Withdrawal Form - OnePath

1 of 7 Withdrawal Form1 July 2018 OnePath Life Limited ABN 33 009 657 176 AFSL 238 341 242 Pitt Street, Sydney NSW 2000 Instructions Please cross (x) one of the following:nDeferred Annuity (USI MMF0331AU)nAllocated Annuity (USI MMF0332AU)nRetireInvest Preferred Rollover Bond (USI LEF0158AU)Note: Death benefits This form is not required when claiming a death benefit, please call Customer Services on 133 665 for claim requirements. Please complete this form and forward to: OnePath Life Limited, GPO Box 5306, Sydney NSW 20011. Policy number 2. Policy holder detailsTitle Mr Mrs Ms Miss Dr Other Surname Given names(s) Date of birth (dd/mm/yyyy) DD / MM / YYYYMale Female Residential address (this cannot be a PO Box)Street Suburb State Postcode Country Postal address (if different from above)Street Suburb State Postcode Country Phone Business Mobile Home Email Customer Services Phone 133 6 65 Email Website of 73.

3 of 7 5. Withdrawal instructions The minimum withdrawal is $1,000, however if your account balance falls below $2,000 (Deferred Annuity), $1,000 (Allocated Annuity),

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