Apply for a payment (financial hardship)

How to apply
Follow the instructions on this form to apply for a payment from your super.
You generally need to be permanently retired from work and have reached a certain age to access your super savings.
If you’re struggling financially, you may be able to get some or all of your super to meet your immediate needs.

The fastest way of accessing your super due to financial hardship is to apply online. Not only is it simple
and secure, but when applying online we can match your identity document details (e.g. driver’s licence
number) against secure databases.
Simply log into your account at australiansuper.com/login and complete the online form.

1 Check that you’re eligible 2 What you need to apply

Applying before reaching your preservation age • Your Centrelink Customer Reference Number
You can apply to access up to $10,000 of your super under • Proof of your identity. There are two ways you can
severe financial hardship, if you: provide your proof of identity:
• haven’t made a withdrawal from any super fund under – you can choose to have your identity electronically
financial hardship in the past 12 months, and verified, or
• are currently receiving and have been receiving eligible – you can choose to attach certified paper copies of
Commonwealth income support payments for at least your proof of identity documents to this application.
26 continuous weeks, and Read page 2 of this form for information about how to
• can’t meet reasonable and immediate family living expenses. do this.

Note: If you're under your preservation age and

you've claimed for financial hardship in the past
Things you should know
12 months, you'll need to wait 12 months after the • If you’re withdrawing your whole account balance,
date of your previous claim before you can claim again. your account will be closed and any insurance cover
you have will end.
Applying after reaching your preservation age • If you want to keep your account open, you’ll need to
If you’ve reached your preservation age and 39 weeks you leave a minimum of $1,000 in your account after the
can apply for any amount if: withdrawal.
• you’ve been receiving eligible Commonwealth income • If you want to keep your insurance cover, you'll need
support payments for a cumulative period of at least 39 to keep a minimum balance to cover the cost of your
weeks since reaching your preservation age, and ongoing insurance cover. Cover may stop for many
• you’re unemployed or employed for less than ten hours a reasons, including if no money is received into your
week when you make your application for payment under super account for 16 months. To learn more,
financial hardship. please read the 'When cover stops' section in the
You’re not eligible to apply for a payment on financial Insurance in your super guide for your division at
hardship grounds if you’re a temporary resident in Australia. australiansuper.com/InsuranceGuide

Use this table to find your preservation age • Please ensure you complete the application in full
and provide all the necessary documents, properly
Date of birth Preservation age certified. We can’t process your application if it’s not
Before 1 July 1960 55 complete and you haven’t included the necessary
documents.
1 July 1960 to 30 June 1961 56
1 July 1961 to 30 June 1962 57 • Once we receive your completed form and proof of
identity, it usually takes around five business days to
1 July 1962 to 30 June 1963 58
process your request.
1 July 1963 to 30 June 1964 59
1 July 1964 or after 60

Claiming a tax deduction for personal super contributions

If you have made personal contributions during the year you might be able to claim a tax deduction.
To claim a tax deduction for personal super contributions, you must send us a claim form before you withdraw
your super benefit, transfer any part of your account to a retirement income account or close your account.
We can’t accept your request for a tax deduction after an application for a benefit payment or to open a
retirement income account has been processed. To find out more about claiming a tax deduction for personal
super contributions, see our Tax and super fact sheet at australiansuper.com/factsheets

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898. 1264.8 11/22 ISS16 page 1 of 6
 Before applying for a payment…
It’s important to consider: HM Revenue & Customs in the UK. And if the UK
• how it will impact your retirement Government considers you to be a UK tax resident at the
time of payment or at anytime during the preceding ten UK
• if you’ll need to pay more tax
tax years, you may have to pay tax to the UK Government.
• any impacts it will have on benefits you’re receiving The UK Government will contact you regarding any tax you
i.e. Centrelink, Work Cover etc have to pay.
Former UK pension funds transferred into your For more information on UK tax, contact HM Revenue &
account Customs directly at hmrc.gov.uk or on 001144 3000 533 148.
If you’ve transferred a pension fund from the UK into Please have your UK National Insurance number on hand.
your AustralianSuper account within the last ten years,
we’re required to report any payments or transfers to

How to certify your documents

Read this section if you choose to attach paper copies of certified documentation for providing proof of your identity.

1 Go to your local police station 2 Ask them to certify your ID

Take both the ORIGINAL and a photocopy of your To certify your ID, the authorised person needs to compare
CURRENT driver’s licence or passport to your local the photocopy to the ORIGINAL and include the following
police station. If you are using your driver’s licence, details on the copy:
you’ll need to photocopy BOTH sides. • stamp or write ‘This is a true and correct copy of
All ID must have the same name and mailing address the original’
that we have for your super account. • their qualification (such as police officer)
• their name
• their address and phone number, and
• their signature and the date it was signed.
Every page of the documents we receive from you must have
been certified and dated within the last 6 months. Undated
documents will be rejected.

If you can’t get to a police station, a number of other people can certify your ID for you.
Go to australiansuper.com/IDHelp for more information.

Privacy Collection Statement

Please read this Privacy Collection Statement to see how AustralianSuper uses your personal information.
AustralianSuper Pty Ltd (ABN 94 006 457 987) of GPO Box 1901, Melbourne Victoria 3001, collects your personal information (PI) to
operate your super account (including insurance), improve our products and services and keep you informed. If we can’t collect your PI
we may not be able to provide these services. PI is collected from you but sometimes from third parties like your employer. We will only
share your PI where necessary to perform our activities with our administrator (Australian Administration Services Pty Ltd, Link Group),
service providers, as required by law or court/ tribunal order, or with your permission. Your PI may be accessed overseas by some of our
service providers. A list of countries can be found at the URL below. Our Privacy Policy details how to access and change your PI, as well
as the privacy complaints process. For complete details go to australiansuper.com/privacy or call us on 1300 300 273.

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898. 1264.8 11/22 ISS16 page 2 of 6
Apply for a payment (financial hardship)

Complete this form to apply to withdraw money from your super for immediate financial needs.
Please complete in pen using CAPITAL letters and print (✗) to mark boxes. You should read the Privacy Collection
Statement on page 2 of this form to see how AustralianSuper uses your personal information.

1 Provide your personal details

Last name
p i p p i g
First name/s
A n t h o n y m i c h a e l
Date of birth Male Female Mr Mrs Ms Miss Dr
D
2 D
7 M
1 M
1 Y
1 Y
9 Y
9 Y
0 X X X X X X X
Tax File Number Member number Centrelink Customer Reference number
8 4 1 5 6 2 2 7 7
2 0 8 1 5 8 8 0 1 t

For how we use your TFN, go to australiansuper.com/RefTFN Without your Centrelink Customer
Reference Number, we can’t process your request.

Street address
2 / 2 7 b e l m o r e t c e
Suburb State Postcode
W o o d v i l l e p a r k
s a
5 0 1 1
Postal address (if different)

Suburb State Postcode

Telephone (business hours) Telephone (after hours) Mobile
0 4 3 1 9 7 8 3 0 1 0 4 3 1 9 7 8 3 0 1 0 4 2 0 6 6 4 8 9 6

2 Provide withdrawal details

Are you withdrawing your whole account balance? (Please choose (7) one option only)

X 
Yes – This will close your account and any insurance cover will end. Investment returns, tax and insurance and management
costs will change the final amount paid.
Please check that any final contributions have gone into your account before you complete this form. If we receive any late
contributions, we need to open a new account for you.
Do you have Member Direct (MD) investments?
If you’re withdrawing your whole account balance you should sell your MD investments and close your MD account before
you lodge your request, so we can process your withdrawal as soon as possible. Otherwise, we’ll sell your MD investments
and close your MD account for you, which will lead to a delay and may incur additional fees. We’ll sell your investments at
market value on the day of the sale. Refer to the Terms and Conditions for using the AustralianSuper Member Direct online
platform document and the Member Direct investment options guide for more information.
Now complete step 3.

X No – Please answer the two questions below.

1. How much do you want to withdraw (before tax)? $ , , .00
Unless you’ve reached your preservation age and 39 weeks, the most you can withdraw is $10,000. Applicable tax will be
taken out of the amount approved (up to 22% provided that we have your TFN). For most people, this means the maximum
net amount you may receive is $7,800. If required to keep your account open, your withdrawal will be reduced to keep an
account balance of $1,000.

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898. 1264.8 11/22 ISS16 page 3 of 6
 2 Provide withdrawal details (continued)
2. Which investment option/s should be used to fund the payment?

Complete this section ONLY if you’re invested in Complete this section ONLY if you’re invested in the
Pre-mixed and DIY Mix option/s. Member Direct option
Write the percentage you want to withdraw from each If you have super invested in AustralianSuper’s Member
investment option below. If you leave this blank, your Direct option, do you want to sell these holdings to
withdrawal will be made from your selected future make this withdrawal?
contribution investment choice/s. If you don’t have (Please choose (7) one option only)
enough money in one or more of your selected options,
the balance of your withdrawal will be pro-rated in X Yes – I will sell my Member Direct holdings.
proportion to the balance in each option.
You need to complete the sell down and transfer the
High Growth proceeds to your other investment options prior to
%
submitting this form. If you wish to redeem a Term
Balanced % Deposit before its maturity date, early redemption
costs may apply. Refer to the Member Direct
Socially Aware % investment option: Terms and Conditions or the
Indexed Diversified Member Direct investment option guide available for
%
download from australiansuper.com/MemberDirect
Conservative Balanced % for more information.
Stable % X No – I don’t want to sell my Member Direct holdings.
Australian Shares You must maintain a minimum total account balance
%
to continue using Member Direct. If your total
International Shares % super account balance falls below $10,000, or your
pension account balance falls below $30,000, your
Diversified Fixed Interest % Member Direct account may be closed.
Cash %
TOTAL MUST ADD UP TO 100% 1 0 0 %

3 Provide payment details

To have your money paid straight into your bank account, please provide your account details.
Account name – must be held in your name or jointly in your name
A n t h o n y p i p p i g
Name of bank or financial institution
b a n k s a
Branch BSB number Account number
k i n g w i l l i a m s t r e e 1 0 5 0 7 4 0 6 0 1 0 3 0 4 0

4 Tell us about your eligibility

You have two options (please choose (7) one only). See the information at the front of this form for full details.
X You’ve received eligible Commonwealth income support payments for a continuous period of at least 26 weeks, are
currently receiving these payments, and you can’t meet reasonable and immediate living expenses.
Now complete steps 5, 6, 7, 8 and 9.
X You’ve reached your preservation age, received eligible Commonwealth income support payments for at least 39 weeks
since reaching your preservation age and are currently either unemployed or employed for less than ten hours a week.
Now complete steps 6, 7, 8 and 9.

5 Provide details of the bills you can’t pay

List debts which relate to you, your spouse or your dependants
Minimum weekly payment Amount that is overdue
Home or housing loan repayments (mortgage, rent, 9 0 0
$ , ,
3 5 0 . 00 $ , , . 00
urgent repairs)
Personal loan/s repayments (eg car) 5 0 0 . 00 5 0 0
$ , , $ , , . 00
Credit card repayments
$ , , . 00 $ , , . 00
Other:
$ , , . 00 $ , , . 00
Other:
$ , , . 00 $ , , . 00

TOTAL DEBTS $ , , . 00 $ , , . 00

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898. 1264.8 11/22 ISS16 page 4 of 6
 6 Provide details of your assets
Please provide details of assets (other than your family home) owned by you or your spouse. Don’t list business assets.
Estimate current market value

Property other than your family home – for example, an investment property $ , ,
0 . 00

Motor vehicle: Year Make Model $ 0

, . 00
Motor vehicle: Year Make Model $ 0
, . 00
Furniture $ , 0 . 00

Other assets – for example, a caravan or boat: $ ,

0 . 00

Bank accounts $ ,
0 . 00

Bonds $ ,
0 . 00

Shares $ ,
0 . 00

Other investments $ ,
0 . 00

TOTAL $ , ,
0 . 00

7 Provide proof of your identity

Please complete (7) one of the options below.
X Option 1 – I want to use electronic verification.
By giving you my Medicare, driver’s licence or Australian passport details below, I authorise the use of my personal details on
this form for the purpose of electronic data verification. I understand that my information will be subject to an information
match request in relation to relevant official record holder information and a corresponding information match result will be
provided via the use of third party systems.
Any TWO of the following:

1. Full name as appears on my Medicare card

A n t h o n y m p i p p i g
My Medicare number is Valid to
My reference number
5 1 4 6 4 1 0 7 0 5 M
0 M
3 Y
2 Y
0 Y
2 Y
7 on this card is 1

2. Full name as appears on my driver’s licence

A n t h o n y M i c h a e l p i p p i g
Licence number Card number* * Visit australiansuper.com/IDHelp
b p 1 3 8 3 d 0 0 0 2 7 w e u to find the card number on your
driver's licence.
State of issue Expiry date
s a D
2 D
6 M
1 M
1 Y
2 Y
0 Y
2 Y
7

3. My Australian passport number is Place of birth (as shown on your passport)

Country of birth (not shown on your passport)

Family name at birth (not shown on your passport)

X Option 2 – I want to attach paper copies of certified documentation

I have attached certified copies of my proof of identity to this form. See page 2 of this
Please ensure that you provide photocopies of your original identification documents form for information
and that they are correctly certified. Each page must be certified as a true copy. The about how to have
documents we receive from you must have been certified and dated within the last your documents certified.
6 months. Undated documents will be rejected. For instructions on who can certify
documents, go to australiansuper.com/IDHelp

X Electronic verification if the paper copies of my proof of identity documents are incorrectly certified or can’t be read
I authorise the use of my personal details for the purpose of electronic data verification if the paper copies of my certified
documentation are incorrectly certified or unable to be read. I understand that my information will be subject to an
information match request in relation to relevant official record holder information and a corresponding information match
result will be provided via the use of third party systems.

Issued by AustralianSuper Pty Ltd ABN 94 006 457 987 AFSL 233788 Trustee of AustralianSuper ABN 65 714 394 898. 1264.8 11/22 ISS16 page 5 of 6
 8 Benefit payment checklist
X Have you checked you are eligible for payment or rollover?
X Have you completed Section 7 Proof of ID?
X Are you claiming a tax deduction for any personal contributions? If so, refer to page 1 for more information.
X Have you completed all the required sections and signed this form?

9 Sign this form

To the best of my knowledge, the information I have I authorise:
provided on this form is correct. The amount I’m requesting • AustralianSuper and its administrator to use Centrelink
is necessary to meet my reasonable and immediate living Confirmation eServices to perform a Centrelink
expenses. I confirm that I don’t have any assets that I could superannuation confirmation enquiry of my customer details.
reasonably sell to meet immediate financial needs. These • the Australian Government Department of Human Services
assets could include money in the bank, share investments, (DHS) to provide the results of that enquiry to AustralianSuper
an investment property (not including my family home) or and its administrator.
any other similar investment.
I understand that:
I have read the Privacy Collection Statement as set out on
• DHS will use information I’ve provided to AustralianSuper
page 2 of this form, and I understand how AustralianSuper and its administrator to confirm my eligibility for early
will use my personal information. Where authorised, release of superannuation on the grounds of financial
AustralianSuper and its administrator may use my details hardship based on whether I have been in receipt of a
to contact Centrelink to verify that I’m eligible to receive qualifying Centrelink payment for a specified period.
a payment for financial hardship and to check my identity
• DHS will disclose to AustralianSuper and its administrator
using personal and other information held on electronic my personal information including my name, date of birth
databases, including third party databases. and payment status.
I confirm I am either an Australian citizen/permanent • this consent, once signed, remains valid while I’m a member
resident, a New Zealand citizen. of AustralianSuper unless I withdraw it by contacting
I understand that if I withdraw my whole account balance AustralianSuper or DHS.
this will close my AustralianSuper account and any • if I withdraw my consent or do not alternatively provide
insurance cover will end. AustralianSuper will no longer proof of my circumstances/details, I may not be eligible
have any responsibility for my account. for the early release of superannuation on the grounds of
I understand if you receive any contributions after my financial hardship provided by AustralianSuper.
account has been closed you may open a new account • if I have not reached preservation age I can only receive a
for me. Financial Hardship payment once every 12 months.

Sign here
       Date

D
1 D
5 M
0 M
3 Y
2 Y
0 Y
2 Y
3
Print name
A n t h o n y M i c h a e l p i p p i g

10 Send this form to us

Please post this form and certified proof of your identity (if you haven't opted for electronic verification) to
AustralianSuper, GPO Box 1901 MELBOURNE VIC 3001. Or upload scanned copies of your completed forms
and certified identification via our website at australiansuper.com/email

Please return this completed form to:

AustralianSuper, GPO Box 1901, MELBOURNE VIC 3001
or upload a copy via our website to australiansuper.com/email
Questions? Call 1300 300 273 or visit australiansuper.com 1264.8 11/22 ISS16 page 6 of 6