Establishment of a New Fund

Does the Fund require QROPS status?*
Funds should only be registered for QROPS status if there is UK pension money to be transferred to the SMSF. Additional fees are incurred for QROPS registrations.
- Yes
- No
What was the date of leaving the UK for Tax Purposes?*

DD
MM
YYYY
National Insurance Number - Member 1
National Insurance Number - Member 2
Trustee Option:*
- Individual Trustee
- Corporate Trustee
How many Members/ Trustees?*
Member 1 Name*
Prefix First Middle Last
Has Member 1 ever had a change of name?*
- Yes
- No
Member 1 What was the prior name?*
Member 1 Street Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Member 1 Mobile Phone Number*
Member 1 Email Address*
Member 1 Gender*
- Male
- Female
Member 1 Date of Birth*

DD
MM
YYYY
Member 1 Specific Occupation*
Please be as detailed as possible. We cannot accept "Manager" we require detail about the Industry as well.
Member 1 Town & Country of Birth*
City State / Province / Region Country
Member 1 TFN*
Trustee 2 Name*
Prefix First Middle Last
Has Trustee 2 ever had a change of name?*
- Yes
- No
Trustee 2 What was the prior name?*
Is the street address for Trustee 2 the same as Member 1?*
- Yes
- No
Trustee 2 Street Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Trustee 2 Mobile Phone Number*
Trustee 2 Email Address*
Trustee 2 Gender*
- Male
- Female
Trustee 2 Date of Birth*

DD
MM
YYYY
Trustee 2 Town & Country of Birth*
City State / Province / Region Country
Trustee 2 Specific Occupation*
Please be as detailed as possible. We cannot accept "Manager" we require detail about the Industry as well.
Trustee 2 TFN*
Member 2 Name*
Prefix First Middle Last
Has Member 2 ever had a change of name?*
- Yes
- No
Member 2 What was the prior name?*
Is member 2 address the same as member 1?*
- Yes
- No
Member 2 Street Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Member 2 Mobile Phone Number*
Member 2 Email Address*
Member 2 Gender*
- Male
- Female
Member 2 Date of Birth*

DD
MM
YYYY
Member 2 Specific Occupation*
Please be as detailed as possible. We cannot accept "Manager" we require detail about the Industry as well.
Member 2 Town & Country of Birth*
City State / Province / Region Country
Member 2 TFN*
Member 3 Name*
Prefix First Middle Last
Has Member 3 ever had a change of name?*
- Yes
- No
Member 3 What was the prior name?*
Is member 3 address the same as member 1?
- Yes
- No
Member 3 Street Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Member 3 Mobile Phone Number*
Member 3 Email Address*
Member 3 Gender*
- Male
- Female
Member 3 Date of Birth*

DD
MM
YYYY
Member 3 Specific Occupation*
Please be as detailed as possible. We cannot accept "Manager" we require detail about the Industry as well.
Member 3 Town & Country of Birth*
City State / Province / Region Country
Member 3 TFN*
Member 4 Name*
Prefix First Middle Last
Has Member 4 ever had a change of name?*
- Yes
- No
Member 4 What was the prior name?*
Is member 4 address the same as member 1?
- Yes
- No
Member 4 Street Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Member 4 Mobile Phone Number*
Member 4 Email Address*
Member 4 Gender*
- Male
- Female
Member 4 Date of Birth*

DD
MM
YYYY
Member 4 Specific Occupation*
Please be as detailed as possible. We cannot accept "Manager" we require detail about the Industry as well.
Member 4 Town & Country of Birth*
City State / Province / Region Country
Member 4 TFN*
Is Corporate Trustee already Established?*
- Yes
- No
Company Name*
Company ACN*
Would you like SMSF Alliance to become the Registered Agents?*
There is an additional yearly fee for SMSF Alliance to act as the Registered Agents & Address. We will also need the Company Register
- Yes
- No
Company Registered Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Preferred Company Name*
Option 1 Option 2 Option 3
Would you like SMSF Alliance to act as the Registered Agents?*
There is an additional yearly fee for SMSF Alliance to act as the Registered Agents & Address. We will also need the Company Register
- Yes
- No
Registered Address*
Street Address City State / Province / Region ZIP / Postal Code Country
How many Directors/ Members?*
Director 1 Name*
Prefix First Middle Last
Director 1 Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Director 1 Any prior name*
- Yes
- No
Director 1 Prior Name*
Director 1 - SMSF Member?*
- Yes
- No
Director 1 - Gender*
- Male
- Female
Director 1 Date of Birth*

DD
MM
YYYY
Director 1 Place of Birth*
Please include Town and Country

City State / Province / Region Country
Director 1 Email*
Director 1 TFN*
Director 1 Mobile phone number*
Director 1 - Is Director 1 a Company Secretary?*
1 Company Secretary MUST be appointed per Company Establishment
- Yes
- No
Director 1 - Is Director 1 a Public Officer?*
- Yes
- No
Director 1 - Is Director 1 a Shareholder?*
- Yes
- No
Director 1 - Number of ordinary shares @ $1.00 per share
Director 1 Specific Occupation*
Please be as detailed as possible. We cannot accept "Manager" we require details about the Industry as well.
Director 2 Name
Prefix First Middle Last
Director 2 Have they ever changed their name?
- Yes
- No
Director 2 What was the prior name?*
Director 2 - SMSF Member?*
- Yes
- No
Director 2 Gender*
- Male
- Female
Director 2 Date of birth*

DD
MM
YYYY
Director 2 Place of Birth*
Please include the Town & Country

City State / Province / Region Country
Director 2 Email Address*
Director 2 Mobile Phone Number*
Director 2 TFN*
Director 2 Is the address the same as Director 1?*
- Yes
- No
Director 2 Street Address
Street Address City State / Province / Region ZIP / Postal Code Country
Director 2 Specific Occupation*
Please be as detailed as possible. We cannot accept "Manager" we require details about the Industry as well.
Director 2 - Will they be a Company Secretary?*
- Yes
- No
Director 2 - Will they be a Public Officer?*
- Yes
- No
Director 2 - Will they be a shareholder?*
- Yes
- No
Director 2 - Number of ordinary shares @ $1.00 per share
Director 3 Name*
Prefix First Middle Last
Director 3 Any prior names*
- Yes
- No
Director 3 What was the prior name*
Director 3 Gender*
- Male
- Female
Director 3 Date of Birth*

DD
MM
YYYY
Director 3 Place of Birth*
Please include Town & Country

City State / Province / Region Country
Director 3 Email*
Director 3 Mobile number*
Director 3 TFN*
Is Director 3 Address the same as Director 1*
- Yes
- No
Director 3 Street Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Director 3 Specific Occupation*
Please be as detailed as possible. We cannot accept "Manager" we require details about the Industry as well.
Director 3 Will they be Company Secretary?*
- Yes
- No
Director 3 - Will they be a Public Officer?*
- Yes
- No
Director 3 - Will they be a shareholder?
- Yes
- No
Director 3 - Number of ordinary shares @ $1.00 per share*
Director 4 Name*
Prefix First Middle Last
Director 4 Any prior name*
- Yes
- No
Director 4 Prior name*
Director 4 Gender*
- Male
- Female
Director 4 Date of Birth*

DD
MM
YYYY
Director 4 Place of Birth*
Please include Town and Country

City State / Province / Region Country
Director 4 Email*
Director 4 Mobile Number*
Director 4 TFN*
Director 4 - Address the same as Director 1?*
- Yes
- No
Director 4 Street Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Director 4 Specific Occupation*
Please be as detailed as possible. We cannot accept "Manager" we require details about the Industry as well.
Director 4 - Will they be Company Secretary?*
- Yes
- No
Director 4 - Will they be a Public Officer?*
- Yes
- No
Director 4 - Will they be a shareholder?*
- Yes
- No
Director 4 - Number of ordinary shares @ $1.00 per share*

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Any additional information?
Payment Summary
Individual Trustee
Individual Trustee
Price: $ 300.00
Corporate Trustee
Corporate Trustee
Price: $ 950.00
Corporate Trustee
Corporate Trustee
Price: $ 350.00
QROPS Establishment Fee
QROPS Establishment Fee
Price: $ 450.00
Fee (inclusive of GST)
$ 0.00
How will you be paying?
- Fee Authority on File
- Credit Card
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
How would you like the Establishment Fee dealt with?
- Refunded back to the member once funds are received
- Eligible Member Contribution within the caps
Once the fund receives rollovers/ contributions the Establishment Fee can be paid back to the paying member or taken up as a Contribution for the member/s if eligible. If a refund is chosen, please note this should be done by the Trustees as soon as possible once monies have been received by the Fund.
Member Contributions
Please provide information on how the member contribution should be processed. ie. 100% to member 1, 50/50 split between member 1 & 2 etc

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Establishment of a New Fund

Establishment of a New Fund.

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