Commonwealth PensionSelect
Notification of change of details
You may lodge this form by posting to:
Commonwealth Financial Services
GPO Box 3306
SYDNEY NSW 2001.
Alternatively, you can fax this form to 1800 002 715.
Please note: Changes will be made effective the date your completed documentation is received at our principal
office of administration.
New name*
Section A – Personal (to be completed in all cases together with Section H)
Given name(s) Surname
Email address
Postal address
State Postcode
Given name(s) Surname
Daytime phone number
Evening phone number
Mobile number
Section C – Change of address and contact details
New street address
State Postcode
New postal address
State Postcode
Email address
Daytime phone number
Evening phone number
Mobile number
Section B – Change of name*
Account number
(If changing your name and/or address, please write your name and/or address last notified to Commonwealth Financial Services.)
* Please attach evidence i.e. certified copy of Deed Poll, Marriage Certificate, etc. We cannot accept a fax for your
name change.
Old signature
New signature
Title
Mr
Mrs Miss Ms Other
Title
Mr
Mrs Miss Ms Other
Equity Trustees Superannuation Limited ABN 50 055 641 757 AFSL 229757 (ETSL)
The Colonial Mutual Life Assurance Society Limited ABN 12 004 021 809 AFSL 235035 (CMLA)
‘Commonwealth Financial Services’ is used under licence by CMLA.
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Section D – Nomination of beneficiary (non–binding)
Please () tick the appropriate box, complete details and sign in Section H.
Indicate how you would like your benefit to be paid
I wish to nominate a beneficiary on my account (please read the section ‘Important information about beneficiary
nominations’ and then complete ‘Indicate how you would like your benefit to be paid’ below) and/or
I wish to revoke any previous beneficiary nomination made in respect of my account
Who is a dependant?
Under the Fund Trust Deed, a dependant includes:
a spouse, including a person (whether of the same or a different sex) with whom you are living on a genuine domestic basis in a
relationship as a couple and a person with whom you are in a relationship registered under State or Territory law
a child of any age (including an adopted child, step child or an ex-nuptial child, a child of your spouse and your child within the
meaning of the Family Law Act 1975)
a person with whom you have an interdependency relationship
a person financially dependent on you.
Under superannuation law, an ‘interdependency relationship’ will exist where two people (whether or not related by family) meet
all of the following conditions:
they have a close personal relationship
they live together
one or each of them provides the other with financial support, and
one or each of them provides the other with domestic support and personal care.
There may also be an interdependency relationship where two people have a close personal relationship and either or both of
them suffer from a physical, intellectual or psychiatric disability. In this circumstance, there is no requirement for cohabitation or
for provision of financial or domestic support.
Important information about beneficiary nominations
Do not complete this section if you have a reversionary beneficiary (binding) in place. This information is available on your
Annual Statement or simply call 13 2015, between 8.30am and 6pm (Sydney time), Monday to Friday.
Please note: Upon notification of your death, we will move your whole account balance to the Commonwealth Savings
investment option. Your benefit will remain in this investment option until such time as the Trustee makes a decision as to who
will receive your benefits.
The Trustee has absolute discretion when distributing death benefits but will take your nomination into account. You may
nominate anyone who is a ‘dependant’ as defined in the Trust Deed and/or your estate (i.e. your legal personal representative).
If the person whose name is specified below differs from a previous appointment made by you, the previous appointment(s) will
be automatically revoked.
Lump sum nomination
Full name
Relationship to your (spouse, child,
interdependant, financial dependant) Date of birth
Share of
benefit
%
%
%
%
My Estate (i.e. legal personal representative) %
100%
Pension nomination (a pension cannot be paid to your Legal Personal Representative)
Full name
Relationship to your (spouse, child,
interdependant, financial dependant) Date of birth
Share of
benefit
100%
Although children generally qualify as dependants, a child aged 18 or over can only receive a pension if the child is financially
dependent on you at your death and under age 25, or suffers from certain types of disability. Where a child aged 18 or over receives a
pension, unless the child suffers from a relevant disability, the pension must be cashed as a lump sum when the child turns 25.
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Section F – Payment frequency
Please alter the frequency of my pension payments to:
(If a change prevents payment of minimum annual income an additional ‘Special’ payment may be required)
Monthly
Quarterly
Half yearly
Yearly
Fortnightly Please nominate day of payment
M T W T F
Section G – Payment instructions
BSB Account identification number
Bank Branch
Please credit my account
Name of account
Section H – Declaration and acknowledgement
I declare that the information provided on this form is correct;
I request that your records be updated to reflect the changes indicated.
Member’s signature Date
Section E – Gross pension amount per annum/indexation rate
Please note: pension payment being received must be above the legislated minimum levels.
Please alter my pension payment as follows. Please () tick the appropriate box.
Minimum pension
or per annum per payment
Specified amount
$
or
$
Optional Annual Indexation Rate
(0–5%) whole numbers only
(max 5%)
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