DECLARATION OF RELEASE OF SRS FUND BY
PRODUCT PROVIDER UNDER THE SUPPLEMENTARY
RETIREMENT SCHEME (SRS)
SINGAPORE POST CENTRE
POST OFFICE
P.O. BOX 394
Singapore 914014
Tel: 6356 7012
Email:
https://mytaxmail.iras.gov.sg
Operating Hours: 8am to 5pm
(Mon to Fri)
Note: This form may take you 5 minutes to complete. Please get the following ready:
a) Particulars of the non-resident
b) Details of the withdrawal
Section A: Particulars of SRS Operator
Name of SRS Operator
Address
Tax Reference No.
Contact Person
Contact No.
Section B: Particulars of SRS Account Holder
Name of SRS Account Holder
Citizenship
Singapore Citizen / Non-Singapore Citizen *#
SRS Account No.
Address
Identification Type *
Identification No.
*Identification type:
Date of Birth (dd/mm/yyyy)
Nationality Code #
(as at date of withdrawal) #see attached
Section C: Particulars of Product Provider (PP)
001 NRIC
002 Foreign Identification Number (FIN)
011 Malaysia IC
012 Passport Number
020 Other Identification
Name of Product Provider
Address
Identification Type **
Contact Person
Identification No.
**Identification type:
006 ROC Number
020 Other Identification
Telephone No.
Section D: Details of Payments by Product Provider
1) Date of First Contribution (dd/mm/yyyy)
2) Date of Withdrawal (dd/mm/yyyy)
3) Date of Deemed Withdrawal (dd/mm/yyyy) (if applicable)
4) Status of Withdrawal
Full/Partial/Annuity/Release by Product Provider ***
5) Gross Amount Released (S$)
6) Gross Amount Applicable to Tax (S$)
Tax Rate (%)
7) Amount of Withholding Tax, if any (S$):
8) Withholding Tax Withheld and Remitted to IRAS?
Yes/No***
9) Penalty for Premature Withdrawal (S$)
10) Penalty for Premature Withdrawal Withheld and Remitted to IRAS?
Yes/No***
11) Reasons for release by Product Provider
Please specify:
Section E: Declaration by SRS Operator
I certify that the information given in this form is true and complete.
Name of SRS Operator
Name of Officer/Designation
Signature
Contact No
Date
*** Delete whichever is not applicable
# NATIONALITY CODES
Code
Description
301
Singapore Citizen
300
Singapore PR
302
Bruneian
303
Indonesian
304
Malaysian
305
Filipino
306
Thai
331
Japanese
334
Taiwanese
336
Chinese
354
Indian
103
French
104
German
109
Dutch
110
British
202
Bulgarian
503
American
701
Australian
705
New Zealander
999
Others
<This Attachment is for Reference only>