SELF MANAGED SUPERANNUATION FUND ORDER FORM

Full Name of SMSF (required)

Address of SMSF (required)

Trustee Details
CORPORATE - If existing company, complete Section A and C - If new company, complete Section B and CINDIVIDUAL – Complete Section C only

SECTION A – Corporate Trustee – Existing Company

Name of Company

Registered Office Address(required)

ACN (required)

ABN (required)

TFN (required)

Director 1

Full Name (required)
Tax File Number (required)
Date of Birth (required)
Residential Address (required)

Director 2

Full Name (required)
Tax File Number (required)
Date of Birth (required)
Residential Address (required)

Director 3

Full Name (required)
Tax File Number (required)
Date of Birth (required)
Residential Address (required)

Director 4

Full Name (required)
Tax File Number (required)
Date of Birth (required)
Residential Address (required)

SECTION B – Corporate Trustee – New Company

Preferred Name of Company (required)

Business Address of Company (must be a street address)

Registered Office Address (must be a street address)
Same as aboveOther (please specify)

Company Postal Address
Same as aboveOther (please specify)

Director 1

Full Name (required)
Tax File Number (required)
Date of Birth (required)
Place of Birth (required)
Residential Address (required)

Director 2

Full Name (required)
Tax File Number (required)
Date of Birth (required)
Place of Birth (required)
Residential Address (required)

Shareholder 1

Full Name (required)
Tax File Number (required)
Date of Birth (required)
Place of Birth (required)
ACN if Company
Address (must be a street address)
How many shares (we recommend one each)
Beneficially owned

Shareholder 2

Full Name (required)
Tax File Number (required)
Date of Birth (required)
Place of Birth (required)
ACN if Company
Address (must be a street address)
How many shares (we recommend one each)
Beneficially owned

SECTION C – Individual Trustees / Member Information

Member / Trustee 1

Member / Trustee 1
MemberTrusteeBoth
Full Name (required)
Tax File Number (required)
Date of Birth (required)
Residential Address (required)

Member / Trustee 2

Member / Trustee 2
MemberTrusteeBoth
Full Name (required)
Tax File Number (required)
Date of Birth (required)
Residential Address (required)

Member / Trustee 3

Member / Trustee 3
MemberTrusteeBoth
Full Name (required)
Tax File Number (required)
Date of Birth (required)
Residential Address (required)

Member / Trustee 4

Member / Trustee 1
MemberTrusteeBoth
Full Name (required)
Tax File Number (required)
Date of Birth (required)
Residential Address (required)

Payment Details:

The cost to establish a new Self Managed Super Fund which has an existing company or
individual trustee is $1,100.00 (including GST).

The cost to establish a new Trustee Company and Self Managed Super Fund is $1,925.00
(including GST).

I/We enclose payment of $1,100.00 for the establishment of a new Self Managed Super Fund only (to be paid before Super Evolution Pty Ltd begins the order).

I/We enclose payment of $1,925.00 for the establishment of a new Trustee Company and Self Managed Super Fund (to be paid before Super Evolution Pty Ltd begins the order).

Payment Methods:

Cheque
Please make cheque payable to Super Evolution Pty Ltd

EFT
NAB Bank Chatswood, BSB: 082-201, Account: 83-921-9913

(Please use the name of your new super trustee company as a reference when making your EFT payment)

VisaMastercardAmex (2% surcharge)

Cardholder Name
Card Number
Expiry Date
Signature