New Pension ApplicationIf you have any questions please do not hesitate to contact us on 1300 809 933.For the establishment of an account based pension for SMSFs under our administration we do not charge an establishment fee.ORDER DETAILS:Name of Person Completing this Form* First Last Email Address*This email address will receive a confirmatory email when this form has been successfully submitted. Are you completing this form on behalf of the adviser?* Yes NoAdviser Name*The adviser will receive a copy of this form on submission. First Last Adviser Email* Are you an existing adviser with us?* Yes NoAdviser Company Name*Adviser Phone*Adviser Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Fund Name*Is SMSF Alliance the Administrator for this fund?* Yes NoPlease contact us at customercare@smsfalliance.com.au or on 1300 809 933 to discuss your request instead of proceeding with your application.Is this fund a QROPS fund?*Is this fund registered for QROPS with HMRC? Yes NoPlease supply NINO numbers and the date they left the United Kingdom for all UK members?* Member Details:Name* First Middle Last Date of birth* Day Month YearGender* Male FemaleImportant Acknowledgement*This is generally a free service but a fee of $330 will apply if it needs to be redone due to quarterly TBAR requirements. Unless a pension is commenced with a fixed amount, the amount used is a best estimate. Unmatched items, retrospective asset valuations, and more, mean the exact balance is not available until after the event. TBAR reporting of such adjustments is onerous and will incur a fee but can be avoided if we use the large APRA fund methodology and accept the best estimate as being correct with any unders and overs applied against other fund accounts. If there are no unmatched items before the start date the starting balance should be reasonably accurate. Where the subsequent difference is no more than $2,000 we will process it as an income or expense item against any other account for the member, before involving other members. Our process will minimise the tax effect which may be positive or negative. In the worst-case scenario, fund tax will increase by $300. Where the exact balance subsequently differs from the best estimate balance by more than $2,000 we will, after checking with you first, redo the process for a fee of $330. You may also request this irrespective of the difference by indicating your selection below. If the best estimate value differs by no more than $2,000 from the subsequently determined exact value the best estimate is to be accepted as correct and the difference processed against other accounts. If the difference is greater, our/trustee approval will be required before redoing the documentation. Where this is required a fee of $330 will apply. I require the documentation to be replaced if the best estimate does not precisely match the subsequently determined exact value. A fee of $330 will apply. This is not a consideration as the pension commencement balance is fixed. It does not need to be calculated.New or Restarted pension date*For account based pensions (not transition to retirement pensions) a TBAR must be lodged within 28 days of the end of the quarter in which the pension was commenced. If you select a date where this requirement cannot be satisfied we will process the pension but cannot guarantee that the ATO will accept it. Day Month YearPension action required*NOTE: You must ensure that the minimum pension has been drawn before a pension can be restarted. New Pension Restart after combining with existing accumulation and/or pensionsType of Pension* Transition to Retirement Account Based PensionImportant: The ATO will not provide a member’s transfer balance account details to us. This is only available from the member’s myGov account which is accessible either by the member personally or the member’s personal tax agent. In making this application you have determined that eithercommencing this pension will not cause a breach of the member’s transfer balance account and/oryou have checked the ATO’s data from the member’s, or the member’s personal tax agent’s, myGOV access.Acknowledgement* I confirm that commencing this pension will not cause a breach of the member’s transfer balance cap.Has the member reached preservation age at pension start date?* Yes NoPlease contact us on customercare@smsfalliance.com.au to discuss this matter further.Purchase Price* Entire Member balance Partial balancePartial amount*Purchase Price* Entire Member balance Partial balancePartial amount*Is an existing death benefit pension involved with this restart?* Yes NoA death benefit pension cannot be merged with any other pension or accumulation account. A death benefit pension can only be left intact or commuted from the fund. Please clearly describe the death benefit pension that is to remain unaltered in the specific instructions at the end of this application so we don't inadvertently include it.Is an existing accumulation account involved in this restart?* Yes NoWhat is the condition of release?*Please selectOver preservation age, but under 60, and retiredAged from 60 to under 65 and retiredUnder 65 and not retired but changed/ceased an employment situation from age 6065 or overTotal & Permanent DisablementTerminal IllnessDeathOtherWhat is the condition of release?*Please selectOver preservation age, but under 60, and retiredAged from 60 to under 65 and retiredUnder 65 and not retired but changed/ceased an employment situation from age 6065 or overTotal & Permanent DisablementTerminal IllnessDeathOtherDate of Retirement* Day Month YearDate of Retirement* Day Month YearDate of Employment Change* Day Month YearDate of Death* Day Month YearWe require a death certificate for audit purposes.You must supply us with 2 medical certificates, one from a specialist, confirming that the member is unlikely to ever engage in gainful employment again. The pension should be commenced within a year of the medical certificate dates. These should be provided to us via the portal.You must supply us with 2 medical certificates, one from a specialist, confirming that the member is unlikely to survive for 2 years. The pension should be commenced before the 2 years covered by the medical certificates expires. They should be provided to us via the portal.Please provide further information*Is the tax free threshold to be claimed for this pension?* Not applicable as over age 60 Yes NoIs the tax free threshold to be claimed for this pension?* Not applicable as over age 60 Yes NoIs the tax free threshold to be claimed for this pension?* Not applicable as over age 60 Yes NoIs the pension to be reversionary?* Yes NoIs the pension to be reversionary?* Yes NoReversionary Name* First Middle Last Reversionary Date of Birth* Day Month YearReversionary Gender* Male FemaleWhat is the relationship to the member?*SpouseChild under 18Child over 18 but under 25 and financially dependentPermanently disabled child over 25OtherDo you wish to include an auto commutation authority to cater for pension payments over the minimum?*Treating pension payments over the minimum as commutations, optimises members' transfer balance accounts. It's not suitable for everyone as it may have adverse social security and/or death benefit pension effects, including estate planning consequences where customised measures have been arranged. It should also be used with caution where UK Pension funds are involved as any commutation of an accumulation account requires reporting to HMRC. The authority is applied on a fund basis, not a member, basis. If this fund already has a standing authority in place, then it should be renewed. Yes NoWe require a permanent direction to treat all fund benefit payments in excess of the pension minimums in the following order: 1. To satisfy the minimum requirement for any other fund pension, across all members 2. As a lump sum drawdown from any accumulation account 3. As a partial commutation of a pension account starting with that containing the highest taxable component. We acknowledge that:* We have considered any social security, death benefit pension, estate planning and UK pension reporting consequences, if applicable, and that the trustee may revoke this authority in writing at any time.Please provide further information*Specific Instructions*As this application involves pension and/or accumulation account amalgamations and restarts we need specific information on what is required for each account. Note that the minimum pension must be drawn before an existing pension can be restarted.Specific Instructions*As this application involves pension and/or accumulation account amalgamations and restarts we need specific information on what is required for each account. Note that the minimum pension must be drawn before an existing pension can be restarted.Additional InformationAdditional Information