FF516 -
Who should complete this form?
Please use this form to apply for a retirement withdrawal and/or set up a regular withdrawal from your Fisher Funds
KiwiSaver Scheme or Fisher Funds TWO KiwiSaver Scheme account (“KiwiSaver account”).
You can make a retirement withdrawal once you’ve reached the age of 65*. You do not have to withdraw all or any of
your KiwiSaver savings immediately when you retire and there are many options (see Section 5) to help you with your
retirement objectives. If you choose to do nothing your savings will continue to be invested as they are currently and you
can even continue to add to your account if you wish.
If you would like help in completing this form, please email kiwisaver@fi
sherfunds.co.nz or phone us on
0800 FF KIWI (0800 335 494).
You can complete this form on-screen by typing directly into each field. Once you have completed this form:
If you have selected Option 1 as your preferred identification method and the value of your withdrawal is under $50,000
you can email your completed application to kiwisaver@fisherfunds.co.nz
If you have selected Option 2 as your preferred identification method you must post your application and supporting
documents to Fisher Funds Management Limited, Private Bag 93502, Takapuna, Auckland 0740 or send by courier to
Fisher Funds Management Limited, Crown Centre, 67-73 Hurstmere Road, Takapuna, Auckland 0622.
If the value of your withdrawal is over $50,000 you must post or courier your application and supporting documents to us.
Withdrawal Form
Section 1: Your Details
Title First Name/s
Date of Birth KiwiSaver Account No. IRD Number
Prescribed Investor Rate (PIR) (please tick one)
10.5% 17.5% 28%
To work out your PIR, or for more information, visit fisherfunds.co.nz/pircalculator or call us on 0508 347 437.
If your selected PIR differs to the rate we have on file, the change will require 1 business day to update before your withdrawal
can be processed. If you do not select a PIR, your withdrawal will be processed at the rate we hold on file for this account.
City Country Postcode
Home Phone Work Phone Mobile
Email Address
( ) ( ) ( )
*If you joined KiwiSaver (or a complying fund) before 1 July 2019, a 5 year minimum membership requirement applies
if you were aged 60 or over when you joined. During the 5 year minimum membership period you are entitled to the
Government contribution, and compulsory employer contributions if you are contributing from your wages or salary.
Once you’ve reached the age of 65 you can opt out of this requirement and make a partial or full withdrawal, however
if you do so you will forego your entitlement to the Government contribution and compulsory employer contributions.
Tick this box to opt out of the 5 year minimum membership requirement
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Section 2: Identification Options
Your withdrawal request must be submitted with one of the identification options set out below. We may have your
identification documents on file, please contact us to confirm this. We may need to request new identification documents
from you.
Option 1 – Electronic identity verification
Fisher Funds has the ability to electronically verify your identity and address. Once we have received your withdrawal
request we will send you an SMS via our third party partner to biometrically verify your identity. To complete this method
of verification you must have: a smartphone (with a front camera that is capable of taking a photo/video) and a current
(not expired) version of one of the following:
» New Zealand Passport
» New Zealand Drivers Licence
» Australian Passport
» Australian Drivers Licence
If this method of identification is unsuccessful you will be required to provide certified ID and proof of address.
Option 2 – Certified copies of identity documents and proof of residential address
Please provide a certified copy of your identity documents and proof of your residential address. Refer to Sections 3 and
4 for information on acceptable identity documents and who can certify them.
Preferred identification method — please select one of the following options:
Option 1 – I would like Fisher Funds to electronically verify my identity
Option 2 - I would like to provide Fisher Funds with certified copies of my identity documents
Section 3: Certified Identity Documents
If you selected Option 2 as your preferred way for us to verify your identity please select one of the certified identification
options below. If you have selected Option 1 you do not need to provide certified ID now.
We are only able to accept original certified copies of certified ID (i.e. the copy that has been physically certified).
These documents must be posted to us, our postal address is on page 1.
Passport (containing name, date of birth,
photograph and signature)
New Zealand Firearms Licence
New Zealand Driver Licence (front and back)
OPTION A: (preferred)
Full Birth Certicate
AND one of the following
18+ Card/Kiwi Access Card
Overseas Drivers Licence
Your photo identification must be current (not expired). If you’re unable to provide the above documentation please contact us
to discuss other options.
A Fisher Funds representative can verify your identity documents if you visit our office.
* If you are supplying foreign identity documents you must also supply proof of New Zealand residency to enable us to conrm your eligibility to join / have joined KiwiSaver.
FF516 -
I certify this to be a true copy of the original document
and confirm it represents the identity of Joe Smith.
Jane Doe
Occupation: Justice of the Peace
Date: 18/08/2020
Please note: Certification is valid for three
months and must have been carried out
within three months of this application.
Your identity documents must be certified
by one of the following people: Justice of
the Peace, Registered Lawyer, Chartered
Accountant, Registered Teacher, Registered
Doctor, Police Officer, Notary Public,
Registrar/Deputy Registrar.
Photocopy ID at 150%
So the details are legible.
Please do not send in your physical
identity documents e.g. passport,
driver’s licence, birth certificate etc.
How to have your ID correctly certified
Mr Joe Smith
58 Green Street
New Zealand
19 XXXX 2020
Dated in the last 12 months, an invoice,
statement, letter or contract from:
» utility provider e.g. water, power, phone
» professionals e.g. accountant, doctor
» service providers e.g. Sky TV, insurance
» government e.g. IRD, WINZ, rates notice
» current employer e.g. payslip
» bank correspondence or statement
» tenancy agreement
Please note: We cannot accept a statement/correspondence
from Fisher Funds as proof of your address.
Current physical address
Can’t be a PO Box number.
Section 4: Proof of Address
If you have selected Option 2 as your preferred identification method please provide proof of your residential address
as set out below. Your proof of address doesn’t have to be certified. If you selected Option 1 you do not need to provide
proof of address.
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Section 5: Your Withdrawal Options
If you are submitting this form prior to your eligibility date, your withdrawal will begin processing from the date of eligibility.
Partial Withdrawal
Withdraw $ (minimum withdrawal amount is $500)
Regular Withdrawal
We require at least two business days to set up a regular withdrawal from receipt of this withdrawal request.
Set up a regular withdrawal facility $
Start Date Frequency
Weekly Fortnightly Monthly Quarterly Annually
*Please note this is the date your withdrawal will be priced, it will then be paid 3-5 working days after this date. Please
bear this in mind if you want to receive the funds by a certain date.
If you are invested in more than one Fund we will withdraw an amount from each Fund in line with the proportion in
which are you currently invested in each Fund. Alternatively, please contact us on 0800 FF KIWI (0800 335 494) to discuss
how you would like your withdrawal deducted.
Full Withdrawal
Withdraw my full account balance and close my KiwiSaver account
Your final Government contribution claim will be processed by Inland Revenue before your withdrawal is actioned,
so payment may take up to 15 working days from receipt of this form.
(minimum withdrawal amount is
$100 regardless of frequency)
Transfer my Balance
If you would like to transfer your KiwiSaver account balance to another Fisher Funds investment please call us on
0800 FF KIWI (0800 335 494) to discuss the options available and how we can help you.
Section 6: Payment Details
We will only make payments in New Zealand dollars to a New Zealand bank account in your name (held individually or
jointly). Any payment will be adjusted for tax at the notified Prescribed Investor Rate (PIR) on your account.
Name of Bank Account
Account Number
Bank Branch Account Number Suffix
Name of Bank and Branch Address
Please provide proof of your bank account (one of the following)
» Bank statement
» Internet banking screenshot
» Over the counter receipt with a teller’s stamp
The proof of bank account must contain the account name, number and the logo of your bank.
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Section 8: Privacy Statement
Any information that you provide to us may be used by Fisher Funds and the Supervisor and any of their respective
related entities, and by other service providers to provide services in relation to your withdrawal request. You have the
right to access the information held by us and you may also request that it be corrected.
Section 7: Confirmation of New Zealand Residency
If you have previously completed the following confirmation of New Zealand residency and statutory declaration
you do not need to do it again.
When you request a KiwiSaver withdrawal for any reason, you must complete a statutory declaration confirming
whether your principal place of residence was New Zealand for the period of your KiwiSaver membership. Going
overseas on a holiday, even for several months is not considered a change of principal residence, however if you lived
or worked overseas and received KiwiSaver Government contributions, we must refund that portion of the Government
contributions back to Inland Revenue.
I confirm that for the period that I have been a member of KiwiSaver, my principal place of residence was New Zealand
except for the periods:
From To From To
From To From To
My principal place of residence has been New Zealand for the entire period I have been a KiwiSaver member
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Section 9: Statutory Declaration
A Statutory Declaration is a written statement that allows a person to declare something to be true. This page will need
to be completed in front of an authorised person who will witness the declaration.
Who can witness me making the declaration?
The following people can witness you making the declaration
Notary Public
Justice of the Peace
Enrolled solicitor or barrister of the high court
Registrar/Deputy Registrar
Name of KiwiSaver member
Address Occupation
solemnly and sincerely declare that:
I am applying to withdraw or transfer some or all of my KiwiSaver account. I understand that on full payment of my
KiwiSaver account, my account will be closed and I agree to release all claims that have been made by me on the
Manager and/or Supervisor in relation to my KiwiSaver account.
I understand that my withdrawal value may fluctuate based on the unit price(s) which applies when the withdrawal
is processed and that fees, taxes and expenses may be deducted from my KiwiSaver account.
I am entitled to make this withdrawal request and the information given in this form is true and correct. I
acknowledge that the Manager and the Supervisor will rely on information provided in (or in connection with) this
form and accordingly agree to indemnify them against any claims, liability, losses, damages, costs and expenses
whatsoever which may arise directly or indirectly as a result of any information provided in (or in connection with)
this form being untrue or misleading (including omission).
I understand that the Manager and/or Supervisor will not be able to complete its assessment of this withdrawal if
the information given in this form is incomplete or incorrect.
I understand the information supplied by me with this withdrawal request can be used to electronically verify my
identity and address (where necessary) and may be disclosed for these purposes to third parties where relevant.
I have read the privacy statement in this form.
I make this solemn declaration conscientiously believing the same to be true and by virtue of the Oaths and Declarations
Act 1957.
Your Signature
Declared at
Address Date
Before Me
Please complete the checklist on the next page
FF516 -
Please compete the checklist below and supply the relevant documents to support your request.
Complete Section 1.
Select a preferred identification method in Section 2 and provide evidence (refer to Sections 2, 3 & 4)
Select your withdrawal option(s) – refer to Section 5
You have provided your payment details and provided proof of your bank account – refer to Section 6
Confirm your New Zealand residency – refer to Section 7
Complete the Statutory Declaration in front of a Justice of the Peace, enrolled Solicitor or Barrister, Registrar/
Deputy Registrar of the District or High Court
Provide the original of this completed form (only if you have selected Option 2 as your preferred Identification
method or the value of your withdrawal is over $50,000)