Section A - Personal information

Member names as it appears in original documentation

Section B - Beneficiaries and Guardian(s) Details

Complete Section B overleaf

For official use only

Beneficiaries Details

I hereby request the Trustees to pay any benefits which shall become due to me under the Trust Deed and Rules of the Fund to the beneficiaries detailed below in the proportion(s) indicated against the name of each beneficiary.

Beneficiaries


Add Beneficiaries

Guardian Details

In the event that children are under the age of 18 years and you wish to appoint a guardian for them, indicate the details of the Guardian(s) below:



Member Declaration

I the undersigned, recognize that my circumstances and those of the persons shown above as beneficiaries may change. I undertake to advise the Trustees when any change should be made regarding my nominated beneficiaries. I understand that this form amounts to an expression of my wishes only and that it is not binding on the Trustees. I further understand that this nomination nullifies any previous nominations completed and submitted to the Trustees.