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Death Benefit Nomination


Death Benefit Nomination

Please fill in your details below. Fields marked * are mandatory and must be filled
in prior to submission. Once the form is completed, hit the submit button.

Any further queries please contact Rebecca James.

Contact details    
First Name  
Surname  
Name of Firm  
Email address  
Telephone  
fax  
Address
(if a company, please supply registered address.)
 

Name of fund    
Name of Fund  
Date of Fund  

Member    
Full name of member  
Street address of member  
TFN of member  
     

Dependants    
     
Full name of dependant 1  
Relationship to member  
Amount or percentage of benefit  
     
   
Full name of dependant 2  
Relationship to member  
Amount or percentage of benefit  
     
   
Full name of dependant 3  
Relationship to member  
Amount or percentage of benefit  
     
   
Full name of dependant 4  
Relationship to member  
Amount or percentage of benefit  
     
Total amount of percentage of benefit for all dependants must add up to 100% of member's benefit.

Binding or non-binding    
Dependants mus be the member's spouse, child, financial dependant or someone they are in an interdependancy relationship with.
Binding  
Non-binding  
    Please issue this order form with a copy of the superannuation fund’s establishing deed and any subsequent amendment variations and change of trustee documentation.

Further information
If you would like to include any queries you have please do so below
You may type as much as you wish

Disclaimer

We will not be able to complete the documentation requested if any of the required fields in the order form are not complete or if any of the required supporting documents (ie superannuation fund deed) are not provided.

We will prepare the documentation requested based on the information provided in the order form. Please ensure the information provided is correct prior to submitting the order form.  We reserve the right to charge at our hourly rates for any additional work we are asked to undertake to amend documents where the initial information provided to us in the order form was incorrect or incomplete.



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