About this form
Form and instructions to help superannuation funds meet their legal requirements to give information to an individual before payment of a superannuation lump sum. (NAT 70764)
How to obtain this form
You can download this form in Portable Document Format (PDF) – download Superannuation lump sum pre-payment statement (NAT 70764, PDF, 932 KB).
Instructions
Who should complete this statement?
You should complete this statement if you:
- are a super fund, approved deposit fund (ADF), retirement savings account (RSA) or annuity provider
- need to inform a member that they have not met a condition for the release of funds, and
- need further instructions from your member about how to deal with these funds.
You are not required to use this form before making a lump sum payment to your member - it is provided as a guide for funds on the sort of information you should be providing and receiving from your member prior to making a lump sum payment.
End of attentionBefore making a lump sum payment, you should provide members with a Superannuation lump sum pre-payment statement to obtain instructions on how you should make the payment.
What part of this statement do I need to complete?
You complete ‘Part 1’ of the statement by providing the amounts of each component of the superannuation lump sum. After this, send the statement to the member.
The member completes ‘Part 2’ of the statement by specifying whether they wish to:
- receive all or part of the lump sum in cash now, or
- roll over all or part of the lump sum
- into a complying super fund
- into a complying ADF
- into a RSA, or
- to purchase a super annuity.
The member should then return the completed statement to you.
How to complete the statement – super provider
You must complete all the sections in ‘Part 1’ of the statement, if you are:
- a super fund
- a RSA
- a ADF, or
- an annuity provider.
Section A: Superannuation provider
Complete your details.
Section B: Member’s details
Complete the member’s details.
Section C: Superannuation lump sum payment details
Complete details about the super lump sum payment, including the:
- date the calculation is valid until
- components of the lump sum, and
- preservation amounts of the lump sum.
The lump sum is made up of taxable and tax-free components. The tax-free component is made up of the contributions segment and the crystallised segment. The taxable component can be made up of:
- an element taxed in the fund, that is, the part of the taxable component that has been subject to tax in the fund, and
- an element untaxed in the fund, that is, the part of the taxable component that has not been subject to tax (for example, public sector funds or schemes established under a state act will generally have an element untaxed).
The preservation amount can include:
- preserved amounts
- restricted non-preserved amounts, and
- unrestricted non-preserved amounts.
Preserved and restricted non-preserved amounts generally cannot be taken as a cash payment. They can be rolled over into a member’s super account for their retirement or until they meet a condition of release and there are no cashing restrictions.
- The unrestricted non-preserved amount can be taken as a cash payment or rolled over into the member’s super account.
Section D: Superannuation providers signature
Complete the date the statement is issued to the member, the date your member is to return the completed statement to you and your signature.
Give the statement to the member. When the statement is returned, make the payment as instructed in ‘Part 2’.
You don’t need to send a copy of the statement to us; however, you should keep a copy of the statement for your records for a period of five years.
End of attentionIf you have been instructed to:
- roll over all or part of the super lump sum, you will need to fill in a Rollover benefits statement (NAT 70766), or
- pay all or part of the lump sum in cash, you will need to complete a PAYG payment summary – superannuation lump sum (NAT 70947).
How to complete the statement –members
If you are receiving the super lump sum payment you must complete all the sections in ‘Part 2’ of the statement.
You may wish to speak with a tax professional or your super fund, ADF, RSA or annuity provider to make sure you are aware of your tax obligations and super roll over options.
End of attentionSection E: Cash amount
Work out how much of the lump sum you want paid as cash and write the amount at ‘Pay me a gross cash amount of: $’. If you don’t want any of the payment paid as cash leave this blank.
The amount you choose to be paid as cash generally cannot be more than the unrestricted non-preserved amount on your statement (‘Section C’ of the statement). If you choose to receive your lump sum as a cash payment, you cannot change your mind to roll over this cash payment at a later stage.
End of attentionFor more information about unrestricted non-preserved amounts, preserved amounts and restricted non-preserved amounts, refer to Glossary – superannuation (NAT 4346).
End of further informationSection F: Rollover payment
Work out how much of the lump sum you want to roll over into a complying super fund, complying ADF, RSA or to purchase a super annuity.
Complete the details for the super fund, ADF, RSA or annuity provider, including:
- their full name
- their address
- their Australian business number (ABN)
- your account number, and
- the amount you want rolled over.
If you don’t want to roll over any of the payment, leave this step blank and go to ‘Section G’.
If you are rolling over your super lump sum into more than one fund, RSA, ADF or annuity provider you will need to give payment instructions to your super fund, ADF, RSA or annuity provider for each payment.
End of attentionSection G: Member’s declaration
Complete your full name, signature and date.
Return the statement to your super fund, ADF, RSA or annuity provider either:
- within 30 days of receiving it, or
- by the date requested.