QSuper Form
Please complete in block letters, in blue or black ink.
1
Make a Binding Death
Benefit Nomination
When should I use this form?
Complete this form if you want to nominate who receives your super when you pass away.
You can also use this form to renew, change or cancel an existing nomination.
Important information
What is a binding death benefit nomination?
You can choose who receives your super when you pass away by
making a binding death benefit nomination.
We’re bound to pay your death benefit according to your
nomination1 provided:
•
it’s correctly completed
•
it’s less than three years old at the time of your death, and
•
you’ve given us the original copy of the form before
your death.
Who can I nominate to receive my super?
You can nominate your legal personal representative (executor of
your will or administrator of your deceased estate) and/or one or
more of your dependants.
Nominating your legal personal representative
If you nominate your legal personal representative, your benefit will
be paid to your estate and distributed according to your will. This
gives you the opportunity to give your super to people who aren’t
otherwise considered dependants for super purposes (such as a
parent or sibling for example).
Nominating your dependant/s
A dependant includes:
•
your spouse (including same-sex and de facto)
•
your child, your adopted child, your stepchild, a child of your
spouse or your child within the meaning of the Family Law
Act 1975
•
someone who’s financially dependent on you
•
someone who has an interdependent relationship with you,
meaning:
•
a close personal relationship
•
they live with you
•
one or each of you provides the other with financial and
domestic support, and personal care.
Just remember that if you nominate a dependant, they need to be
your dependant both when you nominate them and when you
pass away.
Nominating
who receives
your super?
What happens if I don’t make a binding death
benefit nomination?
If you haven’t made a nomination at the time of your death, or for
some reason the nomination is invalid, we’ll generally pay your
benefit to a legal personal representative or dependant.
What if my situation changes?
Because we’re bound by your nomination, it’s important to
remember to change or renew your nomination if something
in your life changes so it continues to reflect your wishes. You
might get divorced or have a new spouse, or you might have a
new dependant if you have a child for example. To replace your
nomination, please complete a new Make a Binding Death Benefit
Nomination form and send it to us. You can also cancel your binding
death nomination at any time by completing sections 1, 2, 5 and 6
of this form.
Are there any situations where a nomination won’t take effect?
Your nominated beneficiaries must still be eligible to receive your
benefit at the time of your death otherwise your nomination won’t
be valid. If this happens, we’ll generally pay your benefit to your
legal personal representative or dependant.
If you have an Income account and you’ve nominated a
reversionary beneficiary (the person who receives the money
from your Income account in the event of your death), this will
take precedence for your Income account funds over an otherwise
valid binding death benefit nomination (provided they’re eligible).
Your binding death benefit nomination will still apply to any
Accumulation or Defined Benefit accounts you have.
If you have a State, Police or Parliamentary account, we’re required
to automatically pay certain benefits to a spouse or eligible
children. These requirements are part of our governing rules, and
they take precedence over an otherwise valid binding death benefit
nomination.
Give us a call if you’d like more info on this.
How long does a nomination last?
You need to know there are restrictions on how long a binding
death benefit nomination can last. Your nomination will be valid for
three years from the date you sign it but remember you can renew,
change or cancel it at any time by completing a new Make a Binding
Death Benefit Nomination form.
You can renew your nomination via Member Online
if there are no changes to the nomination and it hasn’t
expired.
1 A binding death benefit nomination mightn’t be binding if there’s a court order or Family
Law agreement in place on the account.
2
Make a Binding Death Benefit Nomination
Personal details
1
Client number
List the people who you want to receive your benefit in the event
of your death. If you nominate a legal personal representative
(executor of your will or administrator of your deceased estate), you
don’t need to provide name, date of birth or address details.
Your client number can be found on your annual statement
or by logging in to Member Online.
Title
Nominate your beneficiaries
4
Please note amendments to this form cannot be accepted.
Given names
A. Relationship (select one relationship type only)
Surname
Date of birth (dd/mm/yyyy)
Home phone number
Mobile phone number
Work phone number
Legal personal representative
Spouse
Child
Financial dependant
Title
Interdependent
Given names
Surname
Email address
Date of birth (dd/mm/yyyy)
Postal address
Address
State
Postcode
I want QSuper to send me info by email. I’d prefer to have my
annual statements emailed to me rather than sent in the post. I’d
also like important event notices, product disclosure statements,
and updates on services and products emailed to me.
2
Type of nomination
State
Please tell us the portion of your benefit
that you want this person to receive
(as a percentage)
I want to renew an existing nomination – please go
to section 5 of this form (if you’re renewing an existing
nomination before it’s expired, you don’t need to have the
form witnessed).
I want to cancel an existing nomination – please go to
sections 5 and 6 of this form and make sure it’s signed in front
of two witnesses.
3
Legal personal representative
Spouse
Child
Financial dependant
Title
Interdependent
Given names
Surname
Date of birth (dd/mm/yyyy)
Address
Finding your other super
If we have your TFN, we can use it to find any other super you may
have. This could include lost super, other active accounts and any
other money held by the ATO. If we find any other super, we’ll write
to you to see if you want us to consolidate it into your QSuper
account. And don’t worry if you change your mind, just call, write
or email us to let us know.
%
B. Relationship (select one relationship type only)
You must complete this section.
I want to make a new nomination or change an existing
nomination – make sure you complete all sections of this
form.
Postcode
I want QSuper to find my other super.
State
Please tell us the portion of your benefit
that you want this person to receive
(as a percentage)
Postcode
%
3
Make a Binding Death Benefit Nomination
Legal personal representative
Spouse
Child
Financial dependant
Interdependent
Declaration and authorisation
5
C. Relationship (select one relationship type only)
Make sure this section is completed by you because we can’t
accept nominations made under a power of attorney.
By signing this form, I declare I understand that:
Title
Given names
•
QSuper must carry out my wishes regarding who’ll receive my
super when I die as long as the beneficiaries I’ve nominated
are eligible to receive my benefit at the time of my death. I also
understand there are certain situations that my nomination
doesn’t apply to, as described in this form.
•
I can renew, cancel or change my nomination at any time
by completing a new form and sending it to QSuper. It’s my
responsibility to make sure my nomination doesn’t expire and
continues to reflect my wishes.
•
If I have a QSuper Income account and have nominated a
reversionary beneficiary to receive a pension when I die, unless
cancelled, the reversionary beneficiary nomination takes
precedence over this binding death benefit nomination.
•
My nomination will remain in effect for three years from the
date I first signed, renewed or changed my nomination.
•
If my nomination is invalid or hasn’t been received by the
QSuper Board before I die, the Board determines who receives
my death benefit.
•
This form replaces any previous binding death benefit
nomination form received by QSuper.
Surname
Date of birth (dd/mm/yyyy)
Address
State
Postcode
Please tell us the portion of your benefit
that you want this person to receive
(as a percentage)
%
D. Relationship (select one relationship type only)
Legal personal representative
Spouse
Child
Financial dependant
Title
Interdependent
Given names
Name
Signature
Surname
Date (dd/mm/yyyy)
Date of birth (dd/mm/yyyy)
6
Address
Declaration of witness
I declare the member signed and dated this form in my presence. I’m
over 18 years of age and I’m not listed on this form as a beneficiary.
State
Witness one
Title
Name
Postcode
Please tell us the portion of your benefit
that you want this person to receive
(as a percentage)
TOTAL (it needs to equal 100%)
Make sure the portion of your benefit that you nominate
to be paid to your beneficiaries adds up to exactly 100%
otherwise your nomination won’t be valid. For example,
if you want to nominate three beneficiaries, you might
consider nominating two of your beneficiaries to receive
33.3% and 33.4% to the third beneficiary.
If you want to nominate more than four beneficiaries,
please provide the necessary beneficiary and witness
details on a separate letter and attach it to this form.
Remember that you must sign and date the separate letter
and the witnesses must also provide their name, signature
and date on the letter.
%
%
Signature
Date (dd/mm/yyyy)
Witness two
Title
Name
Signature
Date (dd/mm/yyyy)
4
Make a Binding Death Benefit Nomination
7
Checking your nomination is valid
To ensure your nomination is valid and so we can process it as soon
as possible, make sure:
You’re completing this document for yourself because we
can’t accept nominations signed under a power of attorney.
You send us original signed documents (remember, if you
email or fax your documents, the nomination won’t be valid).
The proportion of benefits to be paid to each beneficiary is
allocated on this form and totals 100%.
Your witnesses are over the age of 18 and aren’t named as
beneficiaries on this form (not required for renewals).
You renew or replace your nomination at least once every
three years to ensure it doesn’t expire and continues to reflect
your wishes.
Your witnesses have both signed and dated this form on the
same day as you.
You have completed all beneficiary details including selecting
a relationship for each beneficiary.
Where do I send the form?
Send your completed form to us at: QSuper, GPO Box 200,
Brisbane QLD 4001.
We’re here to help
To help you get the most out of your super, you might want to get
some personal financial advice. QInvest offers personal financial
advice services including ‘one-off’ specific advice about your
QSuper benefit, through to comprehensive advice about your
financial situation. Just call 1800 643 893 or visit qinvest.com.au
Need more information
To find new ways to get more out of your super, have a
play around with the tools and calculators on our website
at qsuper.qld.gov.au. You can experiment with as many
different inputs and scenarios as you like.
And we’re always here to help on the phone too. Just call us
on 1300 360 750 to get in touch.
Member Centres 70 Eagle Street Brisbane and 63 George Street Brisbane
Telephone 1300 360 750 (+617 3239 1004 if overseas)
Monday – Friday 8.30am to 5.00pm Queensland time
Postal address GPO Box 200 Brisbane Qld 4001
Fax 1300 242 070
Website qsuper.qld.gov.au
ABN: 60 905 115 063
SFN: 2610 419 41
9521 01/07/16 FO110
We need to let you know that this form is issued by the QSuper Board (ABN 32 125 059 006). All QSuper products are issued by the QSuper Board as trustee for the QSuper Fund (ABN 60 905 115 063).
We take the privacy of your personal information very seriously. We’re collecting this information to administer your superannuation account and are authorised to do this under the Superannuation
(State Public Sector) Act 1990. We may pass your information on to your employer, authorised service providers (e.g. external insurers), other superannuation funds and government departments or
agencies. We may also disclose this information to third parties if we need to, if you’ve given consent to the disclosure, or if we’re required to by law. If you want to know more about our privacy policy,
you can download QSuper’s Your Privacy factsheet from our website or call us on 1300 360 750 and ask for a copy. © QSuper Board of Trustees 2016.