EAFR02
Commonwealth
income support
To qualify for early access to your super
benefit, at the date of application you must
have been in receipt of Commonwealth
income support payments for a continuous
period of 26 weeks, or for 39 weeks
since reaching your preservation age.
Tax File Number
Under the Superannuation Industry (Supervision) Act 1993, CSC is authorised to collect, use and disclose your
tax file number. We may disclose your tax file number to another superannuation provider when your benefits
are being transferred, unless you request to us in writing that your tax file number not be disclosed to any other
superannuation provider. Declining to quote your tax file number is not an offence, however giving your tax file
number to us will have the following advantages:
• we will be able to accept all permitted types of contributions to your account/s;
• other than the tax that may ordinarily apply, you will not pay more tax than you need to - this affects
both contributions to your superannuation and benefit payments when you start drawing down your
superannuation benefits; and
• it will make it much easier to find different superannuation accounts in your name so that you receive
all your superannuation benefits when you retire.
B
How much do you need released?
Please enter the amount you need to meet your reasonable and immediate family living expenses. We can only approve
one release in any 12 month period. The maximum amount that can be released is $10,000 (before tax).
The amount I am requesting to be released is
Or
I am over Preservation Age, have been in receipt of Commonwealth income support payments for at least
39 weeks since reaching my Preservation Age, and request
To find out your preservation age, refer to the Early Access factsheet.
C
Centrelink consent
Complete this section if you are in receipt of Commonwealth
income support payments through Centrelink.
Note: You are not required to complete this
section if you are supplying a DVA income
statement with your application. Proceed to Section D.
I,
Customer Reference
Number (CRN)
authorise:
• Commonwealth Superannuation Corporation (CSC) and/or Mercer Administration Services to use Centrelink
Confirmation eServices to perform a Centrelink enquiry of my customer details;
• Services Australia (the agency) to provide the results of that enquiry to CSC and/or Mercer Administration Services.
I understand that:
• the agency will disclose information to CSC and/or Mercer Administration Services based on whether I have been
in receipt of a qualifying Centrelink payment for a specified period to confirm my eligibility for early release of
superannuation on financial hardship grounds;
• the agency will disclose to CSC and/or Mercer Administration Services my personal information, including my name,
date of birth and payment status;
• this consent, once signed, remains valid while I am a customer of CSC, unless I withdraw it by contacting CSC,
Mercer Administration Services or the agency;
• I can get proof of my circumstances/details from the agency and provide it to CSC and/or Mercer Administration
Services so that my eligibility for early release of superannuation on the grounds of financial hardship can
be determined;
• if I withdraw my consent or do not alternatively provide proof of my circumstances/details, I may not be eligible
for the early release of superannuation on the grounds of financial hardship provided by CSC or Mercer
Administration Services.
SIGNATURE
Date signed
D D M M Y Y Y Y
/ /
$
net (after tax) to be released.
Sign
$
net (after tax).
4 of 10
