Authority to Transfer
Cook Islands National Superannuation Fund
to the Samoa National Provident Fund (SNPF)
1 MEMBER DETAILS — COOK ISLANDS NATIONAL SUPERANNUATION FUND
RMD Number
CINSF Member No.
Title (Mr / Mrs / Ms / Dr / Other)
Gender (Male / Female)
Name
First Name
Last Name
Residential Address
Home Phone
-
Area Code
Phone Number
Mobile Phone
-
Area Code
Phone Number
Email Address
example@example.com
Date of Birth (dd/mm/yy)
-
Day
-
Month
Year
Date
Final Contribution Date (dd/mm/yy)
-
Day
-
Month
Year
Date
2 DETAILS OF THE SAMOA NATIONAL PROVIDENT FUND (SNPF) SCHEME
Member Tax ID Number
SNPF Member Number
SNPF Business Address Level 4, SNPF Building, Beach Road, Apia, Samoa
SNPF Bank Details — Please tick the relevant account:
BANK DETAILS
Bank Account#
Address
Swift Code
3 AUTHORISATION AND ACKNOWLEDGEMENT — TRANSFER TO SNPF
Please arrange for the transfer of funds from my Cook Islands National Superannuation Fund scheme to the Samoa National Provident Fund (SNPF) Scheme as set out in Part 2 of this Authority Form. I understand that this application is subject to the approval of the provider of the SNPF or Complying Superannuation Scheme and the office of the Cook Islands National Superannuation Fund.
I authorise the
SNPF provider
to act on my behalf if required for the purpose of actioning the transfer. This includes obtaining documents and other information from the Cook Islands National Superannuation Fund that are required to complete the transfer.
I have / will provide the SNPF with any information it may require to complete the transfer. I understand that any information I give to the Cook Islands National Superannuation Fund may be passed on to the SNPF as reasonably required, and I authorise the Cook Islands National Superannuation Fund to give such
Cook Islands National Superannuation Fund | PO Box 3076, Avarua Rarotonga, Cook Islands | enquiry@superfund.gov.ck | +682 25515 | www.cinsf.com | UNCLASSIFIED
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Authority to Transfer
Cook Islands National Superannuation Fund
to the Samoa National Provident Fund (SNPF)
information in relation to this transfer as requested by the SNPF. This information may also be provided to any related entities of the SNPF and those who provide services to those entities.
I acknowledge that there may be tax consequences when transferring my Cook Islands National Superannuation Fund scheme to the SNPF, and that I am liable for any such tax consequences.
I acknowledge that the SNPF has recommended that I seek independent and professional Cook Islands and Samoa tax and financial advice regarding my circumstances in relation to the proposed transfer.
I am a Samoan citizen and entitled to live in Samoa indefinitely. I am a current member of the SNPF. I have permanently emigrated from the Cook Islands to Samoa and do not intend to return to the Cook Islands to live or work.
I do not intend to migrate to another country before the transfer of my savings from the Cook Islands National Superannuation Fund takes place.
I understand that once my Cook Islands National Superannuation Fund has been transferred to the SNPF, those funds will become subject to the rules and regulations governing the SNPF.
I understand that the bank fees incurred for the transfer of funds from the Cook Islands National Superannuation Fund to my selected SNPF or Complying Superannuation Scheme will be met from my Cook Islands National Superannuation Fund funds.
Signature
Date:
-
Day
-
Month
Year
Date
4 CHECKLIST — REQUIRED DOCUMENTATION
The following documentation must be submitted after completing your
6-month waiting period
, which begins after your departure from the Cook Islands:
Required Documentation Checklist
A fully completed and signed authority to transfer form.
A copy of your passport.
A letter from your Cook Islands employer confirming employment start and end dates, or a copy of your signed employment contract.
Confirmation of departure (e-ticket or immigration departure stamp).
Letter from the Samoa National Provident Fund (SNPF) confirming you as a member.
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