CSCri
CSC
retirement
income
RI04
04/13
Make a lump sum withdrawal or rollover
For a transition to retirement income stream
Use this form if you have a transition to retirement income stream and wish to
>> make a cash lump sum withdrawal from your account
>> roll over a partial amount to another complying superannuation fund.
Please complete this form using BLACK ink, in clear BLOCK LETTERS, and mark answers in boxes with an X.
Access to your money
As a transition to retirement income stream member, your ability to access amounts from your CSCri
account (as either income payments, lump sum withdrawals or partial rollovers to other complying
superannuation funds) is restricted by law. Unless you satisfy one of the conditions of release listed below,
you are subject to a maximum annual withdrawal amount.
Your annual withdrawals cannot exceed this amount, which is 10% of your account balance for that year,
calculated on the date you commence your income stream in your first year and on 1 July for each year thereafter.
If you do satisfy a condition of release, however, you can request to change your CSCri account from a
transition to retirement income stream to a standard retirement income stream.
Conditions of release
>> You have reached your preservation age, ceased working and do not intend to work for more than 10 hours a
week in the future (you have permanently retired).
>>
>>
>>
>>
>>
You have reached age 65.
You changed employment on or after age 60 (you do not need to have permanently retired).
You retire due to permanent disablement or invalidity.
You have a terminal medical condition as defined under superannuation law.
You are a temporary resident permanently leaving Australia (except New Zealand citizens).
I satisfy a condition of release and wish to make a lump sum withdrawal or rollover
Please do not complete the remainder of this form. Instead, you should do the following:
>> Complete the Change your account details form available at cscri.gov.au to change the status of your
account from a transition to retirement income stream to a standard retirement income stream.
>> Complete the Make a lump sum withdrawal or rollover for a standard retirement income stream form
available at cscri.gov.au
Note: You can complete and send us both your forms together at:
CSCri
Locked Bag 8840
Wollongong NSW 2500
I do not satisfy a condition of release but still wish to make a lump sum withdrawal or rollover
You can still make a withdrawal or rollover, providing that you do not exceed your maximum annual
withdrawal amount. In addition, the amount you do wish to withdraw (and are eligible by law to withdraw)
must not be less than $5,000. If you wish to proceed with your withdrawal or rollover, please complete the
remainder of this form and return it to us at the above address.
Your Government Super at Work
Any financial product advice in this document is general advice only and has been prepared without taking account of your personal objectives, financial situation or needs. Before acting
on any such general advice, you should consider the appropriateness of the advice, having regard to your own objectives, financial situation or needs. You may wish to consult a licensed
financial advisor. You should obtain a copy of the CSCri Product Disclosure Statement (PDS) and consider its contents before making any decision regarding your super.
Commonwealth Superannuation Corporation (CSC) ABN: 48 882 817 243 AFSL: 238069 RSEL: L0001397
Commonwealth Superannuation Corporation retirement income (CSCri) is offered by CSC,
the trustee of the Public Sector Superannuation accumulation plan (PSSap) ABN: 65 127 917 725 RSE: R1004601
Industry Fund Services (IFS) ABN 54 007 016 195 AFSL 232514
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Before you complete this form
>> Contact us on 1300 736 096 during business hours to:
>> confirm how much you can withdraw or roll over from your account
>> receive a pre-payment statement detailing the tax components of your withdrawal and/or rollover.
>> Read your CSCri Product Disclosure Statement (PDS) available to view and download at cscri.gov.au
Expert financial advice for your situation
Speak to a licensed financial planner to receive advice for your own objectives, financial situation and needs.
The Commonwealth Superannuation Corporation (CSC) has partnered with Industry Fund Services to make an
advice service available to you. To find out more, please visit csc.gov.au/advice
To book your first appointment please call 1300 277 777 during business hours.
Section A – Confirm your personal details
Member number
Personal information (as currently displayed on your account)
Title
Mr
Mrs
Ms
Miss
Other
Surname
Given name(s)
Residential address
Suburb
D
Date of birth
State
D
M
/
M
Y
Y
Y
Postcode
Y
/
Section B – Nominate your withdrawal or rollover option
I wish to: (please choose ONE
option only)
Make a partial lump sum withdrawal (cash payment to me)
Go to Section C
Make a partial rollover to another complying superannuation fund
Go to Section D
Section C – Provide your withdrawal payment details
Partial lump sum withdrawal amount
Note: The maximum amount by law that you can withdraw each year is 10% of your CSCri account balance
which covers all types of withdrawals – income stream payments, lump sum withdrawals and partial rollovers.
This is your maximum annual withdrawal amount. It is calculated on the day your income stream commences
in your first year (and is not pro-rated) and 1 July for every year thereafter. Please note that if you wish to make
a lump sum withdrawal, it must also be no less than $5,000.
To confirm how much you can withdraw, please call us on 1300 736 096 during business hours.
Please make my partial lump sum payment to me as follows:
Amount:
$
. 0 0
Section C continued on next page
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Payment method
I wish to receive my lump sum withdrawal as:
Electronic payment into the same bank account used for my regular income
stream payments
Cheque sent to the postal address nominated on my account
Electronic payment into my bank account as follows:
Name(s) in which your account is held
Name of your bank/financial institution
Account number
BSB
–
Note: Your benefit can only be deposited into an account held in your name or jointly in your name.
Only an Australian financial institution with a BSB number will be accepted. We will not be liable for any
errors that occur based on the account details you provide.
If the electronic payment to the above account is unsuccessful, we will issue a cheque payable to you and
send it to the postal address we hold for your CSCri account on-file.
Investment option drawdown (if in two or more options)
Complete this section to indicate from which investment option or mix of options your partial lump sum amount will
be withdrawn. You should only complete this part if you wish to make a partial withdrawal and your CSCri account
balance is currently invested in two or more investment options.
Cash
$
. 0 0
Income Focused
(default option)
$
. 0 0
Balanced
$
. 0 0
Aggressive
$
. 0 0
Total
$
. 0 0
Please ensure your total amount is the same as the
lump sum withdrawal amount you listed above.
Section D – Provide your rollover payment details
Rollover amount
Note: The maximum amount by law that you can withdraw each year is 10% of your account balance which
covers all types of withdrawals – income stream payments, lump sum withdrawals and partial rollovers.
This is your maximum annual withdrawal amount. It is calculated on the day your income stream commences
in your first year (and is not pro-rated) and 1 July for every year thereafter. Please note that if you wish to roll
over a partial amount, it must also be no less than $5,000.
To confirm how much you can roll over, please call us on 1300 736 096 during business hours.
Please roll over part of my CSCri account balance to another complying super fund as follows:
Amount:
$
. 0 0
Section D continued on next page
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Your other superannuation fund
Fund name
Phone
Postal address
Suburb
State
Postcode
Your membership number
Unique Superannuation
Identifier (USI)
Australian Business
Number (ABN)
Cheque made payable to:
Investment option drawdown (if in two or more options)
Complete this part of the form to indicate from which investment option or mix of options your partial rollover amount
will be withdrawn. You should only complete this part if you wish to make a partial rollover (not a full rollover) and
your account balance is currently invested in two or more investment options.
Cash
$
. 0 0
Income Focused
(default option)
$
. 0 0
Balanced
$
. 0 0
Aggressive
$
. 0 0
Total
$
. 0 0
Please ensure your total amount is the same as the partial rollover amount you listed above.
Section E – Declaration
By signing this request form I am making the following statements:
>>
>>
>>
>>
I have read and understood the CSCri PDS
I declare that, to the best of my knowledge, the information I have provided on this form is true and correct
I authorise CSCri to transfer and/or pay my benefit as instructed on this form
I discharge the Commonwealth Superannuation Corporation, the trustee of PSSap through which CSCri
is offered, from all further liability in respect of the benefits transferred and/or paid
>> I am aware that personal information I or a third party provide, such as my employer, is collected, held,
used and disclosed as required or authorised by law in accordance with the privacy policies and notice,
available via cscri.gov.au or by contacting us on 1300 736 096, for the purpose of managing my super.
This includes the management of superannuation investments, providing me with superannuation
products and information, the administration of my account, conducting market research and product
development. The privacy policies and notice contain important information about how personal
information is handled, including rights to access and update that information and how a complaint
about a breach of privacy can be made.
Signature
Date signed
D
D
M
/
M
Y
Y
Y
Y
/
Please send your completed form to:
CSCri
Locked Bag 8840
Wollongong NSW 2500
email
phone
financial advice
post
[email protected]
1300 736 096
1300 277 777
web
overseas callers
fax
cscri.gov.au
+61 2 4298 6052
1300 304 241
CSCri
Locked Bag 8840
Wollongong NSW 2500
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