit
Male Female
Spouse Child Financial dependant Interdependency relationship
%
Relationship to applicant:
Full name of beneficiary
Date of birth* Sex Proportion of total benefit
Male Female
Spouse Child Financial dependant Interdependency relationship
%
Relationship to applicant:
Full name of beneficiary
Date of birth*
Relationship to applicant:
Sex Proportion of total benefit
Male Female
Spouse Child Financial dependant Interdependency relationship
%
Total
Total benefit must equal 100%
A20 of 28
%
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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.
A) Binding beneficiary nomination* B) Non-binding beneficiary nomination† C) Reversionary beneficiary^
* If 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 2 witnesses sign the witness declaration in the Agreements and Declarations section, of this form on page A26.
† If 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.
^ A reversionary beneficiary will receive the income stream from your retirement account on your death.
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:
your spouse (including a de facto spouse)
your children (including an adopted child, a step child, or ex-nuptial child)
Same as superannuation beneficiaries, OR
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 of your death.
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
Proportion of total benefit
%
I nominate the following beneficiaries to receive the specified proportion of the benefit payable at my death:
Full name of beneficiary
Date of birth* Sex Proportion of total benefit
Male Female
Spouse Child Financial dependant Interdependency relationship
%
Relationship to applicant:
Full name of beneficiary
Date of birth* Sex Proportion of total benefit
Male Female
Spouse Child Financial dependant Interdependency relationship
%
Relationship to applicant:
Full name of beneficiary
Date of birth*
Relationship to applicant:
Full name of beneficiary
Spouse date of birth
Sex Proportion of total benefit
Male Female
Spouse Child Financial dependant Interdependency relationship
%
Date of birth*
Relationship to applicant:
Sex Proportion of total benefit
Male Female
Spouse Child Financial dependant Interdependency relationship
%
Total
Total benefit must equal 100%
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 sex
Male Female
A21 of 28
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Do you want to apply for personal insurance as part of this super account?
What type of insurance do you want to apply for?
Yes No
Essential Protection
You will need to:
EP complete the questions below.
Flexible Protection FP
You will need to:
complete the Application for Flexible Protection Insurance beginning on page D1, then
complete the Personal Statement beginning on page E1.
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
Cover Type
Cover amount (up to $250,000)
Death or Death and Total & Permanent Disablement (TPD)
$
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
Do you have or have you ever had any of the following:
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
Yes No
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 5 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.
Do you work more than 10 hours per week in any occupation other than home duties?
If “Yes”, which of the following best describes your primary occupation? White collar Light manual
Find out more about insurance and see examples of occupation tables in our Fact Sheet: Insurance.
Are you primarily engaged in home duties?
Heavy manual
Yes No
Hazardous
Yes No
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
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.
A22 of 28
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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® - Super
Flexible Lifetime® - Allocated Pension
Flexible Lifetime® - Term Pension
Flexible Lifetime® - Investments (Series 1)
Flexible Lifetime® - Investments (Series 2).
Title Surname
Given names
Date of birth Sex
Male Female
Relationship to you - Please select the relationship you have with them:
Spouse
Grandparent
Son/Daughter-in-law
Parent Sibling (brother/sister) Child
Grandchild Father/Mother-in-law Brother/Sister-in-law
Interdependency relationship (refer to the AMP Flexible Super PDS for definition)
Complete this section if you would like to link or add accounts under Flexible Bonus.
ACCOUNT/PLAN NUMBER
IF APPLICATION IS IN PROGRESS PROVIDE CUSTOMER NAME
YOU
OWNER OF PLAN/ACCOUNT
YOUR FAMILY
MEMBER OR
DEPENDANT
JOINT COMPANY/
PARTNERSHIP/
DECEASED
ESTATE/TRUST/
SUPER FUND
Was any advice provided about the higher insurance offer - Flexible Protection
Complete this section if you have agreed a Member Advice Fee with a financial planner who has an agreement with AMP.
a) A one-off amount paid from my initial investment
Yes No
Super account
OR
Retirement account b) Ongoing Member Advice Fee
(including GST)
(including GST)
Super account
AND/OR
Retirement account
per month (including GST) or
per month (including GST) or
%
pa (including GST) paid monthly
%
pa (including GST) paid monthly
Note:
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.
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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 2 or more continuous years of service with one or more licensees.
Financial company officer with 2 or more continuous years of service with one or more finance companies (for the purposes of the
Statutory Declaration Regulation 1993).
An officer with 2 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 2 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 Justice of the Peace.
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 2 or more years of continuous membership.
A notary public (for the purposes of the Statutory Declaration Regulation 1993).
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 supplements or updates to that PDS.
2. To the best of my knowledge, information and belief, the information provided in this application and in any other documents I provide for the purposes of this application is true and correct.
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. For 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. If 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 NS4631 available from www.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 supplements or updates.
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.
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1 I authorise the transfer of my benefits from my previous superannuation fund(s) (shown on page A18 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.
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 & 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.
Member Advice Fee and Plan Service Fee (see page A23)
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 A23.
Signature of applicant Date
1. If 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. If 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
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
A25 of 28
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For a binding death benefit nomination, the following is to be read and signed by the 2 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 A21 of this form.
3. This form was signed and dated by the applicant in my presence.
1st Witness signature Date
Name of witness
2nd Witness signature Date
Name of witness
153256 1110 NS5272.indd 26
A26 of 28
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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.
NAME PLANNER NUMBER PHONE NUMBER EMAIL
NAME PLANNER NUMBER PHONE NUMBER EMAIL
Customer identification has been verified by (tick at least one box):
Original documentation Certified copies of documentation
Customer identification documentation attached
The customer has received and signed the form summary
The customer has wetsigned.
I have received signatures on the Consolidation and/or Choice of Fund forms and am forwarding them to AMP to action .
I have received signatures on the Consolidation and/or Choice of Fund forms and am forwarding them to the relevant institution .
I want AMP to create the Consolidation and Choice of Fund forms and send them to the customer for signature.
Have you received an authority number from AMP for the Statement of Advice (SoA) associated with this application?
If “Yes”, please provide the authority number.
-
Yes No
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.
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You must provide all information requested on this form.
Providing the wrong information may lead to incorrect amounts of tax being withheld from payments made to you.
■ payer – we are referring to the business or individual making payments under the pay as you go (PAYG) withholding system.
■ payee – we are referring to the individual being paid.
You should complete this form before you start to receive payments from a new payer. For example, when you receive:
■ payments for work and services as an employee, company director or office holder
■ payments under return-to-work schemes
■ payments under labour hire arrangements or other specified payments
■ benefit and compensation payments
■ superannuation benefits.
The information you provide on this form is used to determine the amount of tax to be withheld from payments made to you.
For example, whether you:
■ claim the tax-free threshold
■ are an Australian resident for tax purposes
■ have a Higher Education Loan Program (HELP) debt
■ have a Financial Supplement debt.
Individuals who reach age 60 and commence a superannuation benefit that does not include an untaxed element, do not need to complete this form for that superannuation benefit.
NAT 3092-07.2010
You will find your tax file number (TFN) on:
■ your income tax notice of assessment
■ correspondence sent to you by the ATO
■ a payment summary issued to you by your payer.
If you have a registered tax agent, they may also be able to tell you your TFN.
If you still can’t find your TFN you can:
■ phone 13 28 61 between 8.00am and 6.00pm, Monday to Friday
■ visit your nearest shopfront (phone 13 28 61 to make an appointment).
If you phone or visit us we need to know we are talking to the right person before we can discuss your tax affairs. We will ask for details only you, or someone you have authorised would know. An authorised contact is someone who you have previously told us can act on your behalf.
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.
B1 of 8
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You may need to complete the following forms:
■ Withholding declaration (NAT 3093) if:
– you claim entitlement to the senior Australians tax offset
(question 9) or other tax offsets (question 10) on this form
– you want to advise your payer to adjust the amount withheld from payments made to you
– there is a change to information you previously provided in a
Tax file number declaration (NAT 3092). For example:
- advise your payer that you have become, or ceased to be, an Australian resident for tax purposes
- claim, or discontinue claiming, the tax-free threshold
- advise your payer of, or make changes to, your HELP or
Financial Supplement repayment obligations
- increase the rate or amount to be withheld, claim or vary your entitlement to zone, overseas forces, dependent spouse, special tax offset or senior Australians tax offset
■ Medicare levy variation declaration (NAT 0929) if you qualify for a 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).
This question asks you to quote your TFN. If you need to find your TFN, refer to ’Where can you find your TFN?’ on page 1.
Your payer and the ATO are authorised by the Taxation
Administration Act 1953 to collect your TFN on this form. It is 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 payer with a completed Tax file number declaration (NAT 3092)
■ quote your TFN
■ claim an exemption from quoting your TFN.
Print
X
in the appropriate box if you:
■ have lodged a TFN application or enquiry form for individuals or made a phone or shopfront enquiry to obtain your TFN. You now have 28 days to provide your TFN to your payer who must withhold at the standard rate during this time. After 28 days, if you have not given your TFN to your payer, they will withhold the top rate of tax plus the Medicare levy from future payments
■ are claiming an exemption from quoting a TFN because you are:
– under 18 years of age and do not earn enough to pay tax
– an applicant or recipient of certain pensions, benefits or allowances from:
- Centrelink – however you will need to quote your TFN if you receive Austudy, Newstart, sickness or parenting allowance
- Department of Veterans’ Affairs – a service pension under the Veterans’ Entitlement Act 1986
- the Military Rehabilitation and Compensation Commission.
Your payer must quote your TFN to the superannuation fund to which contributions are being made on your behalf. If your superannuation fund does not have your TFN, we can provide it to them. After this is done:
■ your superannuation fund can accept all types of contributions to your account(s)
■ additional tax will not be imposed on contributions as a result of failing to provide your TFN to your superannuation fund
■ there will be no additional tax to be deducted when you start drawing down your superannuation benefits, other than the tax that may ordinarily apply
■ you can trace different superannuation accounts in your name so that you receive all your superannuation when you retire. 2
Under the Superannuation Industry (Supervision) Act 1993 , your superannuation fund is authorised to collect your TFN, which will only be used for purposes of the superannuation laws. The trustee of your superannuation fund may disclose your TFN to another superannuation provider if your benefits are being transferred.
You may write to the trustee of your superannuation fund and ask them not to disclose your TFN to any other trustee.
For more information about privacy, see ‘Privacy of information’ on page 4.
Check with your payer if you are not sure.
Generally, we consider you to be an Australian resident for tax purposes if you:
■ have always lived in Australia or you have come to Australia and now live here permanently
■ are an overseas student doing a course that takes more than six months to complete
■ have been in Australia continuously for six months or more and for most of that time you worked in the one job and lived in the same place
■ will be or have been in Australia for more than half of the financial year (unless your usual home is overseas and you do not intend to live in Australia).
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.
The criteria we use to determine residency are not the same as used by the Department of Immigration and Citizenship or Centrelink.
A higher rate of tax applies to non-residents’ taxable income and non-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 zone or overseas forces tax offsets – see question 10.
For more information on your entitlement:
■ visit www.ato.gov.au/declarationguide
■ phone 13 28 61 between 8.00am and 6.00pm, Monday to Friday.
Answer ‘NO’ to this question if you are not an Australian resident for tax purposes. You must also answer ‘NO’ at questions 8, 9 and
10 (unless you are a non-resident claiming a senior Australians, zone or overseas forces tax offset).
The tax-free threshold is the amount of income you can earn each year that is not taxed. It is available only to people who are Australian residents for tax purposes (that is, people who answered ‘YES’ at question 7).
You can claim the tax-free threshold from only one payer at a time, generally, from the payer you expect to pay you the most during the income year. To change the payer you are currently claiming the tax-free threshold from, you must complete a
Withholding declaration (NAT 3093) to advise the payer you no longer want to claim it from them. If you are already claiming the tax-free threshold from Centrelink you cannot also claim it from another payer.
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Answer ‘YES’ if you:
■ are an Australian resident for tax purposes
■ are not currently claiming the tax-free threshold from another payer
■ want to claim the tax-free threshold.
If you answer ‘YES’ your payer will reduce your withholding to allow a claim for 50% of the low income tax offset amount where your payment is at the relevant level.
Answer ‘NO’ if you either:
■ answered ‘NO’ to question 7
■ have claimed the tax-free threshold from another payer
■ do not wish to claim the tax-free threshold.
For more information on your entitlement, which payer you should claim it from, or how to vary your withholding rate:
■ visit www.ato.gov.au/declarationguide
■ phone 13 28 61 between 8.00am and 6.00pm, Monday to Friday.
You are not entitled to reduce your withholding amounts, or claim the senior Australians tax offset with more than one payer at the same time.
If you receive income from more than one source and need help with this question, phone 1300 360 221 between 8.00am and
6.00pm, Monday to Friday.
You must meet the eligibility conditions to receive the senior
Australians tax offset. Your rebate income, not your taxable income, determines the amount, if any, of senior Australians tax offset you will receive.
Answer ‘YES’ if you are eligible and choose to receive the senior
Australians tax offset. You can reduce the amount withheld from payments made to you during the year by completing a Withholding declaration (NAT 3093). If your payer does not have copies of the form, see ‘More information, Forms and publications’ on page 4.
Answer ‘NO’ if you are either:
■ not eligible for the senior Australians tax offset
■ eligible but want to claim your entitlement to the tax offset as a lump sum in your end-of-year income tax assessment.
For more information on your eligibility to claim the tax offset or rebate income:
■ visit www.ato.gov.au/declarationguide
■ phone 13 28 61 between 8.00am and 6.00pm, Monday to Friday.
You are not entitled to claim tax offsets from more than one payer at the same time.
You may be eligible for:
■ a zone tax offset if you live or work in certain remote or isolated areas of Australia
■ an overseas forces tax offset if you serve overseas as a member of Australia’s Defence Force or a United Nations armed force
■ a special tax offset for a dependent invalid relative, dependent parent, housekeeper caring for an invalid spouse or a dependent child-housekeeper.
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. You also need to complete a Withholding declaration
(NAT 3093).
Answer ‘NO’ to this question if you are not eligible or choose to receive any of these tax offsets as an end-of-year lump sum through the tax system.
If you are not a resident of Australia 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 on your entitlement:
■ visit www.ato.gov.au/declarationguide
■ phone 13 28 61 between 8.00am and 6.00pm, Monday to Friday.
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.
■ the Australian Government lends you money under
HECS-HELP, FEE-HELP, OS-HELP, VET FEE-HELP
■ you have a debt from the previous Higher Education
Contribution Scheme (HECS).
For information on repaying your HELP debt:
■ visit www.ato.gov.au/declarationguide
■ phone 13 28 61 between 8.00am and 6.00pm, Monday to Friday.
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.
For information on repaying your Financial Supplement debt:
■ visit www.ato.gov.au/declarationguide
■ phone 13 28 61 between 8.00am and 6.00pm, Monday to Friday.
When you have repaid your accumulated HELP or Financial
Supplement debt, you must complete a new Withholding declaration (NAT 3093).
Make sure you have answered all the questions in Section A and signed and dated the declaration. Give your completed declaration to your payer.
Important information for payers. See the reverse side of the PAYER’S copy of the form.
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■ Visit www.ato.gov.au/declarationguide for more information about residency, tax-free threshold, HELP, Financial
Supplement debt or your entitlement to claim tax offsets
■ If you are a permanent migrant or temporary visitor to
Australia apply for a TFN online at www.iar.ato.gov.au
■ Visit www.abr.gov.au
– apply for an Australian business number (ABN) online for sole traders, companies, partnerships, trusts and superannuation funds.
■ Payee – for more information phone 13 28 61 between
8.00am and 6.00pm, Monday to Friday. If you want to vary your rate of withholding phone 1300 360 221 between
8.00am and 6.00pm, Monday to Friday.
■ Payer – for more information phone 13 28 66 between
8.00am and 6.00pm, Monday to Friday.
If you do not speak English well and want to talk to a tax officer, phone the Translating and Interpreting Service on 13 14 50 for help with your call.
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:
■ TTY users, phone 13 36 77 and ask for the ATO number you need (if you are calling from overseas, phone
+61 7 3815 7799 )
■ Speak and Listen (speech-to-speech relay) users, phone
1300 555 727 and ask for the ATO number you need
(if you are calling from overseas, phone +61 7 3815 8000 )
■ internet relay users, connect to the NRS on www.relayservice.com.au
and ask for the ATO number you need.
If you would like further information about the
National Relay Service, phone 1800 555 660 or email helpdesk@relayservice.com.au
If you phone we need to know we are talking to the right person before we can discuss your tax affairs. We will ask for details only you, or someone you have authorised, would know. An authorised contact is someone who you have previously told us can act on your behalf.
You can get the following forms and publications from ATO shopfronts or our website at www.ato.gov.au/onlineordering or by phoning 1300 720 092 (some products are also available from most newsagents):
■ Withholding declaration (NAT 3093)
■ Medicare levy variation declaration (NAT 0929)
■ Withholding declaration – upwards variation (NAT 5367)
■ Repaying your HELP debt (NAT 3913)
■ Tax file number – application or enquiry for individuals
(NAT 1432)
■ Tax file number – application or enquiry for individuals living outside Australia (NAT 2628)
■ Tax file number – application or enquiry for Aboriginals or
Torres Strait Islanders (NAT 1589).
We are committed to providing you with guidance you can rely on, so we make every effort to ensure that our publications are correct.
If you follow our guidance in this publication and it turns out to be incorrect, or it is misleading and you make a mistake as a 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 a penalty. Also, if you acted reasonably and in good faith we will not charge you interest.
If you make an honest mistake in trying to follow our guidance 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.
If you feel that this publication does not fully cover your circumstances, or you are unsure how it applies to you, you can seek further assistance from us.
We regularly revise our publications to take account of any changes to the law, so make sure that you have the latest information. If you are unsure, you can check for a more recent version on our website at www.ato.gov.au
or contact us.
This publication was current at July 2010 .
We are authorised by tax laws, including the Income Tax
Assessment Act 1936 , to ask for information on this declaration.
We need this 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 Centrelink, Australian Federal Police, Child Support Agency,
Departments of Families, Housing, Community Services and
Indigenous Affairs, Veterans’ Affairs, and Education, Employment and Workplace Relations.
Only certain people and organisations can ask for your TFN.
These include employers, some Australian Government agencies, including Child Support Agency, trustees for superannuation funds, payers under the PAYG system, higher education 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 TFN reduces the risk of administrative errors and having extra tax withheld.
If you need more information about how the tax laws protect your personal information, or have any concerns about how the ATO has handled your personal information, phone 13 28 61 between
8.00am and 6.00pm, Monday to Friday.
© COMMONWEALTH OF AUSTRALIA 2010
This work is copyright. Apart from any use as permitted under the Copyright Act 1968 , no part may be reproduced by any process without prior written permission from the
Commonwealth. Requests and inquiries concerning reproduction and rights should be addressed to the Commonwealth Copyright Administration, Attorney General’s Department,
3–5 National Circuit, Barton ACT 2600 or posted at http://www.ag.gov.au/cca
PUBLISHED BY
Australian Taxation Office
Canberra
July 2010
JS 15580
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This declaration is NOT an application for a tax file number.
■
■
■
Use a black or blue pen and print clearly in BLOCK LETTERS.
Print X in the appropriate boxes.
Read all the Instructions before you complete this declaration.
www.ato.gov.au
1 What is your tax fi le number (TFN)?
30920710
6 On what basis are you paid?
(Select only one.)
Full-time employment
Part-time employment
Labour hire
Superannuation income stream
Casual employment
See
Privacy of information on page 4 of the
Instructions.
OR I have made a separate application/enquiry to the ATO 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.
7 Are you an Australian resident for tax purposes?
Yes No
You must answer No at question 8.
8 Do you want to claim the tax-free threshold from this payer?
OR I am claiming an exemption because I am in receipt of a pension, benefit or allowance.
2 What is your name?
Surname or family name
Title: Mr Mrs Miss Ms
Only claim the tax-free threshold from one payer.
If you have more than one source of income and currently claim the tax-free threshold from another payer, do not claim it now.
Yes No
Answer No at questions 9 and 10 unless you are a non-resident claiming a senior Australians, zone or overseas forces tax offset.
First given name
Other given names
3 If you have changed your name since you last dealt with the ATO, show your previous family name
9 Do you want to claim the senior Australians tax offset by reducing the amount withheld from payments made to you?
Yes
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 3 of the Instructions.
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?
Yes Complete a Withholding declaration (NAT 3093).
No
4 What is your date of birth?
5 What is your home address in Australia?
Suburb or town
State/territory Postcode
Day Month Year
11 (a) Do you have an accumulated Higher Education Loan
Program (HELP) debt?
Yes
Your payer will withhold additional amounts to cover any compulsory repayments.
(b) Do you have an accumulated Financial Supplement debt?
Yes
Your payer will withhold additional amounts to cover any compulsory repayments.
No
No
DECLARATION by payee: I declare that the information I have given is true and correct.
Signature
Date
Day Month Year
You MUST SIGN here
There are penalties for deliberately making a false or misleading statement.
Once Section A is completed and signed, give it to your payer.
1 What is your Australian business number (ABN) or your withholding payer number?
Branch number
(if applicable)
4 What is your business address?
8 4 0 7 9 3 0 0 3 7 9
2 If you don’t have an ABN or withholding payer number, have you applied for one?
Yes No
See ‘More information’ on page 4 of the Instructions.
Suburb or town
State/territory Postcode
3 What is your registered business name or trading name
(or your individual name if not in business)?
A M P L I F E L I M I T E D
5 Who is your contact person?
DECLARATION by payer: I declare that the information I have given is true and correct.
Signature of payer
Date
Day Month Year
There are penalties for deliberately making a false or misleading statement.
NAT 3092-07.2010 [JS 15580]
Business phone number
6 If you no longer make payments to this payee, print X in this box
Return the completed original ATO copy to:
For WA, SA, NT, VIC or TAS For NSW, QLD or ACT
Australian Taxation Office
PO Box 795
Australian Taxation Office
PO Box 9004
ALBURY NSW 2640 PENRITH NSW 2740
IMPORTANT
See reverse side of
PAYER’s copy for:
■
■ payer obligations lodging online.
TAXPAYER-IN-CONFIDENCE (when completed)
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This declaration is NOT an application for a tax file number.
■
■
■
Use a black or blue pen and print clearly in BLOCK LETTERS.
Print X in the appropriate boxes.
Read all the Instructions before you complete this declaration.
www.ato.gov.au
1 What is your tax fi le number (TFN)?
6 On what basis are you paid?
(Select only one.)
Full-time employment
Part-time employment
Labour hire
Superannuation income stream
See Privacy of information on page 4 of the
Instructions.
OR I have made a separate application/enquiry to the ATO 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.
7 Are you an Australian resident for tax purposes?
Yes No
8 Do you want to claim the tax-free threshold from this payer?
OR I am claiming an exemption because I am in receipt of a pension, benefit or allowance.
Casual employment
You must answer No at question 8.
2 What is your name?
Surname or family name
Title: Mr Mrs Miss Ms
Yes
Only claim the tax-free threshold from one payer.
If you have more than one source of income and currently claim the tax-free threshold from another payer, do not claim it now.
No
Answer No at questions 9 and 10 unless you are a non-resident claiming a senior Australians, zone or overseas forces tax offset.
First given name
Other given names
3 If you have changed your name since you last dealt with the ATO, show your previous family name
9 Do you want to claim the senior Australians tax offset by reducing the amount withheld from payments made to you?
Yes
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 3 of the Instructions.
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?
Yes Complete a Withholding declaration (NAT 3093).
No
4 What is your date of birth?
5 What is your home address in Australia?
Suburb or town
State/territory Postcode
Day Month Year
11 (a) Do you have an accumulated Higher Education Loan
Program (HELP) debt?
Yes
Your payer will withhold additional amounts to cover any compulsory repayments.
(b) Do you have an accumulated Financial Supplement debt?
Yes
Your payer will withhold additional amounts to cover any compulsory repayments.
No
No
DECLARATION by payee: I declare that the information I have given is true and correct.
Signature
Date
Day Month Year
You MUST SIGN here
There are penalties for deliberately making a false or misleading statement.
Once Section A is completed and signed, give it to your payer.
1 What is your Australian business number (ABN) or your withholding payer number?
Branch number
(if applicable)
4 What is your business address?
2 If you don’t have an ABN or withholding payer number, have you applied for one?
Yes No
See ‘More information’ on page 4 of the Instructions.
3 What is your registered business name or trading name
(or your individual name if not in business)?
Suburb or town
State/territory Postcode
5 Who is your contact person?
DECLARATION by payer: I declare that the information I have given is true and correct.
Signature of payer
Date
Day Month Year
There are penalties for deliberately making a false or misleading statement.
NAT 3092-07.2010 [JS 15580]
Business phone number
6 If you no longer make payments to this payee, print X in this box
Return the completed original ATO copy to:
For WA, SA, NT, VIC or TAS
Australian Taxation Office
For NSW, QLD or ACT
Australian Taxation Office
PO Box 795
ALBURY NSW 2640
PO Box 9004
PENRITH NSW 2740
IMPORTANT
See reverse side of
PAYER’s copy for:
■
■ payer obligations lodging online.
TAXPAYER-IN-CONFIDENCE (when completed)
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The following information will help you comply with your pay as you go (PAYG) withholding obligations.
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 prospective employee has a valid visa to work in Australia before you employ them. For more information and to check a visa holder’s status online, visit the Department of Immigration and Citizenship website at www.immi.gov.au
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 published by the ATO. If the payee gives you another declaration, it overrides any previous declarations.
Where the payee indicates at question 1 on this form that they have applied for an individual TFN, or enquired about their existing TFN, they have 28 days to give you their TFN. You must withhold tax for 28 days at the standard rate according to the PAYG withholding tax tables.
After 28 days, if the payee has not given you their TFN, you must then withhold the top rate of tax plus the Medicare levy from future payments, unless we tell you not to.
■ notify the ATO within 14 days of the start of the withholding obligation by completing as much of the payee section of the form as you can.
Print ‘PAYER’ in the payee declaration and lodge the form – see ‘Lodging the form’.
■ 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 any payment to that payee.
You need to lodge TFN declarations with the ATO within 14 days after the form is either signed by the payee or completed by you (if not provided by the payee). You need to retain the payer’s copy for your records. For information on storage and disposal see below.
You may lodge the information:
■ online – lodge your TFN declaration reports using software that complies with ATO specifications. There is no need to complete section B of each form as the payer information is supplied by your software.
■ by paper – complete Section B and send the original to the ATO within 14 days.
For more information about lodging your TFN declaration report online, visit www.ato.gov.au/lodgetfndeclaration
If you make a superannuation contribution for your payee, you need to give your payee’s TFN to their superannuation fund on the day of contribution, or if the payee has not yet quoted their TFN, within 14 days of receiving this form from your payee.
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:
■ submits a new TFN declaration (NAT 3092), you must retain a copy of the earlier form for the current and following financial year.
■ leaves your employment, you must retain a copy of the last completed form for the current and following financial year.
You may incur a penalty if you do not:
■ lodge TFN declarations with us
■ keep the payer copy of completed TFN declarations for your records
■ provide the payee’s TFN to their superannuation fund where the payee quoted their TFN to you.
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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 Consolidation form and return it to you to sign. Alternatively, you can complete this form now.
If you decide to complete the Consolidation form now, your next steps are explained below. We have also provided you with a check list 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.
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 Tax File Number please refer to the Product Disclosure Statement (PDS).
Have you organised certified copies of identification for each non-AMP external rollover (if applicable)?
Have you signed the Consolidation 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.
AMP Superannuation Limited has a Registrable Superannuation Entity Licence. The RSE Licence number is L0000550.
AMP Superannuation Limited registered the AMP Superannuation Savings Trust (“SST”) with the Australian Prudential Regulation
Authority (APRA). The registration number for the SST is R1001648 and the ABN is 76 514 770 399.
The AMP SST 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 SST is a complying superannuation fund under Part 3-30 of the Income Tax
Assessment Act 1997.
For and on behalf of AMP Superannuation Limited.
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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 Standard Choice Form must be used by you to change funds.
Read the below.
Check that the fund you are transferring your benefits TO can accept this transfer.
Refer to these instructions where a question shows a message like this:
Print clearly in BLOCK LETTERS.
Sign the authorisation.
Attach the appropriately certified proof of identity documents.
Review the checklist below.
Send the request form to your fund.
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.
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?
Have you attached the certified documentation including any linking documents if applicable?
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.
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.
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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.
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.
You may use this form to transfer your benefits to your own self managed superannuation fund (SMSF).
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.
You will need to provide documentation with this transfer request to prove you are the person to whom the superannuation entitlements belong.
The following documents may be used.
One of the following documents only: driver’s licence issued under State or Territory law passport.
One of the following documents: birth certificate or birth extract citizenship certificate issued by the
Commonwealth pension card issued by
Centrelink that entitles the person to financial benefits.
AND
One of the following documents: letter from Centrelink regarding a Government assistance payment notice issued by
Commonwealth, State or Territory Government or local council within the past 12 months that contains your name and residential address. For example:
Tax Office Notice of
Assessment
Rates notice from local council.
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
Change of name
SUITABLE LINKING DOCUMENTS
Marriage certificate, deed poll or change of name certificate from the Births, Deaths and Marriages Registration Office.
Guardianship papers or Power of Attorney.
Signed on behalf of the applicant
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.
You can send your completed and signed form with your certified proof of identity documents to either fund.
For more information about superannuation, visit the:
Australian Securities and Investments Commission website at www.fido.asic.gov.au
, or
Australian Taxation Office website at www.ato.gov.au/super
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Under the Superannuation Industry (Supervision) Act 1993
Read the important information pages
Refer to instructions where indicated with a
This form is only for whole (not part) balance transfers.
Sign the authorisation
Send form and certified proof of identity documents to either your FROM or TO fund.
Residential address
Title: Mr Mrs Miss Ms Other
*Address
*Family name
*Given names
*Suburb
Other/previous names
*Date of birth
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.
See “What happens if I do not quote my Tax File Number?”
*State/Territory
Previous address
Postcode
If you know that the address held by your fund is different to your current residential address, please give details below.
*Address
*Gender Male Female
*Contact phone number
FROM
*Fund name
*Suburb
*State/Territory Postcode
Fund phone number
Membership or account number
Australian business number (ABN)
Superannuation
Product Identification
Number (SPIN)
If you have multiple account numbers with this fund, you must complete a separate form for each account you wish to transfer.
TO
*Fund name
AMP Superannuation Savings Trust
*Fund phone number
*Membership or account number
Australian business number (ABN)
Superannuation
Product Identification
Number (SPIN)
PO Box 300, PARRAMATTA NSW 2124
131 267
76 514 770 399
AMP1248AU
You must check with your TO fund to ensure they can accept this transfer.
>
l 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 Pension Card, AND
Centrelink payment letter or Government or local council notice (<1 year old) with name and address.
>
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.
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.
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.
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.
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.
*Name (Print in BLOCK LETTERS)
*Signature
*Date
*Denotes mandatory field. If you do not complete all of the mandatory fields, there may be a delay in processing your request.
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IN CONFIDENCE - When completed
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This page has been left blank intentionally.
153256 1110 NS5272.indd 6
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9/11/10 4:41 PM

Please staple all relevant material together
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 any additional supplements) for AMP Flexible Super.
Member number
Family name Title
Given names
ate of birth Sex
Male Female
Note: This form cannot be used to change address details. Please use a change of address form if you wish to change address.
Address
Unit No.
Street No.
Street name
Suburb
Country
State Postcode
Home phone Fax number Mobile phone number
Email address
Note: Members with existing AMP Flexible Super or AMP Flexible Super Employer Insurance (Death cover or Death cover and Total & 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?
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.
Yes No
Issued by AMP Superannuation Limited ABN 31 008 414 104, AFSL No. 233060, RSE Licence No. L0000550, the trustee of the AMP Superannuation Savings Trust, ABN 76 514 770 399, RSE Registration No. R1001648.
Registered trade mark of AMP Life Limited ABN 84 079 300 379.
D1 of 4
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NS5272D (11/10)
9/11/10 4:41 PM

Name of insurer:
Is this cover to be cancelled*?
Yes No
LIFE COVER ($) TPD COVER ($)
Cover amount
Amount to cancel
If “Yes”, please give policy number:
TRAUMA COVER ($) MONTHLY DISABILITY
(INCOME) COVER ($)
DISABILITY TYPE
TSC
1
IP
2
BOI
3
Name of insurer:
Is this cover to be cancelled*?
Yes No
LIFE COVER ($) TPD COVER ($)
Cover amount
Amount to cancel
If “Yes”, please give policy number:
TRAUMA COVER ($) MONTHLY DISABILITY
(INCOME) COVER ($)
DISABILITY TYPE
TSC 1
IP
2
BOI
3
Name of insurer:
Is this cover to be cancelled*?
Yes No
LIFE COVER ($) TPD COVER ($)
If “Yes”, please give policy number:
TRAUMA COVER ($) MONTHLY DISABILITY
(INCOME) COVER ($)
DISABILITY TYPE
Cover amount
Amount to cancel
TSC 1
IP
2
BOI
3
1. Temporary Salary Continuance Cover.
2. Income Protection cover.
3. Business Overheads Insurance cover.
* 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.
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)
$ , ,
Yes No
$ , ,
Indexed for inflation?
Total & Permanent
Disablement (TPD) Benefit
Indexed for inflation?
TPD Benefit occupation category
Waiver Benefit
Business Safeguard Benefit
Temporary Salary Continuance
(TSC) Benefit
Yes No
A B
Yes No
Yes No
Yes No
C
Please complete the Temporary Salary Continuance
Benefit Section
D2 of 4
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Do you want to select the
Superannuation Contribution
Option?
Yes No
Income pre-tax pa $ , ,
Total maximum monthly benefit
(including Superannuation
Contribution Option amount)
$ ,
Indexed for inflation?
Benefit Period
Yes No
2 years
Waiting Period
4 weeks
TSC Benefit occupation category
4A
to age 65
8 weeks
3A 2A
13 weeks
A
26 weeks
4B 3B
104 weeks
2B 1B
Are you eligible for a transfer of insurance benefits from another AMP plan?
If so, are you applying for an increase in cover or adding any new benefits?
To find out if you are eligible to transfer your insurance benefits, call us on 131 267 .
Yes No
Yes No
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
Please complete the Personal Statement and attach it to this application.
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 supplements 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.
2. To 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.
3. By completing and signing this application form and I have completed a Personal Statement, I:
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.
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.
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.
4. If 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.
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5. I understand that I cannot receive a Terminal Illness Benefit or Total & 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.
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.
Signature of member
Yes
Yes
No
No
Date
Note: If splitting fees this applies to initial risk commission only.
NAME PLANNER NUMBER PHONE NUMBER EMAIL SPLIT % SERVICING PLANNER
Please indicate the insurance commission type and level to apply to insurance benefits. The commission amounts shown are inclusive of GST.
UPFRONT* HYBRID*
112.8% Initial, 11% pa Ongoing
90.2% Initial, 11% pa Ongoing
67.7% Initial, 11% pa Ongoing
45.1% Initial, 11% pa Ongoing
22.6% Initial, 11% pa Ongoing
0% Initial, 11% pa Ongoing
0% Initial, 0% pa Ongoing
Other
55% Initial, 16.5% pa Ongoing
44% Initial, 16.5% pa Ongoing
33% Initial, 16.5% pa Ongoing
22% Initial, 16.5% pa Ongoing
11% Initial, 16.5% pa Ongoing
0% Initial, 16.5% pa Ongoing
*All applications submitted using easywrite will result in a higher initial commission.
LEVEL
22% Level Commission
17.6% Level Commission
13.2% Level Commission
8.8% Level Commission
4.4% Level Commission
AMP will arrange medicals on your behalf. If you prefer to arrange medicals yourself, please tick the box
NOTES:
D4 of 4
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Please staple all relevant material together
Mark boxes with (
✘
) where appropriate, otherwise use block letters.
Leave a box between words.
Title Surname
Given names
Date of birth Sex
Male Female
May we phone or email you if we need to clarify any details contained in this statement?
If “Yes”, please provide preferred contact details:
Phone number
Preferred contact time Preferred contact day
am/pm Any
Mon Tue Wed Thur Fri Any
Email address
No Yes
IMPORTANT NOTE
This Personal Statement must be complete and correct because it will be the basis on which AMP Life Limited (ABN 84 079 300 379) may agree to insure you. You must therefore read and understand your DUTY OF DISCLOSURE explained below.
If you are unsure of anything in the statement, please ask your Financial Planner or AMP to explain it.
If you require more room to provide your answers than has been allocated on this form, please provide a separate signed and dated page(s) and attach this page(s) to your application.
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.
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.
153256 1110 NS5272.indd 1
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NS5272E (11/10)
9/11/10 4:41 PM

a) Are you an Australian or New Zealand citizen, or do you have an Australian permanent residency visa?
If “No”: i) What is your country of birth? ii) How long have you lived in Australia? years months iii) What type of visa do you hold? iv) Have you applied for an Australian permanent residency visa?
a) Do you have any definite plans to travel or reside overseas, other than New Zealand in the next 12 months?
If “Yes”: i) What countries will you travel to?
ii) What is the purpose of travel?
iii) When is the planned departure and duration?
No Yes
No Yes
No Yes
Do you currently participate, or intend to participate, in any hazardous activity, competitive sport, aviation or flying activity other than as a regular fare paying passenger?
If ”Yes”, please complete one of the supplementary questionnaires on page E14.
a) Name and address of your usual doctor (if you do not have a usual doctor, then the last doctor that you saw)
NAME ADDRESS PHONE NUMBER
No Yes
If you have known your doctor for less than 2 years, please provide details of the previous doctor.
NAME ADDRESS PHONE NUMBER b) Date of last consultation with any doctor d) Please advise reason for your last consultation c) Name of doctor that you saw (if same as above, write “As above”) e) Please advise results/outcome of your last consultation f) Were you referred for further tests, investigations or referred to a specialist?
If “Yes”, please provide full details
No Yes
Have you ever made a claim or received benefits in regard to any illness, injury, or condition?
If “Yes”, please provide full details:
E2 of 16
153256 1110 NS5272.indd 2
No Yes
9/11/10 4:41 PM

a) Have you smoked tobacco or any other substance or used nicotine replacement products in the last 12 months?
If “Yes”, please advise the type of substance : quantity per: b) Do you consume alcohol?
If “Yes”, please advise number of standard drinks* per:
day week month
day week month
No Yes
No Yes c) Have you ever used illegal or illicit drugs?
If “Yes”, please advise details including type, frequency and date(s) of usage : d) Have you ever received treatment or been recommended for treatment by a doctor or other medical facility for the use of drugs or alcohol?
No Yes
No Yes
If “Yes”, please advise details including date(s) of treatment:
*A standard drink = 1 nip spirits, 1 wine glass of wine, sherry glass port/sherry, 10oz/285ml glass of beer
Height Weight
cm or ft ins kg or st lbs
If you answer “Yes” to any of the bold conditions, complete the relevant Medical Questionnaire on pages E8 to E13.
If you answer “Yes” to conditions which are not bold, provide details in the Additional Information table on the following page.
Have you ever had symptoms of, been told you had, or received advice from any health professionals including but not limited to doctors, specialists, counsellors or chiropractors for any of the following: a) High blood pressure, chest pain, high cholesterol, stroke or any heart or vascular disorder?
No Yes b) Asthma, bronchitis or any other lung disorder?
c) Epilepsy , seizure disorder, multiple sclerosis, paralysis, migraine, dizziness, neuritis or any other neurological disorder? d) Kidney stones , nephritis, passing blood in the urine or any other kidney or bladder disorder? e) Hepatitis, cirrhosis or any liver or gall bladder disorder? f) Diabetes , sugar in urine, thyroid or pancreatic disorder? g) Indigestion, reflux, ulcer or hernia ?
No
No
No
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes h) Colitis, passing blood from the bowel or any other bowel disorder? i) Anaemia, leukaemia, haemophilia, received a blood transfusion or any other blood disorder? j) Cancer, tumour, lump, cyst or skin lesion of any kind? k) Back or neck pain, sciatica, whiplash or any other spinal disorder?
l) Repetitive strain injury , chronic fatigue syndrome, fibromyalgia, or muscle strain? m) Arthritis, gout or any disorder of the joints?
n) Bipolar, manic or major depressive illness, schizophrenia or any other psychotic disorder?
o) Any other mental health condition , including but not limited to depression, anxiety, stress or personality disorder?
p) Psoriasis, eczema, dermatitis or any other skin condition?
q) Sleep apnoea or any other sleep disorder? r) Any impairment of sight not corrected by glasses or contact lenses? s) Any ear disorder such as hearing loss or tinnitus? t) Have you ever had an occupational needle stick injury?
No
No
No
No
No
No
No
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
No Yes
No Yes
No Yes
E3 of 16
153256 1110 NS5272.indd 3 9/11/10 4:41 PM

u) i) Have you, or do you intend to participate in any activity that increases your chances of contracting the HIV virus?
This would include things such as working or engaging in sexual intercourse with a prostitute or intravenous drug user or someone you suspect or know to be HIV positive, or engaging in anal sexual intercourse.
If you have answered “Yes” to this question, AMP will contact you for further information.
ii) Are you suffering from AIDS, or infected with HIV, or are you carrying antibodies to the HIV virus?
If you have answered “Yes” to this question, AMP will contact you for further information.
v) Have you had any other disorder or impairment, taken any medication or undergone any medical tests, including genetic tests not mentioned above?
w) Do you intend to seek any medical advice, undergo any tests, including genetic tests or investigations in the future?
Males only x) Any prostate disorder or abnormality?
Females only y) Have you had an abnormal pap smear or any gynaecological condition? z) i) Have you ever had a breast ultrasound or mammogram? ii) Have you ever had a breast lump (even if you have not seen a doctor about it?) iii) Are you currently pregnant?
If “Yes”, expected date of delivery?
iv) Have you ever had a complication with a past or current pregnancy?
QUESTION
LETTER
CONDITION/
TEST/
REASON
DATE FIRST
STARTED
DATE
OF LAST
SYMPTOMS
HAVE YOU
COMPLETELY
RECOVERED?
FULL DETAILS
OF TREATMENT
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
No Yes
FULL NAME AND
ADDRESS OF DOCTOR
OR HOSPITAL
/ / / / Yes/No
/ / / / Yes/No
/ /
/ /
/ /
/ /
/ /
/ /
Yes/No
Yes/No
Yes/No
/ /
/ /
/ /
/ /
/ /
/ /
/ /
/ /
Yes/No
Yes/No
Yes/No
Yes/No
/ / / / Yes/No
If you need more room to provide your answers, please provide a separate signed and dated page(s) and attach to your application.
E4 of 16
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Has any first degree blood related family member (father, mother, brother, sister) had diabetes, stroke, a heart condition, familial polyposis, breast, ovarian, colon or bowel cancer, polycystic kidney disease, Huntington’s chorea, motor neurone disease or muscular dystrophy?
If “Yes”, please complete the table below:
FAMILY MEMBER/
RELATIONSHIP TO YOU
LIST ALL CONDITIONS AND CAUSE OF DEATH IF APPLICABLE
(IF CANCER, PLEASE GIVE TYPE AND SITE)
No
AGE AT ONSET
Yes
a) What is your current occupation? b) How many hours per week do you work in your main occupation? hours c) How many weeks per year do you work in your main occupation? weeks d) Do you have any other occupation? No Yes
If “Yes”, please provide details (including type of occupation, duties, number of hours worked per week and the income earned in the last 12 months): e) Do you have any definite plans to change your occupation?
If “Yes”, please provide details:
No Yes f) Have you or any business that you have, or have had, ownership of, ever been made bankrupt, been liquidated or been placed under administration?
If “Yes”, please provide details including when and date of discharge if applicable:
No Yes g) What is your current annual income? (income earned through personal exertion, less any expenses incurred whilst earning that income)?
To be completed only if applying for Total and Permanent Disablement Benefit or Temporary Salary Continuance Benefit.
a) Name of your business or employer b) Address of your business or employer c) Do you hold any professional/trade qualifications?
If “Yes”, give details:
Type d) What are the main duties of your occupation?
DUTIES (EG OFFICE WORK, SALES,
SUPERVISION, MANUAL WORK,
EXPLOSIVES HANDLING)
% OF TIME
%
%
%
%
100%
E5 of 16
Institution
LOCATION (EG OFFICE, ON-SITE, DRIVING,
UNDERGROUND, OFFSHORE, UNDERWATER,
AT HEIGHTS OR AT HOME)
153256 1110 NS5272.indd 5
No Yes
% OF TIME
%
100%
%
%
%
9/11/10 4:41 PM

To be completed if applying for Temporary Salary Continuance Benefit.
e) Has your main occupation and/or employment status changed in the last 3 years?
If “Yes”, please provide details of your previous occupation, duties and dates of change:
OCCUPATION EMPLOYMENT STATUS DATE FROM
/ /
/ /
/ / f) Do you have any definite plans to take extended leave (eg parental or study leave) in the near future?
If “Yes”, please provide full details including type and length of leave and your intentions on returning to work:
No Yes
DATE TO
/ /
/ /
/ /
No Yes g) Do you have definite plans to change your working arrangements to part-time, casual or self-employed?
If “Yes”, please provide full details including current and future employment status:
No Yes h) Are you self-employed (including sole trader, in a partnership or employee of your own company or trust)?
If “Yes”, please complete the questions for SELF-EMPLOYED (i to m)
If “No”, please complete the questions for EMPLOYEE (n to p)
SELF-EMPLOYED - SOLE TRADER, PARTNERSHIP, EMPLOYEE OF OWN COMPANY OR TRUST
years i) How long have you been self-employed? j) Please select which of the following applies:
sole trader in a partnership employee of your own company or trust k) What is the percentage of the business that you own and how many employees do you have? % l) Would any of your income continue if you were unable to work?
If “Yes”, please provide for how long, and the source (eg salary, investment income, company profits):
No Yes
months
employees
No Yes m) Please indicate your share of the business income/expenses, etc for the last 2 financial years for which tax returns, assessment notices and accounts are available.
TAX YEAR ENDING
A
GROSS INCOME
B
EXPENSES
INCURRED
NET PROFIT OR LOSS
BEFORE TAX
A-B=C
ANY SALARY, WAGES,
DIRECTOR’S FEES,
SUPERANNUATION
D
YOUR TOTAL
INCOME
C+D=E
30/06/
30/06/
$
$
$
$
$
$
$
$
$
$
EMPLOYEE - WITH NO OWNERSHIP INTEREST IN YOUR EMPLOYER’S BUSINESS: n) What is your base annual salary from your main occupation
(including salary packaged items, but excluding compulsory government superannuation contributions)?
CURRENT FINANCIAL YEAR
$ o) Do you receive any:
Commission, bonuses or regular overtime
CURRENT FINANCIAL YEAR
PREVIOUS FINANCIAL YEAR
30/06/20
$
Commission
Bonuses
Regular overtime
$
$
$
No Yes
PREVIOUS FINANCIAL YEAR
30/06/20
$
$
$ p) Would any of your income continue if you were unable to work?
If “Yes”, please provide for how long, and the source (eg salary, investment income, company profits):
No Yes
E6 of 16
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I, the insured person, agree and declare that: a) I have read my duty of disclosure. I have kept my duty of disclosure in mind when completing my Personal Statement, and I understand any plan issued by AMP will be based on information I give in my Personal Statement, any additional questionnaire(s), form(s) and statement(s), as well as telephone underwriting (if applicable).
b) I understand I must tell AMP of any change in my health, occupation or pastimes and of any other thing that happens to me which may in any way affect the risk of insuring me, where this change occurs after I have completed this Personal Statement right up to the time that AMP issues the plan.
c) All the information provided in my Personal Statement is complete and correct. If any information has been written by someone else, I have reviewed this information and confirm it is complete and correct. I understand that if I do not comply with my duty to disclose all information completely and accurately, the insurance might be cancelled or the terms may be altered by AMP.
d) I authorise any doctor, hospital or other health service provider that I have or may attend to release details of my personal and family medical history, including referrals to or treatment by other practitioners, to AMP. The purpose is to allow AMP to assess my application for new/additional/reinstated insurance (as applicable) and assess any claim that might arise. I understand that, under Government
Privacy legislation, I may access a copy of these reports from 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.
e) I have read the Privacy Information on page E16 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.
f) I have read the HIV Antibodies Test Information on page E16 and I agree that if an HIV test is required to assess my application for insurance, that I consent to such a test being performed and that I will provide advice at the time of blood collection as to whom I wish to be notified in the event of a positive HIV antibody result.
IMPORTANT: This agreement and declaration must be signed after you have read your duty of disclosure and privacy information and completed your Personal Statement. Only sign this agreement and declaration if you agree to make the declaration.
My signature to this declaration confirms my agreement to all of the above Date
Insured person
Signature of my parent/guardian if I am under age 16 Date
Parent/guardian if applicable
If this application has been discussed with an Underwriter prior to submission, provide the following:
Underwriter’s name Date
Discussion details
Paramedical Exam
Resting ECG
Blood Test
Stress ECG
Pre-arranged medical tests
Other (please specify)
Doctor Medical Exam
Specialist Medical Exam
Express check
E7 of 16
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If you need more room to provide your answers, please provide a separate signed and dated page(s) and attach to your application.
a) When was high blood pressure first diagnosed?
b) What was your blood pressure reading at that time?
c) What was your blood pressure when last tested?
DATE BLOOD PRESSURE READING HAVE TREATMENTS CHANGED SINCE THIS RESULT?
d) Have you taken medication to control your blood pressure?
If “Yes” please provide details of medication, ie type, dose and when taken.
e) Are you currently on the same medication as detailed above?
If “No” please provide details of current treatment.
f) Have you had any medical investigations relating to your high blood pressure?
If “Yes” please provide details.
g) Do you have any complications as a result of your blood pressure?
If “Yes” please provide details.
No Yes
No Yes
No Yes
No Yes h) Does your usual doctor have details of your blood pressure and treatment?
If “No” please provide the name and address of the doctor who has records of your investigations and treatment.
NAME MEDICAL PROVIDER ADDRESS
No Yes
a) When were you first diagnosed with high cholesterol?
b) What was your cholesterol level at this time?
c) What was your cholesterol level when last tested?
DATE CHOLESTEROL READING
/ /
/ / d) Have you ever taken medication to reduce your cholesterol?
If “Yes” please provide details of medication, ie type, dose and when taken
HAVE TREATMENTS CHANGED SINCE THIS RESULT?
No Yes
No Yes e) Are you currently on the same medication as detailed above?
If “No” please provide details of current treatment f) Does your usual doctor have details of your cholesterol results and treatment?
If “No” please provide the name and address of the doctor who has records of your investigations and treatment.
DATE MEDICAL PROVIDER ADDRESS
/ /
No Yes
E8 of 16
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a) Please indicate (
3
the appropriate box(es)) the mental health condition(s) you have had, or received treatment for:
Anxiety (including generalised anxiety, panic or phobic disorder)
Eating disorder (including anorexia nervosa and bulimia)
Depression (including major depression and dysthymia)
Manic depressive illness, bi-polar disorder
Alcohol or other substance abuse or addiction
Post-traumatic stress
Schizophrenia or any other psychotic disorder
Stress, sleeplessness or chronic tiredness
Other (please describe below) b) Has the cause of your condition been identified?
If “Yes”, please provide the details:
No Yes c) How often do/did you have symptoms?
Describe your symptoms
years months d) Date your condition first began Date of last symptoms e) Have you ever been prescribed any medication?
If “Yes”, please provide details including the name of all drugs, dosage and how frequently taken:
MEDICINE (EG ZOLOFT) DOSE FREQUENCY
No Yes f) Are you still taking medication for your condition?
No Yes
If “No”, date ceased? g) Have you ever been absent from work or had your lifestyle restricted in any way, as a result of this condition(s)?
If “Yes”, please provide the details:
No Yes h) Have you or are you consulting any psychologist, psychiatrist, counsellor or any other therapist for this condition(s)?
If “Yes”, please provide details including dates of your most recent visit:
No Yes i) Have you ever been hospitalised for this condition(s)?
If “Yes”, please provide details including dates of hospitalisation and treatment:
No Yes j) Have you ever attempted suicide?
If “Yes”, please provide the details: k) Please provide details of your most recent visit to a doctor, hospital or other therapist for anything related to this condition:
DATE MEDICAL PROVIDER ADDRESS
/ /
No Yes
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a) Name of condition Cause if known
Date of last symptoms b) Date your condition first began c) How often do you have symptoms? d) Have you ever taken medication for this condition?
If “Yes”, please provide details (including name, dose and frequency):
Describe your symptoms d) Have you had a follow up pap smear?
If “Yes”, please provide date and result: e) Give details of your most recent visit to a doctor or hospital relating to this condition:
DATE MEDICAL PROVIDER ADDRESS
/ /
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No Yes e) Are you still taking this medication? f) Have you ever had any other treatment (eg physiotherapy, surgery, etc) or been in hospital or received emergency
Treatment for this condition?
If “Yes”, please provide details:
No Yes
No Yes g) Are any tests, surgery or treatment planned or scheduled in relation to this condition?
If “Yes”, please provide details: h) Are there any residual complications or disabilities resulting from this condition?
If “Yes”, please provide details: i) Have you ever been absent from work or incapacitated as a result of this condition?
If “Yes”, please provide details:
No Yes
No Yes
No Yes j) Does your usual doctor have details of this condition?
If “Yes”, please provide details: k) Please provide details of your most recent visit to a doctor, hospital or other therapist for anything related to this condition:
DATE MEDICAL PROVIDER ADDRESS
/ /
No Yes
a) Please indicate (
3
the appropriate box(es)) the condition(s) you have had, or received treatment for:
Carcinoma Human Papilloma Virus
CIN3
CIN2
Atypia or change (caused by infection or irritation)
Other abnormality
CIN1 b) When was the condition diagnosed? Date c) Has the abnormality been surgically removed?
If “Yes”, please provide details for each abnormality you have selected, including dates:
No Yes
No Yes
9/11/10 4:42 PM

a) Name of condition b) How long has it been since you last experienced symptoms (including but not limited to, shortness of breath, coughing, chest tightness or wheezing)?
c) Do you use any inhalers?
If “Yes” how often to you take your medication?
MEDICINE (EG VENTOLIN) DOSE FREQUENCY
No Yes d) Have you ever required treatment with oral steroids, or been admitted to hospital in the past 12 months as a result of this condition?
If “Yes”, how many times have you used oral steroids or been hospitalised for this condition in the past 12 months?
Please provide details of your most recent visit to a doctor, hospital or other therapist for anything related to your condition:
DATE MEDICAL PROVIDER ADDRESS
/ /
No Yes
a) Please indicate (
3
the appropriate box(es)) the condition(s) you have had, or received treatment for:
Mole or naevi Basal Cell Carcinoma (BCC)
Hyperkeratosis or solar keratosis
Sebaceous (fatty) cyst b) Other lesions (please describe below)
Squamous Cell Carcinoma (SCC)
Melanoma c) Please advise the location(s) of the skin lesion(s): d) Has the lesion been fully removed?
If “Yes”, please advise the method and date(s) of removal (eg frozen “burnt”, lasered off or surgically removed): e) Give details of your most recent visit to a doctor or hospital relating to this condition:
DATE MEDICAL PROVIDER ADDRESS
/ /
No Yes
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a) Name of condition b) What part of your back is affected (eg neck, upper, middle, lower and/or whole spine)? c) What was the cause of this condition? d) How long ago did this condition begin?
e) Are you still experiencing symptoms?
If “Yes”, how frequently do you suffer symptoms?
If “No”, when did you last suffer symptoms?
f) Do, or did your symptoms radiate to other areas (eg legs, arms or groin)?
If “Yes”, please provide details: g) Have you ever had to do or intend to have surgery for this condition?
If “Yes”, please provide details: h) Have you ever had, or are you contemplating having investigations such as CT or MRI scans?
If “Yes”, please provide details (doctor, date and result etc): i) Have you ever been absent from work, incapacitated or had your lifestyle restricted as a result of this condition?
If “Yes”, please provide details:
No Yes
No Yes
No Yes
No Yes
No Yes j) Please provide details of all treatment that you have had or may have in the future for this condition, eg physiotherapy, chiropractic treatment, and/or medications, including dates, name and address of doctors, chiropractors or physiotherapists.
If “Yes” please provide details:
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a) Which of the following best describes your condition:
Type 2 Diabetes (Non-Insulin Dependent)
Type 1 Diabetes (Insulin Dependent)
Gestational Diabetes
Not sure b) How long ago were you diagnosed with this condition?
Glucose Intolerance
Diabetes Insipidus
Insulin Resistant c) How is this condition treated?
Diet
Oral medication
Insulin
Other
Please advise details including name of medication, dosage used per day: d) Do you have any complications as a result of your diabetes (eg eye, kidney or nerve problems, high blood pressure or vascular disease etc)?
If “Yes”, please provide details: e) Have you ever suffered from a diabetic or insulin coma, or required hospitalisation due to your diabetes or any related condition?
If “Yes”, please provide details: f) When did you last have this condition checked by a medical practitioner?
g) Please provide your doctor’s details, including name and address:
DATE MEDICAL PROVIDER
/ /
ADDRESS
a) Have you had any tests performed due to this needle stick injury?
If “Yes”, please advise details of test(s) performed and the results if known: b) Are any tests pending due to your needle stick injury
If “Yes”, please advise what test(s) are to be performed and when this is to occur:
No Yes
No Yes
No Yes
No Yes
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If you need more room to provide your answers, please provide a separate signed and dated page(s) and attached to your application.
a) Which of the following best describes your participation in this activity, please select all that apply:
Scuba Enriched Air Mixed Gases
Snorkel Other Diving Activity b) Do you have recognised diving qualifications eg PADI, FAUI or NAUI and or relevant qualifications for mixed gases?
If “Yes”, please provide details of all diving qualifications you have obtained: c) How many dives do you perform per annum? d) What is the maximum depth to which you dive? (In metres) e) Do you dive:
In caves No Yes
In dams or lakes
In ice diving
No
No
Yes
Yes
If “Yes”, please provide details including frequency: f) Do you ever dive alone or participate in depth record attempts?
If “Yes”, please provide details including number of dives and location of the dives:
At night
Potholing
Internal exploration of wrecks
a) Are you a professional or sponsored driver?
Please indicate (
3
the appropriate box(es)) the activity(ies) you take part in:
Bicycles Jet ski racing
Boats
Car
Karts/go karts
Motorcycles b) Provide details of your involvement
Category
Class
Vehicle
Fuel
Engine capacity
No. of events last 12 mths
No. of events next 12 mths
Maximum speed
No. of vehicles per event
Trucks
Other (specify below) c) Competition licence type d) Do you have definite plans to compete overseas?
If “Yes”, please provide details:
Issuing body e) Do you participate or intend to participate in record attempts, testing of prototypes or testing of vehicles?
If “Yes”, please provide details: f) Have you ever had a motor sport accident, or has your competition licence ever been suspended?
If “Yes”, please provide details:
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No
No
No
Yes
Yes
Yes
No Yes
No Yes
Years held
No Yes
No Yes
No Yes
9/11/10 4:42 PM

a) Please indicate the activity(ies) you take part in:
TYPE OF FLYING* FIXED WING OR HELICOPTER NO. OF HOURS PAST
12 MONTHS
NO. OF HOURS NEXT
12 MONTHS
*Type of flying as defined by the aviation authorities: eg aerobatics; agricultural (including crop dusting and inspecting); airline operations; air racing; aircraft record attempts; ballooning; charter flying; commuter operations; competition flying; experimental flying; gliding; hang gliding; microlighting/powered hang gliders; paragliding and parascending; private flying or business commuting; record attempts; stunt flying; test flying; training/instructing; other (specify).
b) Type of aircraft that you usually fly?
Years held c) Licence type d) Name of your pilot’s club or association e) Air navigation order under which your flying is controlled f) Do you have any definite plans to upgrade or change your licence? g) Do you have any definite plans to fly outside of Australia, or take off or land from anywhere that is not a registered airfield?
If “Yes”, please provide details:
No Yes
No Yes
No Yes h) Have you ever been involved in flying accidents, been grounded or had your licence revoked?
If “Yes”, please provide details:
a) Please indicate the activity(ies) you take part in: b) Frequency of participation? c) Details of any licences or qualifications
per annum d) Name of any club or organisation that you are a member of e) Location(s) where you undertake or participate in this activity f) Maximum altitude/depth or speed etc
Duration of participation? g) Do you participate in competition?
If “Yes”, please provide details: h) Details of any injury(ies) as a result of participating in this activity i) Details of any definite plans to change from what you stated above j) Details of any other relevant features of your involvement in this activity
years
No Yes
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Your privacy is important to us and further information about AMP’s collection of personal information is provided in our Product
Disclosure Statement.
Our primary purpose in collecting information about your health is to assess the application for new or additional insurance from AMP.
We may also use this information for directly related purposes such as deciding whether we need more information from you; arranging reinsurance; assessing future applications for new or altered insurance; and assessing and administering claims.
We will generally collect health information from someone else, such as a doctor, with consent. We may use a third party to collect the information on our behalf. We need this information to assess the insurance application and, if you choose not to provide such consent, we may not be able to process the application.
We need this information to assess the insurance application and, if you choose not to provide such consent, we may not be able to proceed with the application.
We may disclose this type of information to:
If your insurance is part of a superannuation fund, the trustee of that fund.
The Financial Planner or broker responsible for the plan, (if any).
AMP’s reinsurers.
Medical practitioners.
Any person AMP considers necessary to assist in either the assessment of claims under your plan or the resolution of complaints, and
Anyone you have authorised.
Aspects of your health information may be provided to the owner of the Plan in resolving or explaining terms of acceptance or if the standard Plan Rules are varied. You have the right to access personal information held about you by the AMP group, as explained in your
Product Disclosure Statement.
For AMP Life to consider your insurance application, you may need to have a blood test for Human Immunodeficiency Virus (HIV) antibodies. Depending on the type of insurance you have applied for, the blood sample may also be used to determine other matters like your serum cholesterol and kidney and liver functions.
AIDS - Acquired Immune Deficiency Syndrome is the final stage of the illness caused by HIV. HIV destroys some of the defence mechanisms which protect us against infections and cancers. As a result, people infected with HIV may suffer severe infections and cancer as well as organ damage. The most recent evidence suggests that the virus stays in the body indefinitely and causes progressive damage. There is still no cure or vaccine for AIDS but in many cases those infected may survive 10 or more years.
A positive HIV antibody test can have major social, medical, psychological and legal consequences which you should consider before having this test done. These include:
Possible ill-informed discrimination.
Possible lawful exclusion from employment if you work in one of a very limited range of occupations where there is a risk of transmitting HIV.
HIV and AIDS are notifiable to government authorities, but your identity would not be reported.
As HIV positive people will develop AIDS and long term outlook is uncertain, life and disability insurance is not normally available to people with HIV.
Some countries restrict the entry of people with HIV.
It is an offence to knowingly transmit HIV or to put other people at risk of infection.
You may choose to not have the test done. If you decide not to have the test, AMP can’t consider your application for insurance. You may choose to arrange your own HIV antibody test and have the results sent to AMP.
If you choose to have AMP arrange the test, the results will be sent under confidential cover to AMP’s medical officer/chief underwriter to protect your privacy. In the event of a positive result, this will be communicated to you via the doctor you have specified in your authority for HIV test. Otherwise, acceptance of your insurance application will indicate that your HIV antibody test was negative.
E16 of 16
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Please staple all relevant material together
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. 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.
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
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.
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.
Adviser name
Plan number (insert when application is lodged)
AMP Superannuation Limited, ABN 31 008 414 104, AFSL No. 233060 (Trustee), is the trustee of the
AMP Superannuation Savings Trust, ABN 76 514 770 399 (Fund). AMP Life Limited, ABN 84 079 300 379,
AFSL No. 233671 (AMP Life) is the issuer of Flexible Protection. ® Registered trade mark of AMP Life Limited.
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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.
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.
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