Super Manager

Important information before beginning your rollover request

This form can be used to request a rollover to/from your SMSF. Please ensure you carefully read the form and fill in all required fields accurately. If the information is incorrect or does not match ATO and sending / receiving APRA fund’s records, this may delay the processing of the rollover.

Please be advised that you must provide confirmation from the receiving APRA fund of the rollover being received. This must be provided when the member requesting the rollover is under preservation age or has reached preservation age and not retired.

Section 1 - Fund Details

Name of Fund

Section 2 – Member Details

Given Name

Last Name

Address

Suburb

State

Postcode

Date of Birth

Phone

Section 3 – Rollover Amount

Are you rolling into or out of your SMSF?

Rolling into your SMSFRolling out of your SMSF

Rollover Date

Requested rollover amount type

Requested rollover amount

Section 4 – Fund Details

Name of Fund

Address

Suburb

State

Postcode

ABN

USI

Member ID

Section 5 – Declaration

By signing the below declaration I as a trustee/member of the fund:

Acknowledge that I am requesting the rollover of the above be made to/from my SMSF.

Acknowledge that I have not received any advice from Australian Super Manager in regards to the rollover.

Declare that the information I have provided in this form is true, correct, and complete.

Request that Australian Super Manager provide the necessary documentation/ information to complete the necessary changes to certain third parties as needed.

Understand that Australian Super Manager may collect, use, and disclose the information in this form to third parties as needed.

Declare that once this rollover is complete if my balance is Nil I will cease to be a member of the SMSF.