Retirement Benefit | Early Retirement Benefit

PLEASE READ THIS SECTION BEFORE YOU START COMPLETING THIS FORM.

Important Information
Before completing this form, please ensure you have received your personalised pension quotation and understand the pension option you have selected. Once your first pension payment has been made, your pension option cannot be changed.

Before You Start
Please ensure you have:
Received your personalised pension quotation.
Read the information about Joint Life and Single Life Pension options.
Decided which pension option best suits your circumstances.
Gathered all required supporting documents.
If you need assistance, please contact CINSF before completing this form

You may choose one of the following:

You may choose one of the following:

You may select more than one option where applicable. Any remaining balance not withdrawn or transferred will remain invested in your Voluntary Account.

Before your retirement claim is approved, you may make one lump sum contribution of up to NZ$100,000 to increase your pension permanently. Once your pension has commenced, no further top-ups can be made.

(maximum NZ$100,000)

Note: The top-up amount must be received before your retirement claim is process.

Important:Once your first pension payment has been made, your pension option cannot be changed. Your decision is final and cannot be reversed.

Complete this section only if you selected Option A — Joint Life Pension. If you selected Option B — Single Life Pension, leave this section blank.

Retirement payments can only be made to a bank account in your name unless otherwise approved by CINSF.

Please read the statement carefully before signing.

By signing this form, I confirm that:

a. I have received a personalised pension quotation and understand the retirement options available to me.

b. I have had the opportunity to ask questions and understand the pension option I have selected.

c. I understand that my election becomes irrevocable once I sign this declaration and cannot be changed thereafter.

d. If I have selected the Joint Life Pension, I understand that my eligible spouse will continue receiving my pension after my death, in accordance with the Trust Deed.

e. If I have selected the Single Pension, I understand that my spouse (including a de facto partner as defined under the Trust Deed) will not receive an ongoing CINSF pension after my death. I further understand that any remaining balance in my Pension Account at the time of my death will instead be paid as a lump sum to my estate, to be distributed in accordance with my will or, if I do not have a valid will, the Cook Islands rules of intestacy. I confirm that I have discussed this decision with my family and wish to proceed.

f. I understand that the rate of my Single Pension may differ from the pension I would otherwise have received with spousal cover, as the Trustee applies different pension factors depending on this election.

g. If I have elected to make a One-time Compulsory Account Top-Up, I understand it must be received before my claim is approved, will permanently increase my pension, and cannot be withdrawn once my pension has commenced.

h. I understand that my pension is calculated using my final approved account balance, my age at retirement and the Fund's approved pension conversion factors. My account balance remains subject to investment gains and losses until my retirement claim has been approved.

i. I declare that the information and supporting documents I have provided are true, complete and correct. I authorise CINSF to verify this information where necessary to assess my entitlement to retirement benefit.

j. I understand that my retirement benefit is administered in accordance with the Cook Islands National Superannuation Fund Act, the Trust Deed and the Fund Rules, and that these governing documents prevail where applicable.

k. I understand that providing false or misleading information may result in delays, recovery of overpayments or other action in accordance with the Fund Rules or applicable law.

One (1) valid photo identification:

• Passport
• Birth certificate with a current photo
• Driver's licence

Letter from employer confirming the final contribution date to CINSF. (for current employment)

One (1) bank account confirmation:

• Bank confirmation letter
• Bank statement (local accounts only)

One (1) valid photo identification:

• Passport
• Birth certificate with a current photo
• Driver's licence

Medical letter (if applying on medical incapacity grounds):

• Evidence of absence from employment for 6+ consecutive months due to serious illness
• Evidence that you are unlikely to return to employment

Employer letter (if applying on redundancy grounds):

• Confirmation of redundancy and final contribution date to CINSF

One (1) bank account confirmation:

• Bank confirmation letter
• Bank statement (local accounts only

Note: The Claim can only be accepted after the 6-month stand-down period has been completed.

In person: Visit the CINSF office with your completed form and all supporting documents.
By post: CINSF, PO Box 3076, Avarua, Rarotonga, Cook Islands.