RFA Withdrawal benefit claim form: Paid-up members January 2018 Page 1 of 2
Retirement Fund Administration
Withdrawal benefit claim form: Paid-up members
This benefit claim form is for members who:
left their money in the fund previously (when they left the service of their employer),
have not yet reached retirement age, and
now wants to withdraw their money.
A. Member’s personal particulars
Fund name
Title and initials Full names and surname
ID nr / Passport nr Date of birth Income tax number Member number
Contact number (home) Contact number (cell)
e-mail address (this will be our main means of communicating directly with you)
Home address
Postal address
Name of bank Account holder Account number Branch code
Savings Cheque Transmission
Please note the following:
Payments cannot be made to credit card or bond accounts
Payments cannot be made to a third party
Payments cannot be split into different bank accounts
Code
Code
RFA Withdrawal benefit claim form: Paid-up members January 2018 Page 2 of 2
Please select one of the payment options below: Pension Provident
Fund Fund
1. Transfer full benefit to a Pension Fund, Provident Fund, Retirement
Annuity Fund or a Preservation Fund (e.g. the Sanlam Plus
Preservation Fund)
(Please provide the application forms of the applicable receiving fund
separately)
2. Pa
y a portion of the benefit in cash and transfer the balance to a
Pension Fund, Provident Fund, Retirement Annuity Fund or a
Preservation Fund (e.g. the Sanlam Plus Preservation Fund)
(Please provide the application forms of the applicable receiving fund
separately)
Indicate the % or R amount to be paid in cash:
(The % or R amount will be the gross amount before tax)
OR
Indicate the R amount to be transferred:
3. Pay full benefit in cash (The benefit will be subject to tax)
C. Declaration by the member
I, the undersigned member, hereby confirm that:
- The information given herein is true and correct.
- I am the account holder on the above-mentioned bank account.
- I instruct and authorise Sanlam to pay all monies due to me in accordance with my instructions above.
- I understand that upon payment in terms of my above instructions, the Fund will have no further
liabilities in respect of me.
_________________
__________ ___________________________
Member’s Signature Date
Pl
ease e-mail the completed documentation to SEBClientCare@sanlam.co.za
%
R
or
%
R
or
R
R
New form
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome