Mercer Self-Managed Super Service Application form

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Mercer Self-Managed Super Service Application form

Please print in black or blue pen, in uppercase, one character per box.

A

✓

Important information regarding completion of this form

Establishing a self-managed super fund is a very important financial decision. Not only do you need to decide if it is the right decision for you but you also need to make some decisions about how to structure your fund. Prior to completing this form we recommend you seek advice from a qualified professional such as a lawyer and/or a financial adviser to help you decide if it’s the right decision for you and how it should be structured.

For example you need to decide whether your fund should have a corporate trustee, individual trustees or be a single member fund. You also need to consider who should be the Principal which is the person(s) with the power to appoint and remove the Trustee and, in the case of a corporate trustee, who should be the shareholders. This application form assumes you have obtained advice on these and all other relevant matters.

Purpose of this form

The purpose of this form is so that we can obtain sufficient details to enable us to provide you with an Establishment Package which will contain all the information and forms necessary to establish your fund and corporate trustee if you have elected to have one.

The Establishment Package will be provided in accordance with the details provided by you on this form so it is important they are correct, and in the case of directors/individual trustees that the people named have consented and are qualified to act.

Contact details:

Telephone 1800 650 430

Mail Mercer Self-Managed Super

Locked Bag 1100 Edgecliff NSW 2027

Email [email protected] Internet mercerwealthsolutions.com.au

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Self-managed super fund name (e.g. Jones Family Super Fund)

There are no statutory naming standards for self-managed super funds. Two self-managed super funds may have the same fund name.

Self-managed super funds have unique statutory numbers (ABN) not names. Therefore, you can call your fund whatever you like. However, it is common that the words ‘Superannuation Fund’ or ‘Retirement Fund’ are used.

Fund name

Contact Person

The name of the contact person who the regulator (ATO) may contact, at first instance, about the fund.

Title Mr Mrs Ms Miss Dr Given name(s)

Surname

Delivery address for Establishment Package and invoice Title Mr Mrs Ms Miss Dr Given names

Surname

Street address

Suburb State Postcode

Telephone Mobile

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E-Mail

Step 2 – Contact details

Step 1 – Complete your fund details

Please print in black or blue pen, in uppercase, one character per box. ^A ^✓

Start

her e

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Under the Mercer Self-Managed Super trust deed, the Principal is the person or persons empowered to appoint or remove the Trustee.

You can have more than one person assume the role of Principal. A Principal may also perform the role of Trustee.

Principal 1

Title Mr Mrs Ms Miss Dr Date of birth / / Given names

Surname

Street address

Principal 2

Title Mr Mrs Ms Miss Dr Date of birth / / Given names

Surname

Street address

Where there are more than two Principals, please attach the above information for each Principal. The Principal may be those persons nominated or their personal representatives, heirs, assigns or successors, in the event of the death of the Principal. This is an important concept and can have consequences if one or more of the Principals dies as their representative would assume the role and may have control over the appointment and removal of the Trustee.

The Trustee(s) is responsible for the fund. A self-managed super fund can have a corporate trustee or individual trustees. The requirements which your fund must comply with under relevant legislation differ depending on what structure you choose. There are also requirements which must be met if your fund is a single member fund.

Please indicate if the Trustee is to be a company or individual(s) Company Please complete sections A and B

OR

Individual Please complete section B only

Continued over

Step 3 – Principal(s) details

Step 4 – Trustee(s) details

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SECTION A

Where the Trustee is to be a company the Mercer Self-Managed Super Service includes establishment of the company with your chosen company name, directors, shareholders etc in place. You will be provided with all the necessary forms to enable this to occur in the Establishment Package. At this stage we just need the proposed name to make sure it is available and so we can provide you with the appropriate fund Establishment Package.

Preferred company name (e.g. Jones Family Super Fund Pty Ltd)

Please note we are required to search the ASIC register of company names to make sure this name, or a name similar to it is not already in use by another company. If none of the proposed names below are available we will contact you and you will need to choose another name.

First preference Second preference Third preference Registered office

Telephone Fax

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SECTION B Trustee/Director 1

Title Mr Mrs Ms Miss Dr Date of birth / / Gender Male Female

Town/city of birth

Country of birth

Given names

Surname

Street address

Telephone Fax

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E-Mail

Will this person also be a member of this self-managed super fund?

No or Yes

Step 4 – Trustee(s) details (Continued)

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Trustee/Director 2

Town/city of birth

Country of birth

Given names

Surname

Street address

Telephone Fax

- -

E-Mail

No or Yes Trustee/Director 3

Town/city of birth

Country of birth

Given names

Surname

Street address

Telephone Fax

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Step 4 – Trustee(s) details (Continued)

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Town/city of birth

Country of birth

Given names

Surname

Street address

Telephone Fax

- -

E-Mail

No or Yes

Have you received a Statement of Advice in regards to the Mercer Self-Managed Super Service from a Mercer financial adviser?

No. Please proceed to the Signature section OR

Yes. Please complete the section below Adviser surname

Given names

Authorised Rep #

Street address

Telephone Fax

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E-Mail

Step 4 – Trustee(s) details (Continued)

Step 5 – Financial adviser details

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By signing below, I/we declare that I/we:

have received, read and understood the Financial Services Guide for the Mercer Self-Managed Super Service dated December 2010 (FSG).

have obtained advice from a qualified professional such as a lawyer and/or a financial adviser on all relevant matters in regards to the establishment of a self-managed super fund.

agree to acquire the Mercer Self-Managed Super Service as described in the FSG and understand this includes both the Establishment Services and the Administration Services.

agree to the cost of the Establishment Services referred to in the FSG and wish to proceed with establishment of a self-managed super fund and where requested corporate trustee, in accordance with the information entered on this Application.

agree to the cost of the Administration Services referred to in the FSG and understand that the Trustee(s) indicated in Section B of this Application will be required to enter into an Administration Service Agreement detailing these services .

Trustee/Director 1 Signature

7

Date / /

Signature

7

Date / /

Signature

7

Date / /

Signature

7

Date / /

Please make cheque payable to ‘Mercer Self-Managed Super’ and send the cheque and completed Application form to:

Mercer Self-Managed Super Locked Bag 1100

Edgecliff NSW 2027

Step 6 – Signatures

Don’t forget to sign and return this form.

You should also keep a copy for your records.

Issued by Mercer (Australia) Pty Ltd ABN 32 005 315 917 as corporate authorised representative No 260851 of Mercer Investment Nominees Limited ABN 79 004 717 533 Australian Financial Services (AFS) Licensee #235906. Mercer Wealth Solutions and the petal logo are registered trademarks of MINL. Mercer financial advisers are authorised representatives of MINL.