Details of income stream product Instructions

Check this box if, for income streams purchased between 20 September 2004 and 31 December 2005, payments are made for a period that is at least the greater life expectancy of the primary beneficiary and their reversionary partner, and at most the greater life expectancy of both if they were five years younger, with all life expectancies rounded up to the next whole number on the income stream's commencement day. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream's payment period is at least as long as the primary beneficiary's life expectancy, rounded up to the next whole number if not a whole number. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream's payment period is at most the greater of a term based on the primary beneficiary (or their reversionary partner) living to 100 years from the income stream's commencement day, or the life expectancy of the primary beneficiary (or their reversionary partner) if they were 5 years younger (rounded up to the next whole number). Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Provide the account balance as at 1 July for the current financial year, or the income stream's opening balance if the current financial year includes the income stream's commencement day. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'

Please enter the account balance as of 1 July in the current financial year.

Check this box if, for each financial year within the income stream's term, the total amount of payments falls within 90% to 110% of the amount calculated by the SIS Regulations formula. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Tick this box if payments under the income stream are made at least annually throughout the life of the person.

Check this box if the income stream is not eligible to retain the asset test exempt status of the original income stream. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream is eligible to retain the asset test exempt status of the original income stream. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Enter the details explaining why the income stream is eligible to retain its asset test exempt status. Fill only if 'Yes' is 'Yes'.

Enter the day of the commencement date of the original asset test exempt income stream. Fill only if 'Yes' is 'Yes'.

Enter the month of the commencement date of the original asset test exempt income stream. Fill only if 'Yes' is 'Yes'.

Enter the year of the commencement date of the original asset test exempt income stream. Fill only if 'Yes' is 'Yes'.

Check this box if the income stream is not eligible to retain the asset test exempt status of the original income stream. Fill only if 'No' is 'No'.

Check this box if the income stream is eligible to retain the asset test exempt status of the original income stream. Fill only if 'No' is 'No'.

Provide the full name of the authorised officer.

Enter the position of the authorised officer within the organisation.

Provide the name of the company or organisation.

Enter the phone number of the authorised officer, including the area code.

Check this box to confirm that you have read, understood, and agree to the statements and terms presented in this document section.

Provide the authorised officer's signature.

Enter the day of the signature date.

Enter the month of the signature date.

Enter the year of the signature date.

Check this box if the income stream is provided to the primary beneficiary or their reversionary partner on the day of the primary beneficiary's death. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if the income stream's commencement date was the day it was purchased or acquired. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if neither the capital value of the income stream nor the income from it can be used as security for borrowing. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if, when the income stream reverts, its reversionary component is not greater than the account balance immediately before the reversion. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if, when the income stream is commuted, its commuted component is not greater than the account balance immediately before the commutation. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if the income stream has no residual capital value. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if the income stream's commencement date was the day it was purchased or acquired, depending on the scheme type.

Enter the two-digit day (DD) of the commencement date of the original asset test exempt income stream. Fill only if 'Yes' is 'Yes'.

Enter the two-digit month (MM) of the commencement date of the original asset test exempt income stream. Fill only if 'Yes' is 'Yes'.

Enter the four-digit year (YYYY) of the commencement date of the original asset test exempt income stream. Fill only if 'Yes' is 'Yes'.

Check this box if the commencement date of the income stream was the day it was purchased (if purchased) or acquired (for reversionary beneficiaries and defined benefit schemes not purchased). Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream can be commuted to the extent necessary to pay a person's spouse or former spouse under a payment split due to a property settlement or relationship breakdown, as defined by the Family Law Act 1975. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if the income stream cannot be transferred to another party, with the sole exception of a transfer upon the primary beneficiary's death. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if the income stream, purchased or acquired before 20 September 2004, cannot be transferred to another person, except to a reversionary beneficiary upon the death of the primary beneficiary, or upon the death of the reversionary beneficiary if the income stream is for both a primary and reversionary beneficiary. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream can be commuted to the extent necessary to pay a person's spouse or former spouse under a payment split due to a property settlement on marriage or de facto relationship breakdown, as defined by Part VIIIAA or Part VIIIB of the Family Law Act 1975. Fill only if 'Has the income stream been split as part of a property settlement on marriage or de facto relationship breakdown?' is 'Yes'.

Check this box if there have been no commutations since the income stream commenced. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if there have been commutations since the income stream commenced, and then provide the requested details below. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if you have not made any commutations since purchasing the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if you have made commutations since purchasing the income stream and need to provide details below. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Provide a detailed explanation of the commutations made since the income stream was purchased. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if there have been no commutations since the income stream commenced.

Check this box if there have been commutations since the income stream commenced and you need to provide details.

Provide the total monetary amount that has been commuted since the income stream commenced. Fill only if 'Yes' is 'Yes'.

Check this box if there have been no commutations since the income stream commenced, and you wish to go to the next question. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'

Check this box if there have been commutations since the income stream commenced, and you need to provide the details below. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'

Please provide details regarding any commutations that have occurred since the income stream commenced. Fill only if 'Yes' is 'Yes'.

Check this box if the income stream, when commuted, does not have a commuted component greater than the benefit that was payable immediately before its commutation.

Check this box if, when the income stream is commuted, its commuted component is not greater than the benefit that was payable immediately before the commutation. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream does NOT meet all the characteristics required under section 9A or 9B of the Social Security Act 1991, as they applied before 20 September 2007. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream DOES meet all the characteristics required under section 9A or 9B of the Social Security Act 1991, as they applied before 20 September 2007. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Please provide a detailed explanation of the condition of release that was met. Fill only if 'Yes' is 'Yes'.

Please enter the total amount of funds currently held in the account. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'

Please enter the current account balance. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'

Please provide the day for the date the account balance was recorded. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'

Please provide the month for the date the account balance was recorded. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'

Please provide the year for the date the account balance was recorded. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'

Please provide the first part of the customer's reference number.

Please provide the second part of the customer's reference number.

Please provide the third part of the customer's reference number.

Please provide the fourth part of the customer's reference number.

Please provide the customer's family name.

Please provide the customer's first given name.

Please provide the customer's second given name.

Please provide the day of the customer's date of birth.

Please provide the month of the customer's date of birth.

Please provide the year of the customer's date of birth.

Please provide the first line of the customer's permanent address.

Please provide the second line of the customer's permanent address.

Please provide the third line of the customer's permanent address.

Please provide the postcode for the customer's permanent address.

Please enter the percentage of the share owned by Customer 1. Fill only if 'Yes Joint Owner' is 'Yes'.

Please enter the day of the date the contract was signed.

Please enter the month of the date the contract was signed.

Please enter the year of the date the contract was signed.

Enter the day the contract was signed and is the same as the commencement date. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Enter the month the contract was signed and is the same as the commencement date. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Enter the year the contract was signed and is the same as the commencement date. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Please provide the day of the purchase. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Please provide the month of the purchase. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Please provide the year of the purchase. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Provide the day of purchase. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Provide the month of purchase. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Provide the year of purchase. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if the date of purchase (from question 25) is not before 20 September 2007. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the date of purchase (from question 25) is before 20 September 2007. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the death benefit value is not more than the amount allowed under SIS Regulations Capital Access Schedule. Fill only if 'Did you answer 'Yes' to any of question 11?' is 'Yes'.

Please provide the amount of the death benefit. Fill only if 'Did you answer 'Yes' to any of question 11?' is 'Yes'.

Check this box if the death benefit value is more than the amount allowed under SIS Regulations Capital Access Schedule. Fill only if 'Did you answer 'Yes' to any of question 11?' is 'Yes'.

Check this box if the income stream product is NOT related to defence force invalidity payments under the specified acts.

Check this box if the income stream product IS related to defence force invalidity payments under the specified acts.

Please enter the day of the Defined Benefit Income Stream commencement. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Please enter the month of the Defined Benefit Income Stream commencement. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Please enter the year of the Defined Benefit Income Stream commencement. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Please provide the gross amount of fortnightly payments before any deductions for the defined benefit income stream. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Please specify the amount of fortnightly payments made in respect of children. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Check this box if no earlier condition of release was met before reaching 65, such as retirement. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if an earlier condition of release was met before reaching 65, such as retirement. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Provide a description of the early release condition that was met. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the amount of the first commutation. Fill only if 'Yes' is 'Yes'.

Enter the day of the first commutation date. Fill only if 'Yes' is 'Yes'.

Enter the month of the first commutation date. Fill only if 'Yes' is 'Yes'.

Enter the year of the first commutation date. Fill only if 'Yes' is 'Yes'.

Enter the amount of the first commutation. Fill only if 'Yes' is 'Yes'.

Enter the day of the first commutation. Fill only if 'Yes' is 'Yes'.

Enter the month of the first commutation. Fill only if 'Yes' is 'Yes'.

Enter the year of the first commutation. Fill only if 'Yes' is 'Yes'.

Please enter the total amount that was commuted. Fill only if 'Yes' is 'Yes'.

Please enter the day of the commutation date. Fill only if 'Yes' is 'Yes'.

Please enter the month of the commutation date. Fill only if 'Yes' is 'Yes'.

Please enter the year of the commutation date. Fill only if 'Yes' is 'Yes'.

Please enter the total amount that was commuted for the first commutation. Fill only if 'Yes' is 'Yes'.

Please enter the day of the first commutation. Fill only if 'Yes' is 'Yes'.

Please enter the month of the first commutation. Fill only if 'Yes' is 'Yes'.

Please enter the year of the first commutation. Fill only if 'Yes' is 'Yes'.

Enter the monetary amount of the first payment made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the monetary amount of the second payment made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the monetary amount of the third payment made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the monetary amount of the fourth payment made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if the governing rules or contract specify the total amount of payments that may be made under the income stream in the first year after the commencement date, with allowances for commutations.

Check this box if the governing rules or contract specify the total amount of payments that may be made under the income stream in the first year after its commencement date, allowing for commutations. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Enter the amount of the fourth payment made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the day (DD) of the date of the fourth payment made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the month (MM) of the date of the fourth payment made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the year (YYYY) of the date of the fourth payment made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if the income stream was not purchased with funds resulting from the commutation of an asset test exempt income stream, or if the source of the funds is unknown. Fill only if 'No' is 'No'.

Provide details of the source of the funds if this income stream was purchased from the commutation of an asset test exempt income stream. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if the income stream was purchased with funds resulting from the commutation of an asset test exempt income stream. Fill only if 'No' is 'No'.

Provide the total gross annual payment amount the customer expects to receive during the financial year. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'

Enter the day on which the income stream reverted to the reversionary pension beneficiary. Fill only if 'Yes' is 'Yes'.

Enter the month on which the income stream reverted to the reversionary pension beneficiary. Fill only if 'Yes' is 'Yes'.

Enter the year on which the income stream reverted to the reversionary pension beneficiary. Fill only if 'Yes' is 'Yes'.

Check this box if the income stream was NOT purchased with superannuation money or paid from a SMSF or SAF.

Check this box if the income stream was purchased with superannuation money or paid from a SMSF or SAF.

Check this box if the income stream is an Account-based pension, also known as an Allocated Pension.

Check this box if the income stream is a Lifetime, Life Expectancy, or Term annuity/pension.

Enter the number of the next question to proceed to if the income stream is Account-based (Allocated Pension).

Check this box if the income stream is a Market-Linked pension, also known as a Term Allocated Pension.

Check this box if the income stream is a Defined Benefit as described in the introductory text.

Check this box if the income stream is a Military Invalidity Pension.

Check this box if the income stream is a Pooled Lifetime annuity/pension and it was purchased on or after 1 July 2019.

Check this box if the yearly indexation adjustment is capped at the greater of either 5% or the rate of increase in the consumer price index plus 1%, and payments cannot vary downwards. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Specify the method or value used as the base for calculating the increase in the income stream, such as CPI or a fixed value. Fill only if 'Yes' is 'Yes'.

Enter the day component of the next indexation date. Fill only if 'Yes' is 'Yes'.

Enter the month component of the next indexation date. Fill only if 'Yes' is 'Yes'.

Enter the year component of the next indexation date. Fill only if 'Yes' is 'Yes'.

Enter the percentage rate if the indexation is fixed. Fill only if 'Yes' is 'Yes'.

Please provide the basis used for calculating the increase in income stream payments, such as CPI or a fixed rate. Fill only if 'Yes' is 'Yes'.

Please enter the day of the next scheduled indexation of the income stream payments. Fill only if 'Yes' is 'Yes'.

Please enter the month of the next scheduled indexation of the income stream payments. Fill only if 'Yes' is 'Yes'.

Please enter the year of the next scheduled indexation of the income stream payments. Fill only if 'Yes' is 'Yes'.

Please enter the fixed indexation rate as a percentage if applicable. Fill only if 'Yes' is 'Yes'.

Check this box if the income stream payments are not indexed. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if the income stream payments are indexed and you will provide further details. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if the income stream is not indexed. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream is indexed. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Please provide the family name of the joint owner. Fill only if 'Yes Joint Owner' is 'Yes'.

Please provide the first given name of the joint owner. Fill only if 'Yes Joint Owner' is 'Yes'.

Please provide any second given name of the joint owner. Fill only if 'Yes Joint Owner' is 'Yes'.

Please enter the percentage share for the joint owner. Fill only if 'Yes Joint Owner' is 'Yes'.

Check this box if there is no joint owner for the annuities, and you will skip to question 8.

Provide any additional information or clarification regarding the joint owner status for an income stream purchased with superannuation money or paid from an SMSF or SAF.

Check this box if there is a joint owner for the annuities, and you will proceed to the next question.

Check this box if the income stream product is NOT provided as life insurance business by a life company registered under the Life Insurance Act 1995.

Check this box if the income stream product IS provided as life insurance business by a life company registered under the Life Insurance Act 1995.

Provide the day from which the Military Invalidity Pension entitlement was granted. Fill only if 'Indicate the type of income stream' is 'Military Invalidity Pensions'

Provide the month from which the Military Invalidity Pension entitlement was granted. Fill only if 'Indicate the type of income stream' is 'Military Invalidity Pensions'

Provide the year from which the Military Invalidity Pension entitlement was granted. Fill only if 'Indicate the type of income stream' is 'Military Invalidity Pensions'

Enter the day of the month when the income stream payments commenced. Fill only if 'Yes' is 'Yes'.

Enter the month when the income stream payments commenced. Fill only if 'Yes' is 'Yes'.

Enter the year when the income stream payments commenced. Fill only if 'Yes' is 'Yes'.

Provide the gross amount of each income stream payment before any deductions. Fill only if 'Yes' is 'Yes'.

Specify the frequency at which the income stream payments are made (e.g., month, quarter, year). Fill only if 'Yes' is 'Yes'.

Please provide the gross amount of each payment before any deductions. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Please specify the frequency of the payments, for example, 'month', 'week', or 'year'. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream payments have not yet commenced. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if the income stream payments have already commenced. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if the person's life expectancy is 15 years or more, and the payments are made annually for a period that is not less than 15 years but not more than the person's life expectancy, which can be rounded up to the next whole number of years, for income streams purchased before 20 September 2004. Fill only if 'Product Purchased Before 20 Sept 2004' is 'Yes'.

Check this box if, for income streams purchased or acquired on or after 20 September 2004, the person receiving the income stream is the primary beneficiary or their reversionary partner (if any) on the day of the primary beneficiary's death. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Please provide the official name of the product.

Please enter the unique reference number for the customer's income stream.

Check this box if the income stream has not been split as part of a property settlement on marriage or de facto relationship breakdown.

Check this box if the income stream has been split as part of a property settlement on marriage or de facto relationship breakdown.

Enter the full legal name of the provider.

Enter the first part of the Australian Business Number (ABN).

Enter the second part of the Australian Business Number (ABN).

Enter the third part of the Australian Business Number (ABN).

Enter the fourth part of the Australian Business Number (ABN).

Enter the first line of the provider's postal address.

Enter the second line of the provider's postal address.

Enter the postal code for the provider's address.

Check this box if the provider is not a Self Managed Superannuation Fund (SMSF) or a Small APRA Fund (SAF).

Check this box if the provider is a Self Managed Superannuation Fund (SMSF) or a Small APRA Fund (SAF).

Check this box if the income stream product is not under a public sector Superannuation Scheme.

Check this box if the income stream product is under a public sector Superannuation Scheme.

Check this box if the income stream was purchased or acquired before 20 September 2004 and the person had reached pension age on or before the day it was purchased or acquired. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the date of purchase, as entered in question 37, is NOT before 20 September 2007. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if the date of purchase, as entered in question 37, IS before 20 September 2007. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Enter the original price paid for the income stream, including fees but after tax has been deducted.

Enter the original price paid for the income stream, including fees but after tax has been deducted. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'

Check this box if the income stream is not a defined benefit scheme and the amount paid as the purchase price is entirely converted into income. Fill only if 'Indicate the type of income stream' is not 'Defined Benefit'.

Check this box if the income stream is not a defined benefit scheme and the entire purchase price has been converted into income. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Please provide the Relevant Number (RN), which is calculated at the date of purchase and must be a whole number. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'

Provide the Relevant Number (RN), which represents the life expectancy factor of the primary beneficiary, or the longer life expectancy factor if a reversionary pension beneficiary is nominated.

Enter the relevant number (RN) for the income stream, which must be a whole number if purchased on or after 20 September 2004. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Please provide the life expectancy of the primary beneficiary at the assessment day, or the older beneficiary if jointly owned. Fill only if 'Income Stream' is 'Yes'.

Enter the amount of capital that will be returned at the end of the term. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream does not have any residual capital value.

Check this box if the income stream has no residual capital value. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if you did not answer 'Yes' to any part of question 11.

Check this box if you answered 'Yes' to any part of question 11.

Check this box if the product is NOT a retirement savings account within the meaning of the Retirement Savings Act 1997.

Check this box if the product IS a retirement savings account within the meaning of the Retirement Savings Act 1997.

Check this box if the reversionary beneficiary is a child who is a full-time student over 16, and the income stream payments will continue until the end of their full-time studies or until they turn 25, whichever occurs sooner. Fill only if 'Is the customer the reversionary pension beneficiary to whom this income stream has automatically reverted following the death of the primary pension beneficiary?' is 'Yes'.

Check this box if the income stream's reversionary component is not greater than the benefit payable immediately before reversion when it reverts to a reversionary beneficiary. Fill only if 'Is the customer the reversionary pension beneficiary to whom this income stream has automatically reverted following the death of the primary pension beneficiary?' is 'Yes'.

Check this box if the product complies with the condition that if the income stream reverts to a reversionary beneficiary, it does not have a reversionary component greater than the benefit that was payable immediately before the reversion. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if there is no reversionary pension beneficiary nominated to whom this income stream will automatically revert following the death of the primary pension beneficiary.

Check this box if there is a reversionary pension beneficiary nominated to whom this income stream will automatically revert following the death of the primary pension beneficiary.

Check this box if the customer is not the reversionary pension beneficiary to whom this income stream has automatically reverted following the death of the primary pension beneficiary.

Check this box if the customer is the reversionary pension beneficiary to whom this income stream has automatically reverted following the death of the primary pension beneficiary.

Enter the day of the month when the income stream payments are scheduled to commence. Fill only if 'No' is 'Yes'.

Enter the month when the income stream payments are scheduled to commence. Fill only if 'No' is 'Yes'.

Enter the year when the income stream payments are scheduled to commence. Fill only if 'No' is 'Yes'.

Enter the amount that was commuted for the second commutation. Fill only if 'Yes' is 'Yes'.

Enter the day of the second commutation date. Fill only if 'Yes' is 'Yes'.

Enter the month of the second commutation date. Fill only if 'Yes' is 'Yes'.

Enter the year of the second commutation date. Fill only if 'Yes' is 'Yes'.

Enter the total monetary amount of the second commutation. Fill only if 'Yes' is 'Yes'.

Enter the day of the date for the second commutation. Fill only if 'Yes' is 'Yes'.

Enter the month of the date for the second commutation. Fill only if 'Yes' is 'Yes'.

Enter the year of the date for the second commutation. Fill only if 'Yes' is 'Yes'.

Enter the total amount of the second commutation. Fill only if 'Yes' is 'Yes'.

Enter the day of the second commutation date. Fill only if 'Yes' is 'Yes'.

Enter the month of the second commutation date. Fill only if 'Yes' is 'Yes'.

Enter the year of the second commutation date. Fill only if 'Yes' is 'Yes'.

Enter the dollar amount of the second commutation. Fill only if 'Yes' is 'Yes'.

Enter the day of the second commutation. Fill only if 'Yes' is 'Yes'.

Enter the month of the second commutation. Fill only if 'Yes' is 'Yes'.

Enter the year of the second commutation. Fill only if 'Yes' is 'Yes'.

Enter the monetary amount of the second payment made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the day of the date the second payment was made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the month of the date the second payment was made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the year of the date the second payment was made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if neither the capital value of the income stream nor the income from it can be used as security for borrowing.

Check this box if the product complies with the condition that neither the capital value of the income stream nor the income from it can be used as security for borrowing. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream does not meet all the characteristics required under section 9BA of the Social Security Act 1991, as it applied before 20 September 2007. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if the income stream meets all the characteristics required under section 9BA of the Social Security Act 1991, as it applied before 20 September 2007. Fill only if 'Indicate the type of income stream' is 'Market-Linked (also known as Term Allocated Pension)'.

Check this box if the income stream was NOT purchased with funds resulting from the commutation of an asset test exempt income stream, or if the source of the funds is unknown. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Indicate if the source of funds for this income stream is unknown. Fill only if 'Yes' is 'Yes'.

Check this box if the income stream WAS purchased with funds resulting from the commutation of an asset test exempt income stream. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream does not have a special reduction amount. Fill only if 'Indicate the type of income stream' is 'Military Invalidity Pensions'

Check this box if the income stream has a special reduction amount and you need to provide further details. Fill only if 'Indicate the type of income stream' is 'Military Invalidity Pensions'

Enter the current amount of the tax free component per fortnight. Fill only if 'Yes' is 'Yes'.

Check this box if the governing rules or contract specify the total amount of payments in any year other than the first, with allowances made for indexation or certain commutations.

Check this box if the governing rules or contract specify the total amount of payments permitted in any year after the first, including allowances for indexation or certain commutations. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream has not been transferred from another provider under a Successor Fund Transfer arrangement.

Check this box if the income stream has been transferred from another provider under a Successor Fund Transfer arrangement.

Check this box if the income stream product is not regulated by the Superannuation Industry (Supervision) Act 1993.

Check this box if the income stream product is regulated by the Superannuation Industry (Supervision) Act 1993.

Check this box if the income stream was NOT purchased using superannuation monies. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if the income stream WAS purchased using superannuation monies. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Please enter the amount you would receive if you cashed in the income stream on the Assessment Day. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Please provide the surrender value amount. Fill only if 'Yes' is 'Yes'.

Check this box if the surrender value is never more than the amount allowed under SIS Regulations Capital Access Schedule. Fill only if 'Did you answer 'Yes' to any of question 11?' is 'Yes'.

Provide additional details regarding the surrender value compliance, referencing the Capital Access Schedule if applicable. Fill only if 'Did you answer 'Yes' to any of question 11?' is 'Yes'.

Check this box if the surrender value is ever more than the amount allowed under SIS Regulations Capital Access Schedule. Fill only if 'Did you answer 'Yes' to any of question 11?' is 'Yes'.

Check this box if the income stream does not have a tax free component. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Indicate whether the income stream has a tax free component by entering 'Yes' or 'No'. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Check this box if the income stream has a tax free component. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Check this box if the Tax Free Component is NOT calculated using the proportional method as defined in the Income Tax Assessment Act 1997. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Check this box if the Tax Free Component IS calculated using the proportional method as defined in the Income Tax Assessment Act 1997. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Please provide the specific details used for the proportional method calculation. Fill only if 'Yes (Proportional Method)' is 'Yes'.

Please enter the current amount of the tax free component per fortnight. Fill only if 'Yes (Proportional Method)' is 'Yes'.

Check this box if the Tax Free Component is not calculated using the Undeducted Purchase Price (UPP) method for income streams which commenced before 1 July 2007. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Check this box if the Tax Free Component is calculated using the Undeducted Purchase Price (UPP) method for income streams which commenced before 1 July 2007. Fill only if 'Indicate the type of income stream' is 'Defined Benefit'

Please provide the Undeducted Purchase Price (UPP) at the commencement of the income stream. Fill only if 'Yes' is 'Yes'.

Please provide the current amount of the tax free component per fortnight. Fill only if 'Yes' is 'Yes'.

Check this box if the income stream is NOT a term income stream. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream IS a term income stream. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Enter the monetary amount of the third payment made to purchase the income stream. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the day of the month when the third payment to purchase the income stream was made. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the month when the third payment to purchase the income stream was made. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Enter the year when the third payment to purchase the income stream was made. Fill only if 'Indicate the type of income stream' is 'Pooled Lifetime (if purchased on or after 1 July 2019)'

Check this box if the income stream cannot be transferred to another person, except to a reversionary beneficiary upon the death of the person or another reversionary beneficiary.

Check this box if the income stream, purchased or acquired before 20 September 2004, cannot be transferred to another person, except for specific beneficiary and estate conditions upon death. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream, purchased or acquired on or after 20 September 2004, cannot be transferred except upon death. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream is a Lifetime type and was purchased prior to 1 July 2019. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream is a Life Expectancy type. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream is a Term type. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the income stream is a Pooled Lifetime type and was purchased on or after 1 July 2019. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Please provide the duration of the term income stream. Fill only if 'Indicate the type of income stream' is 'Lifetime, Life Expectancy or Term'.

Check this box if the product's yearly indexation adjustment is capped at the greater of either 5% or the rate of increase in the consumer price index plus 1%, and payments cannot vary downwards.