WORK TEST DECLARATION

<<SMSF_Member_Name>>
<<SMSF_Name>>

<<Current_Date>>
To
The Trustee(s)
<<SMSF_Name>>
<<SMSF_Address>>

I hereby declare that I am aged between 67 and 74 years, both years inclusive, and have satisfied the work test requirement of having been gainfully employed for at least 40 hours in a period of 30 consecutive days during the financial year ending 30 June <<Audit_Year>>. The SMSF can accept my employer and/or personal contribution for the financial year ending 30 June <<Audit_Year>>.

<<Signature of SMSF_Member>>
-------------------------------------------
<<SMSF_Member_Name>>