Application | Super

Accumulation Member Application Form

* Indicates required field

Agent Name

Strategy (Optional)

Defensive

Diversified

Growth

Title

Given Name*

Family Name*

Gender

Date of Birth*

Marital Status

Country of Citizenship*

Street Address*

Suburb*

State / Province / Region*

ZIP / Postal Code*

Contact Phone*

Email*

Tax File Number (TFN)*

Occupation*

Hours worked per week*

Are any of the Applicants, Directors, Responsible Officials, Partners, Authorised Representatives, Authorised Signatories, Trustees, Beneficial Owners, Beneficiaries or any other persons listed in the application form, a Politically Exposed Person?*

Yes

Type of Beneficiary Nominations? (optional)

Binding

Non-Binding

Number of Beneficiaries (optional)

(1).

Surname

Given Name

Relationship

Portion (%)

(2).

Surname

Given Name

Relationship

Portion (%)

(3).

Surname

Given Name

Relationship

Portion (%)

(4).

Surname

Given Name

Relationship

Portion (%)

Rollover/Transfer from another Fund

Name of Previous Fund

Fund ABN

Unique Superannuation Identifier

Fund's Phone Number

Member Number

Approximate Value of Benefit

Postal Address of Previous Fund

How do you hear about us?