EXISTING FUND APPLICATION FORM

asterisks (*) indicates mandatory fields

Fund Name	*
Postal Address	*
Fund's ABN		Fund's TFN
Contact Name	*	Telephone(H)	*
Mobile		Telephone(W)
Email	*	Fax

MEMBER AND/OR INDIVIDUAL TRUSTEES

Individuals

Title	*
Full Name	*
Address	*
DOB	*
Is the person a member?
Is the person a trustee?

Title
Full Name
Address
DOB
Is the person a member?
Is the person a trustee?

Corporate trustee (if applicable)

Company Name
Registered Address
ACN/ABN/TFN

PREVIOUS ADMINISTRATION

Name of firm			Contact
Postal Address
Phone			Email

CONTINUING ADMINISTRATION

Superannuation Services Pty Ltd is to be appointed administrator for this SMSF.

AUTHORITY TO PROCEED

Please proceed with the administration of the SMSF. We/I have been supplied with Superannuation Services Pty Ltd fee schedule. We/I understand that Superannuation Services Pty Ltd is not a licensed investment advisor and has not provided any investment advice in relation to this SMSF.

Signed Trustee/Director		Signed Trustee/Director
Referred by
Phone