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 Name
Last Name
Surname
First Name
Last Name
Residential Address
Street Address
Street Address Line 2
City
State / 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)
-
Month
-
Day
Year
Date
Final Contribution Date (dd/mm/yy)
-
Month
-
Day
Year
Date
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
*
Please Select
ANZ (1548581, ANZ House Suva, ANZBFJFX, 010890)
BSP (516682, Ground Floor Pacific House, Suva, BOSPFJFX, 069002)
HFC BANK (100099720, 371 Victorious Parade, Suva, HFCLFJFJ, 129010)
WESTPAC (0018502300, 96 Thomson St, Suva, WPACFJFX, 039001)
BANK OF BARODA (91010100015879, Suva Branch, Mark St, Suva, BABFJFJXXX, 049010)
BRED BANK FIJI (00123697021, MHCC Building, Thomson St, Suva, BREDFJFJ, 119010)
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.
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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:
-
Month
-
Day
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
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 Fiji National Provident Fund (FNPF) confirming you as a member.
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