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Superannuation Information Kit
This kit contains:
Form 6 Declaration to accompany the Superannuation Information Request Form and the appropriate
Superannuation Information Form
A Superannuation Information Request Form
A Superannuation Information Form for use by trustees of all superannuation funds and providers ofretirement savings accounts and eligible annuities other than self managed superannuation funds
A Superannuation Information Form for use by trustees of self managed superannuation funds
The Superannuation Information Request Form and the Superannuation Information Forms are the formsapproved by the Principal Registrar to obtain information from the Trustee of an eligible superannuationplan
An eligible superannuation plan means any of the follo!ing"
A superannuation fund !ithin the meaning of the Superannuation Industry #Supervision$ Act #SIS Act$
An approved deposit fund
A retirement savings account #RSA$
An account !ithin the meaning of the Small Superannuation Accounts Act %&&'
An eligible annuity #a deferred or immediate annuity purchased !holly !ith superannuation monies$
The Trustee includes an RSA or eligible annuity provider and any person !ho manages the particular plan
The persons !ho are able to use these forms are" the member of the superannuation plan(
the spouse of the member(
a person !ho intends to enter into a superannuation agreement !ith the member
These persons are )no!n as the eligible persons
The memberincludes the account holder of the RSA or the holder of an eligible annuity
Page 1 of 22 pages01 July 2007
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57
The date of commencement of the member*s service period is"
8
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The Form 6 Declarationmust accompany a Superannuation Information Request Form to satisfy thetrustee that information is being sought by eligible persons for an approved purpose
The Superannuation Information Formsare for use by the Trustee of the superannuation plan +o!ever,the Trustee may provide the requested information in a different format
Approved by the Principal egistrar in accordance !ith the Family "a! ules on # $uly% &''(
Page 2 of 22 pages01 July 2007
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)*TI+, T* T-, P,S*) .SI)/ T-IS 0IT #T+- -.I/I0.- P-RS121
3ou must complete a Form 6 Declaration for each eligible superannuation plan from !hich you request information If you
are as)ing for information about more than one interest in the same plan, you only need to provide one Form 6 Declaration
If you ma)e a false statement in a declaration you may be sub4ect to a penalty of up to t!elve #%5$
months imprisonment
3ou must complete a Superannuation Information Request Form !here indicated for every
superannuation interest about !hich you !ish to obtain information Indicate the type of informationthat you require by tic)ing the relevant bo
The Trustee may charge a reasonable fee for providing information 3ou should inquire of the Trustee
!hat fee is payable
3ou must insert in the Superannuation Information Request Form the date at !hich you require the
information and7or the valuation If you require a valuation or information as at a different date you !illneed to complete a ne! request for that date
3ou must send to the Trustee"
8 the Form 6 Declaration(8 the Superannuation Information Request Form !ith the appropriate
Superannuation Information Form( and8 the requisite fee
The Trustee !ill complete the relevant parts of the Superannuation Information Form or provide thesame information in their o!n format and return it to you
If you are ma)ing an application for an order for property settlement and you have a superannuation
interest, you must attach the document received bac) from the Trustee to the Financial Statement thatyou file !ith the application
If a document containing the relevant superannuation information has not already been filed or
echanged, that document must be served on each other party at least t!o 95: days before the caseassessment conference or first procedural hearing
If you are ma)ing an application for a consent order in relation to a superannuation interest, you must
attach the document received bac) from the Trustee to that application
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)*TI+, T* T-, T.ST,,
If you receive a Superannuation Information Request Form accompanied by a properly completedForm 6 Declaration and the appropriate fee, you must provide the information sought #Section
&$ Family .a! Act$
3ou are prohibited from providing to the eligible person the address of the member #including a postal
address$ #Section &
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Form 6Declaration to accompany application to trustee for information about asuperannuation interest(Regulation 62), Family Law Act 1975 subsection 90M!(2)
Declaration by Applicant for Information about a Superannuation Interest
I, 9name:,of 9postal address:,born on 9date of birth:,
ma)e the follo!ing declaration in support of my application to the trustee of9name of eligible superannuation plan from !hich information is sought: 2the plan1for information
about"C#a$ my superannuation interestC#b$ a superannuation interest of
9F.. 2A
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Superannuation Information Request Form
If you !ish to re4uest information about a superannuation interest you should complete this formand a Form 6 Declaration% and send both forms together !ith the appropriate SuperannuationInformation Form and the re4uisite fee to the Trustee5
To the Trustee of:92A
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Superannuation Information Form
2for use by trustees of all superannuation funds and providers of retirement savings accounts andeligible annuities that are not Self anaged Superannuation Funds1
To the ,ligible Person
2ame of -ligible Person and address"
2ame 1f -ligible Superannuation Plan"
2ame of Trustee#s$"
2ame of member"
?ontact address #address for service$ of Trustee#s$"
STAT- P1ST?1D-
T-. DH
FAH -
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The superannuation interest is unsplittable #ie, one !ith a !ithdra!al value of less than',;;; or one !here benefits less than 5,;;; per year are being paid as a
lifetime or fied term annuity or as a nonBcommutable lifetime or fied termpension$
)o /1 T1 IT-< 5
es /1 T1 IT-< >
7
7
;;
;;0AS- A
es There are further payments to be made )o /1 T1 IT-< >
es The follo!ing details apply"
The operative time for the split #usually the date of the order or G days after the agreement !as served on the trustee$
In the case of a base amount7s no! being paid, the amount of any future payments 9)*T," T+IS I2T-R-ST @I.. +AE-
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The interest is in the"
gro!th phase
payment phase
The follo!ing information is provided as at 7
7
2this informationshould only be provided if the interest is in the gro!th phase15
Forregulated funds% SAs and deferred annuities, the preservation information is"
The member*s restricted nonBpreserved benefit #as if the member had resigned$"
The member*s unrestricted nonBpreserved benefit"
For Approved Deposit Funds only, the amount of the member*s unrestricted nonBpreserved benefit is"
;;
;;
;;
)*T,:T+- DAT- 1F T+-I2F1R
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Fees are charged for the follo!ing"
A payment split"
A payment flag"
Flag lifting under an agreement"
Termination of a flag by order"
Any other action required to be underta)en by the trustee"
#The Trustee reserves the right to change these fees at any time$
;;
;;
;;
;;
;;
Description of member;s superannuation interest !ith reference to the relevant superannuation informationforms5
ATTA+-,D -,,T* IS PAT A% 7% + * D AS APP*PIAT,
Dated the day of 5;
F1R A2D 12 0-+A.F 1F T+- TRST--
2A
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Part A Superannuation Information FormAccumulation interest in the gro!th phase
The superannuation interest is a deferred annuity
)o /1 T1 IT-< 5
es and the account balance at 7 7 C is
)*T, #" T+- TRST-- IS 21T R-LIR-D T1 PR1EID- T+IS I2F1R
es The value is
)*T," T+- TRST-- IS 21T R-LIR-D T1 PR1EID- T+IS I2F1R
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The member has been provided !ith a member information statement after7
7
C but not before
)o /1 T1 IT-< '
es The follo!ing information is provided"
The value of the interest in the statement immediately after the above date
#the first statement$"
The value of the interest !hen it !as acquired"
The amount, and date if )no!n, of any rollovers or transfers or partial
payments bet!een acquisition and the first statement #including the dates ofacquisition and of the first statement$"
)*T," T+- TRST-- IS 21T R-LIR-D T1 PR1EID- T+IS I2F1R
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,
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PAT 7 Superannuation Information FormPartially vested accumulation interestin the gro!th phase
The gross value of the interest determined in accordance !ith a method or factorsapproved by the of the Family Law (Superannuation) Reulations 2001at 7 7 C is" ;;
1R 21T PR1EID-DThe member has been provided !ith member information statements before and after
7
7
C
)o /1 T1 IT-< >
es The follo!ing information is provided"
The value of the actual vested benefit in the statement immediately before theabove date #the first statement$, the total member credit #if stated in the firststatement$ and the date of the first statement"
The value of the actual vested benefit in the statement immediately follo!ing the
above date #the second statement$, the total member credit #if stated in thesecond statement$ and the date of that statement"
The amount, and date if )no!n, of any rollovers or transfers or partial payments
bet!een the first and second statement including the dates of those statements"
)*T,:T+- TRST-- IS 21T R-LIR-D T1 PR1EID- T+IS I2F1R
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The member has been provided !ith a member information statement after7
7
C but not before
)o /1 T1 IT-< G
es The follo!ing information is provided"
The value of the actual vested benefit in the statement immediately after the
above date #the first statement$ and the date of the first statement"
The total member credit #if stated in the first statement$"
The value of the interest !hen it !as acquired"
The total member credit !hen the interest !as acquired and the date of
acquisition"
The amount, and date if )no!n, of any rollovers or transfers or partial
payments bet!een acquisition and the first statement #including the date ofthe first statement$"
)*T,:T+- TRST-- IS 21T R-LIR-D T1 PR1EID- T+IS I2F1R
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2o member information statement has been provided to the member, and the follo!inginformation is provided"
The value of the actual vested benefit"
The total member credit on the date the interest !as acquired"
The value of the actual vested benefit"
The total member credit as at the date of completing this part"
The amount, and date if )no!n, of any rollovers or transfers or partial payments
bet!een the date the interest !as acquired and the date of completing this part#including the date the interest !as acquired$"
)*T," T+- TRST-- IS 21T R-LIR-D T1 PR1EID- T+IS I2F1R
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3 T-, T.ST,, .ST I)S,T T-, APP*PIAT, DAT, F* T-, I)F*ATI*),
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The AttorneyB/eneral has determined that additional information about the interest isrequired to be provided
)o
es The details of that additional information that is required to be provided #including
the relevant clause, any item number and the title of the Determination thatthe AttorneyB/eneral has made$ is as follo!s" C
The AttorneyB/eneral has determined that information about the interest is not requiredto be provided
)o
es The details of the information that is not required to be provided #including the
relevant clause, any item number and the title of the Determination that theAttorneyB/eneral has made$ is as follo!s" C
3 T-, T.ST,, .ST I)+".D, T-, D,S+IPTI*) *F T-, I)F*ATI*) STAT,D I) T-, ,",=A)T D,T,I)ATI*)
AD, .)D, S.7,/."ATI*) 6>26A1 *F T-, FAMILY LAW (SUPERANNUATION) REGULATIONS 2001A)D% I) T-, +AS,*F ADDITI*)A" I)F*ATI*) ,
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PAT + Superannuation Information FormDefined benefit interest in the gro!th phase
The gross value of the interest determined in accordance !ith any approved schemespecific method or factors or in accordance !ith the method prescribed in Schedule 5 of
the Family .a! #Superannuation$ Regulations 5;;% at 7
7
C is" ;;
1R 21T PR1EID-DThe follo!ing details about the interest are provided"
The member*s retirement age"
The accrued benefit multiple for pension if required and7or lump sum"
The salary figure, assuming retirement at 7 7 C"
If the benefit is a combination of lump sum and pension, and a maimum pension is
specified in the rules,
8 the maimum proportion of lump sum that can be converted to a pension is"
If the benefit is a combination of lump sum and pension, and a maimum lump sum is
specified in the rules,
8 the maimum proportion of the pension that can be commuted to a lump sum is"
If the superannuation fund has a pension component"
3-ARS
;;
K 1F .
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,
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The fund has applied to the AttorneyB/eneral for approval of a method or factors fordetermining the gross value of the interest
)o
es /1 T1 IT-< G
The AttorneyB/eneral has approved a method or factors for determining the gross valueof the interest
)o
es The details including relevant clause and item number in the Family .a!#Superannuation$# are provided as follo!s"
The AttorneyB/eneral has determined that additional information about the interest isrequired to be provided
)o
es The details of that additional information that is required to be provided#including the relevant clause, item number and the title of theDetermination that the AttorneyB/eneral has made$ is as follo!s"
The AttorneyB/eneral has determined that information about the interest is not requiredto be provided
)o
es The details of that additional information that is required to be provided#including the relevant clause, item number and the t itle of theDetermination that the AttorneyB/eneral has made$ is as follo!s"
Page 22 of 22 pages01 July 2007
3
4
5
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3 T-, T.ST,, .ST I)+".D, T-, D,S+IPTI*) *F T-, I)F*ATI*) STAT,D I) T-, ,",=A)T D,T,I)ATI*) AD,.)D, S.7,/."ATI*) 62(1 * 2(A1 *F T-, FAMILY LAW (SUPERANNUATION) REGULATIONS 2001A)D % I) T-, +AS, *F
ADDITI*)A" I)F*ATI*) ,
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PAT D Superannuation Information FormSuperannuation interest in the Payment phase
The gross value of the interest determined in accordance !ith any approved schemespecific method or factors or in accordance !ith the particular method under
Regulation G%, G5 or G> of the Family Law (Superannuation) Reulations 2001!hichapplies to the interest at 7 7 C is"
;;
1R 21T PR1EID-D
The member is receiving ongoing pension payments from an allocated pension orannuity
)o
es The !ithdra!al benefit at 7 7 C is"
)*T," T+- TRST-- IS 21T R-LIR-D T1 PR1EID- T+IS I2F1R
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The amount of any lump sum #if )no!n$ payable is"
* The amount of any future lump sum is not )no!n but8 The amount if the lump sum !ere paid at the date of completing
this part is"8 The method used to inde the lump sum to determine the amount
of the future lump sum is"
3 T-, T.ST,, .ST I)S,T T-, APP*PIAT, DAT, F* T-, I)F*ATI*) ,
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The fund has applied to the AttorneyB/eneral for approval of a method or factors fordetermining the gross value of the interest
)o
es /1 T1 IT-< 6
The AttorneyB/eneral has approved a method or factors for determining the gross valueof the interest
)o
es The details including relevant clause and item number in the Family .a!#Superannuation$ # are provided as follo!s"
The AttorneyB/eneral has determined that additional information about the interest isrequired to be provided
)o
es The details of that additional information that is required to be provided#including the relevant clause, any item number and the title of theDetermination that the AttorneyB/eneral has made$ is as follo!s"
The AttorneyB/eneral has determined that information about the interest is not requiredto be provided
)o
es The details of the information that is not required to be provided #includingthe relevant clause, any item number and the title of the Determinationthat the AttorneyB/eneral has made$ is as follo!s"
Page 26 of 22 pages01 July 2007
5
8
7
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3 T-, T.ST,, .ST I)+".D, T-, D,S+IPTI*) *F T-, I)F*ATI*) STAT,D I) T-, ,",=A)T D,T,I)ATI*) AD,.)D, S.7,/."ATI*) 6>2671 * 62(71 *F T-, FAMILY LAW (SUPERANNUATION) REGULATIONS 2001A)D % I) T-, +AS, *F
ADDITI*)A" I)F*ATI*) ,
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Superannuation Information Form
2for use by trustees of Self anaged Superannuation Funds1
#o t$e %li&ible 'erson
2ame of -ligible Person and address"
2ame of -ligible Superannuation Plan"
2ame of Trustee#s$"2ame of member"
?ontact address #address for service$ of Trustee#s$"
STAT- P1ST?1D-
T-. DHFAH -
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BBBBBBBBBBBBBBBBBBBBBBBBBBBBBBBB+*)TI).,D ),CT PA/,
3 T-, T.ST,, .ST I)S,T T-, APP*PIAT, DAT, F* T-, I)F*ATI*),
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In the case of a base amount7s no! being paid, the amount of any
future payments is"
9)*T," T+IS I2T-R-ST @I.. +AE-
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Fees are charged for the follo!ing"
A payment split"
A payment flag"
Flag lifting under an agreement"
Termination of a flag by order"
Any other action required to be underta)en by the trustee"
;;
;;
;;
;;
;;
The member is receiving ongoing pension payments from an allocated pension
)o
es The !ithdra!al benefit at 7 7 C is"
)*T," T+- TRST-- IS 21T R-LIR-D T1 PR1EID- T+IS I2F1R
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The member is receiving ongoing pension payments from an interest that is not anallocated pension or a mar)et lin)ed pension
)o
es The follo!ing information is provided"
The annual amount of the pension is"
)*T," T+- TRST-- IS 21T R-LIR-D T1 PR1EID- T+IS I2F1R