NOMINATION OF BENEFICIARY INVESTMENT GROWTH BOND
INVESTMENT GROWTH BOND
NOMINATION OF BENEFICIARY.
Please note: if the policy is established as a Child Advancement Policy, you cannot nominate a beneficiary.
Please provide us with your policy number (if known)
SECTION 1
SECTION 2
Bond Owner 1
What is your address?
State Postcode
SurnameTitle
Entity/company/trust name
Entity/company/trust name
Charity, corporation or trust name
Given name(s)
Date of birth
/ /
Date of birth
/ /
Bond Owner 2
What is your address?
State Postcode
SECTION 3
I wish to (please indicate ())
Cancel all current beneficiary nominations for this policy
Nominate the following beneficiaries, in addition to any existing beneficiaries
Replace any existing beneficiaries with the following new beneficiaries
SurnameTitle Given name(s)
Nominated beneficiary 1
004-237 310715 (BRC25)
What is your beneficiary’s address?
State Postcode
Date of birth
/ /
Split %
%
Relationship
SurnameTitle Given name(s)
Issued by The Colonial Mutual Life Assurance Society Limited ABN 12 004 021 809 AFSL 235035 (CMLA).
‘CommInsure’ is used under licence by CMLA.
003-886 011119 (BRC25)
45Investment Growth Bond
SECTION 3 (CONTINUED)
SECTION 4
Beneficiary Nomination Rules
Under Section 48A of the Insurance Contracts Act 1984 your
valid nomination will ensure that death benefit proceeds payable
under the policy will be paid in the designated portions directly to
the nominated beneficiary/ies, which may include a Life Insured
or his/her estate.
Y
our nomination is subject to the following rules:
A nominated beneficiary can be a natural person, charity,
corporation or trust.
Conditional nominations cannot be made.
You may change a nominated beneficiary or revoke a previous
nomination at any time prior to a claim event occurring.
If a nominated beneficiary dies before a claim is made under
the policy and no change in nomination has been made, then
any money payable will be paid to the nominated beneficiary’s
legal personal representative.
If ownership of the policy is assigned to another person
or entity, then any previous nomination is automatically
superseded (i.e. the nomination is revoked).
A nominated beneficiary has no rights under the policy, other
than to receive the nominated policy proceeds after a claim has
been admitted by CMLA. He or she cannot authorise or initiate
any policy transaction.
Date
/ /
SECTION 5
Declaration
I/We have read and understand and accept the beneficiary nomination rules on this form and in the PDS.
I/We understand that this nomination;
will apply to my Policy with CMLA until cancelled by me/us
where indicated replaces any previous nomination made to CMLA
may be cancelled at any time by writing to CMLA.
Signature of Bond Owner 1
Date
/ /
Signature of Bond Owner 2
Please mail this application to
Investment Growth Bond - Alterations PO Box 320, Silverwater NSW 2128
Nominated beneficiary 2
What is your beneficiary’s address?
State Postcode
Date of birth
/ /
Split %
%
SurnameTitle Given name(s)
Relationship
Charity, corporation or trust name
Nominated beneficiary 3
SurnameTitle Given name(s)
What is your beneficiary’s address?
State Postcode
Date of birth
/ /
Split %
%
Relationship
Charity, corporation or trust name
Nominated beneficiary 4
SurnameTitle Given name(s)
What is your beneficiary’s address?
State Postcode
Date of birth
/ /
Split %
%
Relationship
Charity, corporation or trust name
003-886 011119 (BRC25)
Issued by The Colonial Mutual Life Assurance Society Limited ABN 12 004 021 809 AFSL 235035 (CMLA).
‘CommInsure’ is used under licence by CMLA.
46 Investment Growth Bond
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