APPLICATION BY MEMBER TO COMMUTE PENSION AND 
ADD TO ACCUMULATION ACCOUNT

To Trustees,
<<FundName>>
<<Fund_Address>>                                                       			Date: <<Date>>

I hereby request the trustees that my existing Account Based Pension in <<FundName>>			be commuted back into accumulation mode. The details are as below:
TERMS	DETAILS	
DATE TO STOP PENSION
(COMMUTATION)	<<Date when pension has to be commuted>>
	
TYPE OF PENSION	<<Account Based Pension>>
	
START DATE OF ORIGINAL PENSION	<<DATE>>	
PURCHASE PRICE OF PENSION AT COMMENCEMENT	
<<$        >>
	
TAX FREE COMPONENT AT COMMENCEMENT	<<$        >>
	
WHETHER REVERSIONARY	<< YES/NO >>
	
NAME OF REVERSIONARY BENEFICIARY	
<<FULL NAME>>	
DATE OF BIRTH OF REVERSIONARY BENEFICIARY	
<<DATE OF BIRTH>>	
RELATIONSHIP	<<SPOUSE/PARENT/CHILD>>
	
CLOSING BALANCE ON DATE TO STOP PENSION	<<$        >>	
TAX FREE COMPONENT AT COMMUTION DATE	<<$        >>	

Yours Faithfully
<<Signature of Member>>
_____________________________________
<<NAME OF MEMBER>>

MINUTES OF THE MEETING OF THE <<FundName>>		 	HELD ON THE <<DATE >> AT <<SingleLineFund_Address>>

PRESENT:	<<SMSFMember1>> (Chairperson)
<<SMSFMember2>>
<<SMSFMember3>>
<<SMSFMember4>>	
REQUEST TO COMMUTE 
PENSIONS:	It was noted that <<NAME OF MEMBER>> has made an application to the trustees to commute/rollback the following pension to accumulation account for the member in the fund:

Pension                                              <<Pension Description>>
Date Commenced                              <<Date >>
Balance as on commutation date       <<$        >>
Tax free Component                           <<$        >>
Date of commutation                           <<Date >>
	
REQUEST ACCEPTANCE:	IT WAS RESOLVED to accept the member’s request to commute/rollback the Pension in accumulation account in the fund. It was also duly noted that the trust deed of the fund dated <<Date >> permits the internal rollover of pensions back into accumulation account in the fund.
	
DETERMINATION OF CAPITAL VALUE OF PENSION;	IT WAS RESOLVED to request the fund’s administrator to calculate the capital value of the pension that can be commuted, having regard to the minimum amount of the pension that must be paid for the period from 1st July of the financial year to << DATE JUST BEFORE ROLL BACK DATE>>.

After payment of the minimum amount, the capital value of the pension will then combine with the balance of the member’s accumulation account as on that date.	
		
PRODUCT DISCLOSURE STATEMENT	IT WAS RESOLVED by the trustees that the member has access to all the information that a product disclosure statement (PDS) would require to disclose and therefore no PDS will be issued pursuant to section 1012D (2A) of the Corporations Act 2001 (Cth). The member acknowledges that he is aware of his situation and has taken appropriate financial advice to commute his pension.	

<<Signature of SMSF Member1>>
<<Name of SMSFMember1>>
(CHAIRMAN )