How to complete this authority – Member to complete
This information may not apply to the current year. Check the content carefully to ensure it is applicable to your circumstances.
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Section A: Your details
Provide any of your personal details that we have not completed to ensure your super fund can identify you correctly.
Section B: Your super fund's details
Provide your super fund and membership details to ensure your super fund can identify your account.
Only include a nominated amount you want withdrawn from your super fund at question 13, if the amount is less than the full excess non-concessional contributions tax amount because:
- you are withdrawing amounts from more than one super fund to pay the total amount of tax
- you do not have enough funds in your super accounts (other than defined benefit interest funds) to pay the total amount of tax.
You must release the full amount of tax owed from your super interests (other than defined benefit interest).
You must choose who you want your super fund to pay the amount to. If you choose for the amount to be paid to us, we will apply the amount to your excess non-concessional contributions tax debt. If you choose for the amount to be paid to you, you will have to make arrangements to pay your excess non-concessional contributions tax debt to us.
You should contact your super fund for more information if:
- you have more than one account
- you are requesting your fund to make the payment to you, but you have not previously identified a preferred payment method.
If you want amounts withdrawn from more than one super fund, you must complete a separate authority for each fund. You can do this by photocopying the authority and nominating the amount to be withdrawn from each fund.
You must provide an original signature on each copy of the authority you use.
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Section C: Member authorisation
Print your full name, and sign and date the authorisation.
Last modified: 26 Aug 2015QC 21076
Get it done
When you have completed sections A, B and C, send the authority to the super fund you nominated in section B. Do not send the form to us. Your super fund will forward the form to us after they have completed sections D and E.
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