Superannuation
Application for withdrawal: Full payment of
superannuation for temporary residents
Information sheet
When to use this form
Use this form to claim your superannuation benefits under the
Eligible Temporary Resident Visa condition of release.
Important: We can only complete your claim after your
visa has expired or we have evidence that your visa has
been cancelled.
Required certified documents
Please provide the following documents together with this
form when claiming your superannuation benefits:
Certified copies of the pages of your passport showing:
–– your name, date of birth, photo and passport number
–– your entry visa to Australia
–– the date of your final departure from Australia.
If you no longer have a passport, you will need to provide a
certified copy of one of the following:
–– national identity card—issued by a foreign government, the
United Nations or an agency of the UN—which contains
your photograph and signature.
–– foreign driver’s licence, issued in your name and containing
your photograph.
Note: If the foreign document is in a language that is not
English, it must be accompanied by an English translation
prepared by an accredited translator.
Visa Cancellation
If you have departed before the expiry date of your
visa without cancelling your visa, you can contact the
Department of Immigration and Border Protection to cancel
your visa. Once your visa has been cancelled, please send the
original or certified copy of the notification letter confirming
the cancellation.
If your balance is more than $5,000 or you are unable to
provide a copy of your visa, please enclose a Certification of
Immigration Status and/or request to cancel a Temporary
Resident visa (form 1194) as evidence of your eligibility.
You can contact the Department of Immigration and Border
Protection at immi.gov.au to obtain this form.
Issue date: 6 October 2014
AMP Superannuation Limited (ASL) ABN 31 008 414 104, AFSL No. 233060
®Registered trademark of AMP Life Limited ABN 84 079 300 379
What is a certified copy?
A certified copy is a document that has been certified as a true
copy of the original document by one of the following:
–– Australian Consular Officer or Australian Diplomatic Officer
(within the meaning of the Consular Fees Act 1955)
–– bailiff
–– bank officer with 2 or more continuous years of service
–– building society officer with 2 or more years of continuous
service
–– clerk of a court
–– Commissioner for Affidavits
–– Commissioner for Declarations
–– credit union officer with 2 or more years of continuous
service
–– employee of the Australian Trade Commission who is:
–– in a country or place outside Australia, and
–– authorised under paragraph 3(c) of the Consular Fees Act
1955, and
–– exercising his or her function in that place
–– employee of the Commonwealth of Australia who is:
–– in a country or place outside Australia, and
–– authorised under paragraph 3(c) of the Consular Fees Act
1955, and
–– exercising his or her function in that place
–– finance company officer with 2 or more years of continuous
service
–– judge of a court
–– Justice of the Peace
–– magistrate
–– master of a court
–– member of the Australian Defence Force who is:
–– an officer, or
–– a non-commissioned officer within the meaning of the
Defence Force Discipline Act 1982 with 5 or more years of
continuous service
–– notary public
–– registrar or deputy registrar of a court
–– sheriff
–– sheriff’s officer
–– teacher employed on a full-time basis at a school or tertiary
education institution.
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Taxation information
As you are not retiring in Australia, the tax concessions your
superannuation has received will be returned to the Australian
Government though a special withholding tax. A Payment
summary detailing your superannuation components and the
tax withheld will be issued to you with your payment. Please
note that your Tax File Number (TFN) is not required to process
your benefit.
AMP is responsible for remitting this tax to the Australian
Taxation Office (ATO).
Tax File Number (TFN) notification
We are required to tell you the following details before you
provide your Tax File Number (TFN) for your superannuation
products. The Trustee can collect your TFN under the
Superannuation Industry (Supervision) Act 1993. You are under
no obligation to provide your TFN, either now or later, and it is
not an offence to not quote your TFN.
However, if you don’t provide your TFN:
–– Any Employer Contributions will have the “no-TFN tax”
applied at the rate of 31.5%. This is in addition to the
current mandated contribution tax of 15%. “No-TFN tax”
may be refunded if the TFN is supplied within 4 years of the
end of the financial year in which the contribution is made.
Any refund will be added to your superannuation benefit
and will be subject to the usual cashing and taxing rules.
–– We may have to withhold more tax than we would
otherwise have to on your superannuation lump sum
benefits if you do not provide your TFN. This additional tax
may be able to be re-claimed in your next tax assessment
with the ATO.
–– We cannot accept personal or spouse contributions (non-
concessional) and certain other types of contributions into
your superannuation plan.
–– In the future, when we need to pay benefits to you, it may
be more difficult for us to locate or amalgamate all the
superannuation benefits you are entitled to.
–– The consequences of not providing your TFN may change in
the future as a result of further legislative changes.
If you provide your TFN, we will treat it as confidential and use
it for purposes, including:
–– to find your superannuation benefits, where other
information is insufficient
–– to ensure you can continue to contribute to your plan
–– to calculate tax on any superannuation benefits you may
be entitled to
–– if we are paying unclaimed money, we must give your TFN
to the Commissioner of Taxation
–– also, we may give your TFN to the Commissioner of
Taxation if you receive a benefit, or for the purposes of the
Lost Members’ Register.
These purposes may change in the future as a result of further
legislative changes. More information about the use of tax file
numbers for superannuation changes can be obtained from
the ATO Superannuation Hotline on 13 10 20.
Please retain this information sheet for your records.
Do not return it with your completed form(s).
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Application for withdrawal: Full payment of superannuation for
temporary residents
Use this form to claim your superannuation benefits under the Eligible Temporary Resident Visa condition of release.
Please print in CAPITAL LETTERS and place a cross ✗ in any applicable boxes.

1.  Plan details1 2.  Member details continued

Plan number Phone number (include country and area code)

Plan name Mobile number (include country code)

1 CustomSuper, SignatureSuper and SuperLeader employer plans only. Email address

2.  Member details

Fax number (country and area code)
Member number

Occupation (if retired please specify)

Do you have other AMP member accounts?
No
Industry (if applicable)
Yes—please provide details:
Member number
Country of residence

Member number Country of citizenship

Member number
Address for communications

Please cross ✗ if same as residential address.
Note: You will need to complete additional Application for
withdrawal: Full payment of superannuation for temporary Address
residents form/s if your other member account(s) are in
different AMP superannuation trusts. Please refer to the
latest Product Disclosure Statement on amp.com.au for
superannuation trust details.
Title Date of birth Note: Please ensure you provide your full address
  D D MM Y Y Y Y
(eg state/province/region, postal/zip code and country).
Surname 3.  Immigration details

Passport number when you last departed Australia

Given name(s)

Visa class Date of last departure

Residential address (a PO Box is not acceptable)
  D D MM Y Y Y Y

! Certified copies of your passport and visa must be

enclosed with this form. Refer to the information sheet
for full details.
Note: Please ensure you provide your full address
(eg state/province/region, postal/zip code and country).
Issue date: 6 October 2014
AMP Superannuation Limited (ASL), ABN 31 008 414 104, AFSL No. 233060
®Registered trademark of AMP Life Limited ABN 84 079 300 379 1 of 4
 4.  Providing your Tax File Number (TFN)
I confirm that I have read the TFN notification information
in the information sheet and agree to provide my TFN.
My Tax File Number (TFN) is:
I have read the TFN notification information in the
information sheet and I do not wish to quote my Tax File
Number. I understand that by choosing not to provide
my TFN, any payment made directly to me will have tax
deducted at the maximum rate, as required by legislation.
5.  Payment method
How do you wish your payment to be made?
! Proceeds are paid to the member and usually processed
within 5 working days after all relevant information is
received however delays may occasionally occur.
Cheque
Note: The cheque will be sent to the address for
communications
Payment to my Australian bank account:
Name of financial institution
Address of financial institution
Name of account holder
BSB number
Account number
Payment to my overseas bank account:
Name of financial institution
Address of financial institution
Name of account holder
Account number
Swift code
Routing number Currency2
2 We will try to accommodate your nominated currency where possible
6.  Authorisation and declarations
By signing this form, I am making the following statements:
–– I request AMP Superannuation Limited to process my
withdrawal request and pay the proceeds in accordance
with my instructions on this form.
–– I understand that AMP Superannuation Limited can refuse
my withdrawal request:
–– if I have not provided the proof of identity, or
–– if I have not completed the form correctly or fully.
–– I understand that AMP Superannuation Limited will use the
unit price applying on the date my withdrawal request is
received following receipt of all relevant information.
–– I declare that:
–– I take full responsibility for my withdrawal application.
In particular, I have fully read and understood the
information sheet enclosed with this form.
–– I am not commonly known by any names different to
those disclosed in this application form, unless I have
disclosed otherwise to AMP Superannuation Limited.
–– any document or information to be used for the purposes
of this application:
–– is complete and correct
–– if it is about another person, is provided with the
authority of that person (if required) and may be used
for any other products, services or benefits offered or
provided to me/us by or through AMP Superannuation
Limited or any other company in the AMP group.
Note: If you wish to check any information before signing,
you may request a copy of this information from your
financial adviser or AMP Superannuation Limited.
–– I acknowledge that it may be a criminal offence to
knowingly provide false or misleading information or
documents in connection with this application.
–– I am aware that I may ask AMP Superannuation Limited for
all the information that I need to understand my benefit
entitlements in my existing AMP plan (including
information on the fees, insurance cover, investment
options and the effect of a transfer) and I do not require
any further information.
–– I have sought advice from my financial adviser or have
decided not to seek advice.
–– I discharge AMP Superannuation Limited from all further
liability in respect of the benefits paid or transferred.
–– I acknowledge that AMP will determine the final amount
payable and the withholding tax.
–– I am aware that an exit fee may apply to withdrawals from
the MySuper option.
Member’s signature
✗
Date
D D MM Y Y Y Y
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 Checklist Where to send this form:

Have you: Mail this completed form together with your original
  provided your plan details (if relevant) in section 1? certified documents to:

  provided your member details in section 2? CustomSuper

 completed additional applications if your other member AMP Corporate Super
account(s) are in different AMP superannuation trusts Locked Bag 5400
(if relevant)? PARRAMATTA NSW 1741
  completed your immigration details in section 3? AUSTRALIA
 attached the necessary documentation as described in the
information sheet? SignatureSuper
 confirmed your TFN (or indicated that you do not wish to AMP Corporate Super
provide it) in section 4? Locked Bag 5043
  provided your preferred payment method in section 5? PARRAMATTA NSW 2124

  read and signed section 6 authorisation and declaration? AUSTRALIA

 if you are under 18, completed the Under 18 Declaration

form? SuperLeader
AMP Corporate Super
Locked Bag 5095
PARRAMATTA NSW 2124
AUSTRALIA

All other superannuation products

AMP Life Limited
PO Box 300
PARRAMATTA NSW 2124
AUSTRALIA

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