Release of Preserved Benefit
On grounds of severe financial hardship
Please read carefully before
completing this application
Making a claim
A maximum of $10,000 gross of
your preserved benefit can be
released once within a 12 month
period.
A minimum lump sum of $1,000
is generally required.
Additional information
Need a benefit quote?
Assets less than $50,000
If your assets (excluding your home and principal car) exceed $50,000, do not
complete this form. Please call Telstra Super Pty Ltd on 1300 033 166 to
request the correct form.
In accordance with Government regulations, you may be eligible to claim your
preserved benefit on the grounds of financial hardship if you:
• are in receipt of a qualifying Commonwealth Income Support payment; and
• have been receiving a Commonwealth Income Support payment for a
continuous period of 26 weeks; and
• are unable to meet reasonable and immediate family living expenses.
If you are not eligible to claim your preserved benefit on the grounds of severe
financial hardship you may be able to apply for early release under Specified
Grounds.
You must provide Telstra Super with proof of your identity when applying for a
release of your preserved benefit. If you are signing this form on behalf of another
person, please note there are requirements you must also meet. Please see the
enclosed guide for more detail.
The Trustees of Telstra Super have no authority to release preserved benefits
under Specified Grounds. Applications must be made directly to the Australian
Prudential Regulatory Authority (APRA). For further information and to obtain an
application form, contact APRA on 1300 131 060.
Once you are satisfied that you are eligible, return this completed and signed
application and Statutory Declaration with the following supporting documentation:
• Current Centrelink letter Q230 or Q687, stating the type of Commonwealth
Income Support you are receiving and how long you have been receiving that
support. Centrelink letters are only valid for a period 21 days from the date of
issue.
• Asset valuations (refer to Section D of this form).
If there is any additional information which would support your application, please
specify on a separate sheet of paper and return it together with your completed
claim form to Telstra Super Pty Ltd.
You can obtain a current Benefit Quote on 1300 033 166 between 6.00am and
9.00pm Monday to Friday (Melbourne time). You will need your PIN to access this
facility. You can also download a quote if you log in to SuperOnline, available on
our website at www.telstrasuper.com.au
 Your personal details

A Your details Title Surname

Given names

Residential address (PO Box not acceptable)

Suburb State Postcode

Home telephone no. Business telephone no.

Member number Date of birth / /

Email address

I am an Australian/New Zealand citizen OR permanent resident of Australia.*

*If you do not meet one of the above categories, please call us on 1300 033 166, to discuss if you are
able to release your preserved benefit.

B Personal assets Asset Current market value

Car (not principal car)

Car (not principal car)

Furniture

Bank account(s)*

Shares/ Debentures*

Real Estate Property* (not the family home)*

Other assets/investments (please specify)*

Total personal assets

*Provide written evidence of value

Claim details

C Claim amount I request $_______________.00 (total claim amount) be released from my preserved
benefit on grounds of severe financial hardship.

Please note: A maximum of $10,000 gross of your preserved benefit can be

released once in a 12 month period. A minimum of $1,000 (or less if your account
balance is less than $1,000) must be paid out. Any preserved benefit released
prior to retirement age is subject to tax.
D Banking details
To have your benefit paid directly
into your bank account, simply
provide us with a copy of your bank
statement or passbook showing the
BSB and account number.
Telstra Super can only make
payments to an account held solely
or jointly in the name of the member.
Benefits cannot be paid into credit
card accounts.
E Proof of Identity
See the Proof of Identity guide for
more information.
F Statutory Declaration
(1) Insert name, address and
occupation of person making the
declaration
(2) Signature of person making the
declaration.
(3) Signature of person before whom
the declaration is made.*
(4) Here insert the name, qualifications
and address of person before
whom the declaration is made.
Name of bank/financial institution
Branch address
Account name
BSB no Account no
To proceed with payment into your account and ensure the security of your
benefit, Telstra Super requires a copy of the part of your bank statement or
passbook that contain your full name, address and bank account details. This
needs to be received before payment can be made to your bank account.
Telstra Super relies on these details and will not accept responsibility if incorrect
bank details result in your benefit being paid to the wrong account. Any costs
incurred in the retrieval of your benefit in this circumstance may be passed on to
you. Telstra Super is discharged from all liability once it pays your benefit to your
nominated account in accordance with your instructions.
If you do not complete this section and your application is approved, payment will
be made by cheque and posted to the above address.
I have attached a certified copy of a primary identification document
OR
I have attached a certified copy/extract of:
• a primary non-photographic document AND
• a secondary identification document.
If you have not provided valid and correct identification documents your application
is likely to be delayed or refused.
I, (1)
Do solemnly and sincerely declare the following:
• The information provided by me in this application is true and correct; and
• My assets (apart from my family home and principal car) do not exceed
$50,000; and
• I am unable to meet my reasonable family living expenses; and
• I do not have any assets (apart from my family home and principal car) which
could (reasonably and realistically speaking) be used or sold to cover this gap;
and
• The amount I am requesting to be released is necessary to meet these
reasonable and immediate family expenses.
And I make this solemn declaration by virtue of the Statutory Declarations Act 1959,
and subject to the penalties provided by that Act for the making of false statements
in statutory declarations, conscientiously believing the statements contained in this
declaration to be true in every particular.
(2)
Declared at on
Before me (3)
(4)
* Declarations can be made before a pharmacist, doctor, dentist, physiotherapist, accountant, police
officer or full-time teacher. For more options please contact Telstra Super on 1300 033 166. Please note
these witnesses differ to those required for proof of identity later in this document.
 Please return completed form to:
Telstra Super Pty Ltd, PO Box 14309, Melbourne VIC 8001

Telstra Super Pty Ltd complies with the Privacy Act 1988 (Commonwealth). For further
information on privacy please contact the Privacy Officer on 1300 033 166 or visit our website at
www.telstrasuper.com.au to download a copy of our Privacy Policy or Access and Correction Policy.
© Telstra Super Pty Ltd
Telephone 1300 033 166 Facsimile 03 9653 6060 www.telstrasuper.com.au
Telstra Super Pty Ltd, ABN 86 007 422 522, AFSL 236709, is the trustee of the Telstra Superannuation
07/0409 Scheme (Telstra Super) ABN 85 502 108 833.

Please read carefully
Proof of identity requirements
A Photographic documents
B Non-photographic documents
If you are applying using only
non-photographic documents,
you must provide one document
from both sections (i) and (ii).
Authorised individuals
* If issued by a foreign country or the United Nations, it must contain a photograph and signature of the
Proof of Identity
Your guide
Under Commonwealth law, Telstra Super Pty Ltd must collect and verify
information about your identity before cashing, rolling over or transferring your
benefit and in other limited circumstances.
When we request proof of identification we ask that you supply the
information outlined in this guide. Please note all copies must be certified by
an individual approved to certify copies. See overleaf for an approved listing
of authorised individuals.
If you have any questions about this guide, please contact Telstra Super
Pty Ltd on 1300 033 166 from Monday to Friday between 8.00am and 5.30pm
(Melbourne time).
You will need to supply copies of the documents listed in either section A or B.
A certified copy of one of the following current documents:
• driver’s licence issued under State or Territory law
• passport*
(i) A certified copy of one of the following primary documents:
• birth certificate or birth extract issued by the State or Territory
• citizenship certificate issued by the Commonwealth; or
• Centrelink pension card that entitles the person to financial benefits.
AND
(ii) A certified copy of one of the following secondary documents
(or a certified extract):
• notice issued by Commonwealth, State or Territory Government within the
past 12 months that contains the person’s name and residential address, and
records the provision of financial benefits (i.e. Newstart allowance)
• notice issued by the ATO within the past 12 months that contains the
person’s name and residential address, and records a debt payable by that
person to the Commonwealth (or the Commonwealth to the individual) under
Australian Tax law; or
• notice issued by a local council within the past 3 months that contains the
person’s name and residential address, and records the provision of services
by that body to that address or that person (i.e. rates notice).
The complete list of individuals recognised by Telstra Super Pty Ltd to
certify documents as true and correct copies, can be found online at
www.telstrasuper.com.au/ProofOfID. Listed overleaf are the most common
and accessible individuals from within that group.
If you choose to use an individual from the extended list available online at
www.telstrasuper.com.au/ProofOfID where a minimum occupational or
qualification period is required (i.e. an authorised representative of an Australian
financial services licensee with at least 2 years’ continuous service) then
the certification must address this minimum time requirement. If this is not
addressed in the certification, then the application will be rejected.
person. If written in a foreign language, it must be accompanied by an English translation prepared by
an accredited translator.
Certified copies
30 day business rule
Change of name
Signing on behalf of another
Certified extract
Do not provide originals
07/1209
A certified copy means a document has been certified as a true copy of an
original document by one of the following individuals.
Listed below are the most common and accessible individuals authorised to
certify documents as true and correct:
• Police officer;
• Pharmacist;
• Justice of the Peace, Legal Practitioner, registrar or deputy registrar
of a Court, Magistrate or Judge;
• Optometrist;
• Medical practitioner (i.e. GP or higher qualification);
• Member of:
– Institute of Chartered Accountants
– National Institute of Accountants
– Australian Society of Certified Practising Accountants
• Fellow of National Tax Accountants Association
• Member of Parliament;
• Notary public.
The individuals listed above must be currently licensed or registered to practice
in the designation or occupation described. This is usually evidenced by the
placing of the individual’s designation stamp, and sometimes a member number,
beside their name. Failure to apply this stamp may result in the document being
rejected and delay your application.
Telstra Super will aim to process your request as promptly as possible. However
our internal business rules will only permit us to action a benefit instruction
with accompanying identification within 30 business days of receipt, following
which you will need to submit further certified proof of identity with your new
instructions. We do this to minimise the risk of fraud on your account.
Please note that where the underlying document has expired (as at the time of
receipt or processing of your application) it will be rejected and may result in the
delay of your application.
Please ensure that all documents are valid and not expired.
If you have changed your name, proof of the reason for this change must be
shown in the form of a certified copy of a linking document. For example:
• marriage certificate
• deed poll; or
• change of name certificate from the Births, Deaths and Marriages
Registration Office.
If someone is signing on behalf of another, proof of the relationship must be
provided in the form of a certified copy of a linking document. In addition proof
of the identity of the agent or attorney is also required. What can be used for
proof of identification is outlined earlier in this document.
For a linking document:
• guardianship papers
• Power of Attorney
• Agency Agreement (i.e. financial planners); or
• letter from member authorising the nominee to act on their behalf.
Where appropriate, a certified extract of a secondary document may
be provided.
Unless you are applying in person or through Telstra Super Financial Planning
Pty Ltd, please do not supply originals of these documents. Certified copies and
certified extracts will suffice, unless you are advised otherwise.
Telstra Super Pty Ltd complies with the Privacy Act 1988 (Commonwealth). For further
information on privacy please contact the Privacy Officer on 1300 033 166 or download
a copy of our Privacy Policy or Access and Correction Policy from www.telstrasuper.com.au
© Telstra Super Pty Ltd, Level 8, 215 Spring St, Melbourne VIC 3000
Telephone 1300 033 166  Facsimile 03 9653 6060  www.telstrasuper.com.au
Telstra Super Pty Ltd, ABN 86 007 422 522, AFSL 236709 is the trustee of the Telstra Superannuation
Scheme (Telstra Super) ABN 85 502 108 833.