Rollover Request Authorisation

  • I declare I have read this form and the information completed is true and correct.
  • I request and consent to the transfer of superannuation benefits as described above and authorise the superannuation provider of each fund to give effect to this transfer.
  • I understand that the trustee of the fund nominated in (2) ‘From-Fund details (paying institution)’ is discharged from any liability in respect of the amount transferred per this form.
  • I authorise Zurich Australia Limited trading as OnePath Life (“OnePath”) to arrange for the rollover of funds as and when required, and for the amount required, to meet OneCare premium payments due for insurance held in respect of my life. These amounts may include current and ongoing premium payments, and any adjustments which may occur from time to time.
  • I acknowledge this enduring authority allows for subsequent rollovers to be requested, as required, for the purpose of paying insurance premiums. The authority will remain effective until such time as I revoke it in writing.
  • To the best of my knowledge, my other superannuation fund(s) is a complying superannuation fund under the Superannuation Industry (Supervision) Act 1993 (Cth).
  • The Retirement Portfolio Service (the Fund) is a regulated and complying superannuation fund under the Superannuation Industry (Supervision) Act 1993 (Cth).
  • I consent to change my premium frequency to an annual frequency (if applicable).
  • I understand I may be eligible for a rollover rebate, which will reduce the amount of the rollover required to meet the premium amount due, and that the availability of the rollover rebate may be withdrawn in the future.
  • I am aware I may ask my superannuation provider for information about any fees or charges that may apply, or any other information about the effect this transfer may have on my benefits, and do not require any further information.
  • I approve the deduction of any applicable transfer fees, exit fees and taxes from my account with the nominated super fund in addition to the benefit being transferred (subject to legislative restrictions).
  • I understand conditions apply to the transfers the Trustee can accept, and if a transfer is rejected because the conditions are not met, I will make alternative arrangements to pay the premium for OneCare Super. The conditions that apply to transfers include the following:
    • the rollover amount, plus any rollover rebate, must equal the premium due.
    • only rollovers on which any applicable fund tax has already been paid can be accepted. The rollover will be rejected if it contains, in whole or in part, an Untaxed Element of a Taxable Component.
    • rollovers which contain foreign transfer amounts (including UK transfers) or KiwiSaver amounts cannot be accepted.
  • I understand that if I cancel or change my policy, any prorata premium refund or reimbursement will not be paid to me but will be paid into my nominated superannuation fund accumulation account unless I nominate a different fund at the time the refund is processed, and the Trustee will retain a corresponding pro-rata amount of any rollover rebate applied.
  • I understand that I am transferring an amount from my superannuation accumulation account to pay OneCare Super life insurance premiums and therefore my superannuation account balance and retirement savings may be reduced.
  • I understand that each superannuation fund has differing rules such as imposing a minimum rollover amount, and I am aware of all possible member entitlements that I will lose by transferring an amount from my superannuation accumulation account, such as the cancellation of any life insurance cover I have attached to that accumulation account.
  • I acknowledge that my superannuation fund may have particular processing requirements that if not satisfied may prevent or delay the processing of rollovers, and it is my responsibility to ensure any requirements of which I am notified are provided.
  • I understand that where I intend to claim a tax deduction for any contributions I have made to the super fund nominated in this form, it is my responsibility to lodge the required notice of intention with the fund’s trustee, before any rollovers are processed, otherwise I may be prevented from claiming the deduction on the full amount of the contributions.
  • I understand that I may seek advice regarding the implications of rolling over amounts from a super fund with a service period start date earlier than the start date of my OneCare Super membership for tax payable on death and disability benefits payable from OneCare Super, and do not require further information.
  • I consent to the collection, use, storage and disclosure of my personal information as described in the Privacy Policies and the Privacy Statement(s) contained in the PDS (including discussing any information obtained from me and any doctors or accountants with the financial adviser associated with this application). OnePath’s Privacy Policy is available at onepath.com.au/about-us/privacy-policy and OnePath Custodians’ Privacy Policy is available at onepathsuperinvest.com.au/about-us/privacy-policy
  • If I have provided personal information about any identified person, I declare that I have their permission to do so and I have informed them of the Privacy Policies and the Privacy Statement(s).
  • I acknowledge that Zurich Australia Limited trading as OnePath Life (“OnePath”) ABN 92 000 010 195 AFSL 232510 is a company within the Zurich Financial Services Australia Group of companies comprising Zurich Financial Services Australia Limited ABN 11 008 423 372 and its related bodies corporate. OnePath Custodians Pty Limited (OnePath Custodians) ABN 12 008 508 496 AFSL 238346 RSE L0000673 is the trustee of the Retirement Portfolio Service ABN 61 808 189 263 (the Fund) and the issuer of OneCare Super. OnePath Custodians is a member of the Insignia Financial Group of Companies comprising Insignia Financial Ltd (formerly known as IOOF Holdings Ltd) ABN 49 100 103 722 and its related bodies corporate (Insignia Financial Group). Zurich Australia Limited is not a related body corporate of OnePath Custodians or any other company in the Insignia Financial Group.