Online Certificate

If the certificate is for a year prior to 2017/18, please use this form: https://uat.haintzactuarial.com.au/online-certificates-pre-2017-2018/

Fund Details

Fund Name

Type of Trustee

Individual(s) Corporate

Name(s) of Trustee(s)

Financial Year ended 30 June

Unsegregated Periods

How many unsegregated periods were there in the year?

Does the Fund have any Disregarded Small Fund Assets?

Yes No

Do you choose to have a single ECPI for the whole year or separate ECPIs for the segregated period(s) and the unsegregated period(s)

Single Separate

Pension Account Types

Are any of the pension accounts TRP pre-retirement?

Are any of the pension accounts TRP post-retirement.?

Administrator Details

Contact Person

Company Name

Street/PO Box Address

Town/Suburb

Postcode

State

E-Mail Address

Membership Details

Number of pension members

{{ member }} 1 2 3 4 5 6

First Name

Last Name

Date of birth

Account Balances (at start and end of each unsegregated period) - other than TRP balances

Date

Pension Account Balances

Total Fund Balances

First period start date

First period end date

Second period start date

Second period end date

Third period start date

Third period end date

Fourth period start date

Fourth period end date

Fifth period start date

Fifth period end date

Sixth period start date

Sixth period end date

Seventh period start date

Seventh period end date

Eighth period start date

Eighth period end date

Ninth period start date

Ninth period end date

Tenth period start date

Tenth period end date

TRP Account pre-Retirement Balances (at start and end of each unsegregated period)

Date

Pension Account Balances

First period start date

First period end date

Second period start date

Second period end date

Third period start date

Third period end date

Fourth period start date

Fourth period end date

Fifth period start date

Fifth period end date

Sixth period start date

Sixth period end date

Seventh period start date

Seventh period end date

Eighth period start date

Eighth period end date

Ninth period start date

Ninth period end date

Tenth period start date

Tenth period end date

No input is required as you have indicated that there are no pre-retirement TRP accounts

TRP Account Post-Retirement Balances (at start and end of each unsegregated period)

Date

Pension Account Balances

First period start date

First period end date

Second period start date

Second period end date

Third period start date

Third period end date

Fourth period start date

Fourth period end date

Fifth period start date

Fifth period end date

Sixth period start date

Sixth period end date

Seventh period start date

Seventh period end date

Eighth period start date

Eighth period end date

Ninth period start date

Ninth period end date

Tenth period start date

Tenth period end date

No input is required as you have indicated that there are no post-retirement TRP accounts

Account Based Pensions, Lump Sums, and Other Amounts Paid from Pension Accounts in the unsegregated periods

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Add

TRP Pensions, Lump Sums, and Other Amounts Paid from the Fund from TRP Pension Accounts in the unsegregated periods

(a) Pre-Retirement

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Add

No input is required as you have indicated that there are no pre-retirement TRP accounts.

(b) Post-Retirement

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Add

No input is required as you have indicated that there are no post-retirement TRP accounts.

Pension Commutations in the unsegregated periods (and paid to an accumulation account)

(a) Account Based

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Add

(b) TRP Pre-Retirement

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Add

No input is required as you have indicated that there are no pre-retirement TRP accounts.

(c) TRP Post-Retirement

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Add

No input is required as you have indicated that there are no post-retirement TRP accounts.

Pension Accounts Commenced in the unsegregated periods

(a) Account Based

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Add

(b) TRP Pre-Retirement

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Add

No input is required as you have indicated that there are no pre-retirement TRP accounts.

(c) TRP Post-Retirement

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Date

Amount

Add

No input is required as you have indicated that there are no post-retirement TRP accounts.

Non-Pension (i.e. Accumulation) Account Transactions in the unsegregated periods

Type

Date

Amount

Add

Opening and closing Fund balances

Balance on 1 July {{ start_year }} (or at commencement if later)

Fund commencement date if later than 1 July {{ start_year }}

Balance at 30 June {{ end_year }} (or at wind-up if earlier)

Fund termination date if wound-up before 30 June {{ end_year }}

Promotion Code

Enter Promotion Code (if available)