KS10 0420
Opt-out request
April 2020
KiwiSaver Act 2006
Use this form to opt out if you have been automatically enrolled, are a minor who was incorrectly enrolled, and you don’t want to
be a member of KiwiSaver. Or go to
to complete our online form.
Read the notes on the back to help
you ll in this form
Section A
Personal details
1. Your IRD number
If you don’t know your IRD number or you don’t have one, call us on 0800 549 472
2. Your name Mr Mrs Miss Ms Other
Put a dash to indicate your title
First names
3. Your postal
Street number Street address or PO Box number
Suburb, box lobby or RD
Town or city Postcode
4. Your contact
Day Mobile
5. Your email
If you give an email address you may receive KiwiSaver information by email
6. Bank account
Bank Branch Account number Suffix
Name of account holder
7. I wish to opt out
of KiwiSaver
Day Month Year
Section B
Employment details
8. Employer’s
If you don’t have your employer’s IRD number ask them for it.
9. Employer’s
business name
10. Employment
start date
Give this form to your employer or send it to Inland Revenue.
Day Month Year
Section C Late opt-out Read the notes on the back of this form
11. If your request to opt out is more than eight weeks after you started employment, or you are a minor who was incorrectly
enrolled, give a reason for your late opt-out request.
Use this form if:
if you are a new employee who wants to opt out of KiwiSaver
if you were incorrectly enrolled in KiwiSaver under 18 years
of age
You can opt out on or after day 14 and on or before day 56 of
starting new employment.
You can’t opt out in the rst 13 days.
Every time you start new employment, you’ll need to opt out
Complete the form then, either:
give this form to your employer so they can stop deductions
immediately (for prompt return of your contributions, your
employer can direct refund any KiwiSaver deductions they
haven’t sent to us), or
send this form to Inland Revenue—see address below.
If you were under 18 and enrolled in KiwiSaver without the
consent of a parent or legal guardian, you may be able to opt out:
with the consent of a legal guardian if you’re under 16
without the consent of a legal guardian if you’re between 16
and 18.
Send your completed form conrming the reason you’re opting
out (Section C), and your parent or legal guardian’s written
consent (if required) to Inland Revenue at the address below.
Late opt-out request
We may accept late opt-out applications if:
your employer didn’t give you a KiwiSaver information pack
within seven days of starting employment
we didn’t send you an investment statement when we’ve
allocated you to a default scheme
your employer didn’t give you an investment statement (for
their chosen KiwiSaver scheme)
events outside your control meant you couldn’t give us your
opt-out application within the eight-week time limit
you chose to opt in or were opted in to KiwiSaver but you did
not meet the criteria to (see Employee information pack -
KS3 for criteria)
you were incorrectly enrolled under the age of 18.
Note: Give this form to your employer, or send it directly to
InlandRevenue, if you are making a late opt-out application. Your
request can only be considered if it’s received by InlandRevenue
or your employer within three months from the day Inland
Revenue receives your rst contribution. We will advise you if
your opt-out request has been accepted or declined.
Minors incorrectly enrolled
enrolled before your 18th birthday without the necessary
guardians/parents consent
Have not reached your 19th birthday
under 16 years old will need the consent from a parent or
legal guardian to opt out
complete the panel at the bottom of the form with reasons
why you can opt out and attach consent from parent or legal
guardian if you are under 16.
We will send conrmation as to whether your opt out has been
approved or not.
We will also advise your employer. If approved your employer
will stop deductions.
Either Inland Revenue or your employer will refund any
deductions that have been made.
Bank account details
We need your bank account details so we can direct credit any
KiwiSaver funds we are holding for you to your bank account.
If you don’t have these details, send the form to us anyway.
You’ll nd more information in your
Employee information
pack - KS3
or by going to ird.govt.nz/kiwisaver
Meeting your tax obligations means giving us accurate
information so we can assess your tax and entitlements under
the Acts we administer. We may charge penalties if you do not.
We may also exchange information about you with:
some government agencies
another country, if we have an information supply agreement
with them, and
Statistics New Zealand (for statistical purposes only).
You can ask for the personal information we hold about you.
We’ll give the information to you and correct any errors, unless
we have a lawful reason not to. Find our full privacy policy at
What an employer should do with this completed
Send this form to Inland Revenue no later than the next time
you’re required to send an Employment information - IR348
to Inland Revenue at the address below, or you can send the
information electronically in your Payroll returns account in
myIR. Go to ird.govt.nz/myIR to register.
Send this completed form to:
Inland Revenue
PO Box 39090
Wellington Mail Centre
Lower Hutt 5045
For more information about KiwiSaver go to
ird.govt.nz/kiwisaver or call us on 0800549472.