Authority to Transfer: FNPF

Authority to Transfer
Cook Islands National Superannuation Fund
to the Fiji National Provident Fund (FNPF)
1 MEMBER DETAILS — COOK ISLANDS NATIONAL SUPERANNUATION FUND
RMD Number
CINSF Member No.
Title (Mr / Mrs / Ms / Dr / Other)
Gender (Male / Female)
First Name(s)

First NameLast Name
Surname

First NameLast Name
Residential Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Phone
Format: (000) 000-0000.
Mobile Phone
Format: (000) 000-0000.
Email Address
example@example.com
Date of Birth (dd/mm/yy)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Final Contribution Date (dd/mm/yy)

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
2 DETAILS OF THE FIJI NATIONAL PROVIDENT FUND (FNPF) SCHEME
Member Tax ID Number
FNPF Member Number
FNPF Business Address: 33 Ellery Street, Suva, Fiji Islands
FNPF Bank Details – Please tick the relevant account:
Select the Relevant Bank
3 AUTHORISATION AND ACKNOWLEDGEMENT – TRANSFER TO FNPF
Please arrange for the transfer of funds from my Cook Islands National Superannuation Fund scheme to the Fiji National
Provident Fund (FNPF) 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 FNPF or Complying Superannuation Scheme and the office of the Cook Islands National
Superannuation Fund.
I authorise the FNPF 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.

Authority to TransferCook Islands National Superannuation Fundto the Fiji National Provident Fund (FNPF)
I have / will provide the FNPF 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 FNPF as reasonably required, and I authorise the Cook Islands National Superannuation Fund to give such information in relation to this transfer as requested by the FNPF. This information may also be provided to any related entities of the FNPF 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 FNPF, and that I am liable for any such tax consequences. The FNPF has recommended that I seek independent and professional Cook Islands and Fiji tax and financial advice regarding my circumstances in relation to the proposed transfer.
I am a Fijian citizen and entitled to live in Fiji indefinitely. I am a current member of the FNPF. I have permanently emigrated from the Cook Islands to Fiji 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 FNPF, those funds will become subject to the rules and regulations governing the FNPF. I understand that bank fees incurred for the transfer will be met from my Cook Islands National Superannuation Fund funds.
Signature
Date:

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
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
Upload required documentation

Cancelof
Should be Empty:

Authority to Transfer

1 MEMBER DETAILS — COOK ISLANDS NATIONAL SUPERANNUATION FUND

2 DETAILS OF THE FIJI NATIONAL PROVIDENT FUND (FNPF) SCHEME

3 AUTHORISATION AND ACKNOWLEDGEMENT – TRANSFER TO FNPF

Authority to TransferCook Islands National Superannuation Fundto the Fiji National Provident Fund (FNPF)

4 CHECKLIST — REQUIRED DOCUMENTATION