MLC Superannuation Withdrawal/Rollover Form

1 Withdrawal/Rollover FormPage 1 of 6 IMPORTANT INFORMATIONWho can use this form?Generally, you ll be able to use this form if you are requesting a withdrawal or rollover. However, you ll need to call us on 132 652 if you are applying to withdraw your benefit on the basis of: severe financial hardship, being a temporary resident (unless you are the holder of a retirement visa subclass 405 or 410), or a claim for Total and Permanent Disablement or Income things to consider if you are closing your MLC account: If you have insurance with us, a withdrawal from your super account may cause any insurance you hold with us to be cancelled.

2 Contact us on 132 652 if you would like to check whether you are eligible to continue this insurance. If you have made personal contributions and you believe you are eligible to receive unpaid Government co-contributions you should advise the Australian Taxation Office on 13 10 20 of an alternative Superannuation fund. If you haven t provided your TFN we will not be able to refund amounts deducted to pay no-TFN tax . If you wish to split current year concessional contributions to your spouse, or if you wish to split prior year concessional contributions to your spouse you ll also need to submit a Contributions Splitting Application Form, available from If you have an MLC masterkey business super account, before processing your request, we will contact your employer to confirm your employment status and that no further employer contributions are due to be deposited into your account.

3 This may delay your Withdrawal/Rollover ACCOUNT DETAILSQ uestion 2 Surname and given name The name you provide here should be the same as the name the Australian Taxation Office (ATO) has recorded for 4 Residential address, Home Number, Work Number and Email address You may provide a mobile number if this is the best way to contact you during business 5 Providing your Tax File Number Providing your tax file number (TFN) is optional. We are required to tell you the following things before you provide your TFN: your TFN is confidential, we are authorised to collect your TFN(s) by tax laws, the Superannuation Industry (Supervision) Act 1993 and the Privacy Act should be aware that: you are not obliged to provide a TFN however if you do not provide your TFN we will hold your money in trust and contact you or your financial adviser to obtain your TFN.

4 If we do not receive your TFN within 14 days we may return any contributions or rollovers, we are allowed to use your TFN only for lawful purposes, in particular paying out monies, identifying and amalgamating Superannuation benefits for surcharge purposes and for other approved purposes. The approved purposes and consequences of not providing a TFN may change in the future as a result of legislative changes, your TFN may be disclosed to the trustee of another Fund or RSA provider if your benefits are transferred, unless you request in writing that it not be disclosed to any other trustee and to the Commissioner of Taxation but will not otherwise be disclosed to any person or a valid TFN has not been provided.

5 An additional amount of tax at the highest tax rate may apply on the withdrawal CONTRIBUTION DETAILSQ uestion 6 Do you intend to claim a tax deduction for personal contributions made in the current or previous financial year? Question 6 of this form allows you to claim a deduction on personal contributions you have made in the current or previous financial year. If you have made personal contributions, you should check whether you are eligible to claim a tax deduction. Your tax adviser will be able to help you determine if you are eligible, alternatively you can go to the for more information.

6 If you are eligible and you don t claim a tax deduction at the time of making a Withdrawal/Rollover , then we may not be able to accept a future notice. For example, even if your notice is submitted in the required timeframe, we cannot accept a notice where your contributions have been used to start a pension or, where you do not have sufficient personal contributions remaining in your account to cover the amount you are : If you do not check that you are eligible to claim a tax deduction for your personal contributions (or you do not have enough assessable income to cover the amount you are claiming) the ATO could deny your deduction and this could cause you to exceed your contribution limit(s).

7 Where this is the case, if you ve withdrawn any of your benefit or started a pension you may not be able to reduce the amount you told us you were claiming. This could mean you have to pay additional FormMLC SuperannuationMLC Nominees Pty LimitedABN 93 002 814 959 AFSL 230702 RSE L0002998 MLC LimitedABN 90 000 000 402 AFSL 230694 The Universal super Scheme R1056778 Superannuation Fund Number 281 440 944 ABN 44 928 361 101 Please note: do not use photocopies of this form as it contains unique routing and tracking information that assists MLC in the timely processing of your application.*C10002-0008485792*Withdrawa l/Rollover FormPage 2 of 6 ROLLOVER REQUEST DETAILSQ uestion 8 Do you wish to rollover all/part of your benefit?

8 A part rollover will be proportionally taken from the taxable and tax-free components of your account at the time of the 9 Where is your rollover going? The rollover payments can not be paid directly to you. MLC will pay by cheque directly to your chosen rollover institution or Self Managed super Fund. For rollover payments made to Self Managed super Funds, MLC is unable to make these payments by EFT. If you do not provide all the required information, your rollover may be delayed. Your chosen rollover institution can assist you with this information. The fund to which you are rolling over your benefit must be a complying Superannuation fund.

9 Unless the fund is an SMSF registered by APRA prior to 2000, an ABN must be supplied and the fund must be registered by APRA or the ATO. Where an ABN is not supplied or the fund details do not match those on super Fund Lookup (a register of regulated funds), we may ask you to provide further evidence of the complying status before we are able to roll over your benefit. Generally we must process your rollover within 30 days unless the benefit contains illiquid investments or where withdrawals have been restricted due to market conditions. If applicable, we will provide you with information about the restrictions and the expected timeframe for completion of your CASH WITHDRAWAL DETAILSQ uestion 14 Reason for cash withdrawal You may cash your unrestricted non-preserved benefits at any time.

10 Preserved and restricted non-preserved benefits are benefits that cannot be cashed until you have met one of the conditions set out in the table. Note: If you wish to cash your benefit by taking a Transition to Retirement pension you must complete a separate application attached to the Product Disclosure Statement. If you are only partially cashing your benefit, your unrestricted and restricted non-preserved benefits must be paid prior to your preserved 16 Do you wish to withdraw all/part of your benefit A part withdrawal will be proportionally taken from the taxable and tax-free components of your account at the time of the 18 Please provide your Australian account details We can only transfer the payment to an Australian bank account in your name or a joint name where you are an account holder.