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Com.au Transfer Authorisation Form This form is used when you want us to arrange for your some or all of your other superannuation accounts to be transferred into your EmPlus Super account. 1. YOUR DETAILS Your Full Name Your Address Your Date Of Birth Your Member Number Your Email Address Your Mobile Number 2. 1. YOUR DETAILS Your Full Name Your Address Your Date Of Birth Your Member Number Your Email Address Your Mobile Number 2. DETAILS OF THE ACCOUNT TO BE TRANSFERRED INTO EMPLUS SUPER Fund Name Fund Address Fund Unique Superannuation Identifier USI Fund ABN Your Member/Policy number for the account Fund Telephone Number Amount To Be Transferred Full Amount Specified amount. p PO Box 3528 Tingalpa DC Qld 4173 t 1800 336 911 f 07 3899 7299 e info emplus. com*au w www. emplus. com*au Transfer Authorisation Form This form is used when you want us to arrange for your some or all of your other superannuation accounts to be transferred into your EmPlus Super account. 1. YOUR DETAILS Your Full Name Your Address Your Date Of Birth Your Member Number Your Email Address Your Mobile Number 2. DETAILS OF THE ACCOUNT TO BE TRANSFERRED INTO EMPLUS SUPER Fund Name Fund Address Fund Unique Superannuation Identifier USI Fund ABN Your Member/Policy number for the account Fund Telephone Number Amount To Be Transferred Full Amount Specified amount. 3. MEMBER S DECLARATION By signing this form you the EmPlus Super USI ETL0196AU member whose details are provided above and whose signature appears below declare authorise the Trustee of the EmPlus Superannuation Fund to make arrangements with your previous super plan to have the benefits transferred into your account in this plan and understand that this notice is irrevocable request that any contributions received after payment of your benefit be redirected to your account understand that the Trustee of your previous fund is discharged from any further liability in respect of any amount once benefits have been Payment ETP approve the deduction of transfer fees if any from the benefits transferred subject to legislative restriction are aware that you may ask the Trustee of your previous fund for all the information that you need to understand your benefit entitlements in your previous fund including information on the fees insurance cover investment options and the effect of a transfer AND you do not require any further information Super. Member s Signature Date EmPlus ABN 18 838 658 991 RSE Registration Number R1067880. Issued by the trustee Equity Trustees Limited ABN 46 004 031 298 AFS Licence No 240975 RSE Licence No L0003094. p PO Box 3528 Tingalpa DC Qld 4173 t 1800 336 911 f 07 3899 7299 e info emplus. com*au w www. emplus. com*au Transfer Authorisation Form This form is used when you want us to arrange for your some or all of your other superannuation accounts to be transferred into your EmPlus Super account. DETAILS OF THE ACCOUNT TO BE TRANSFERRED INTO EMPLUS SUPER Fund Name Fund Address Fund Unique Superannuation Identifier USI Fund ABN Your Member/Policy number for the account Fund Telephone Number Amount To Be Transferred Full Amount Specified amount. 3. MEMBER S DECLARATION By signing this form you the EmPlus Super USI ETL0196AU member whose details are provided above and whose signature appears below declare authorise the Trustee of the EmPlus Superannuation Fund to make arrangements with your previous super plan to have the benefits transferred into your account in this plan and understand that this notice is irrevocable request that any contributions received after payment of your benefit be redirected to your account understand that the Trustee of your previous fund is discharged from any further liability in respect of any amount once benefits have been Payment ETP approve the deduction of transfer fees if any from the benefits transferred subject to legislative restriction are aware that you may ask the Trustee of your previous fund for all the information that you need to understand your benefit entitlements in your previous fund including information on the fees insurance cover investment options and the effect of a transfer AND you do not require any further information Super.

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