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Payment instruction form - Home - Plum

Page 1 of 5 Telephone 1300 55 7586 Fax 1300 99 7586 Web Box 63 Melbourne VIC 3001 Fund MLC Super Fund ABN 70 732 426 024 TrusteeNULIS Nominees (Australia) Limited ABN 80 008 515 633 AFSL 236465 Payment instruction formPlease complete and sign this form to provide your Payment instructions . Mail the completed form to: Plum Super, Reply Paid 63, Melbourne Vic 8060. If you need assistance in completing this form , please contact us on 1300 55 may also call the ATO Superannuation hotline on 13 10 20 for superannuation tax the steps below to make your 1 Complete your personal details (please use BLOCK letters)Member numberSurname (family name)Given namesTitle Date of birth (DD/MM/YYYY) Gender (please tick)MrMrsMissMsOtherMaleFemaleResidenti al address Postcode StatePostal address (if different to above) Postcode StateBusiness phone Home phone MobileEmail Page 2 of 5 15123461 1300 55 7586 Fax 1300 99 7586 Web Box 63 Melbourne VIC 3001 Fund MLC Super Fund ABN 70 732 426 024 TrusteeNULIS Nominees (Australia) Limited ABN 80 008 515 633 AFSL 236465 STEP 1 Complete your personal details continuedTax File Number detailsDeclining to quote your Tax File Number (TFN) is not an offence.

Page 4 of 5 15123461 P pllummu.mcoP ˘ P plluaau.mcoPP 1 Pageofymofne t iPsmrPopPP ucgFmelwcPhpbPpll ˘ 6 ukbP.eaclPSewTP EsCP.lu.pGuPGoulGP 11 Cdkp.PCmo1wccRPDEeRBlng1nvPk1o1BcTP EsC uclullcum muoppuuP ES.kPGpoPom STEP 4 Rollover payment instructions

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