Application and Transfer Form

Personal Details

(* = compulsory fields)

Title*

First Names:*

Surname:*

Date of Birth:*

IRD Number:*

Your prescribed tax rate:* (tick the box):  10.5% 17.5% 28%

How do I calculate my PIR? Click here

Postal Address:*

Suburb:*

City:*

Postcode:*

Home Phone:*

Business Phone:

Mobile:

Your Email*

Where did you hear about The Law Retirement KiwiSaver Scheme?*
Other:

Contribution Details

IF YOU ARE EMPLOYED:

Employee’s elected contribution rate:

tick the box:  2% 4% 8%

Company name

Postal Address

Postcode

Business Phone

Employer’s IRD number

TRANSFERS (only complete if you are transferring from another KiwiSaver scheme)

Is this a transfer? Tick the box:  yes no

If Yes, – from another KiwiSaver scheme? Name of Scheme:

 yes I apply to transfer my investment from the above scheme to The Law Retirement KiwiSaver Scheme. I authorize the manager of the transferring scheme to provide The Law Retirement KiwiSaver Scheme any of my personal information as necessary to complete the transfer of my investment.

IF YOU ARE NOT EMPLOYED OR SELF-EMPLOYED OR UNDER 18:

Initial Investment Amount

$

TRANSFERS (only complete if you are transferring from another KiwiSaver scheme)

Is this a transfer? Tick the box:  yes no

If Yes, – from another KiwiSaver scheme? Name of Scheme:

 yes I apply to transfer my investment from the above scheme to The Law Retirement KiwiSaver Scheme. I authorize the manager of the transferring scheme to provide The Law Retirement KiwiSaver Scheme any of my personal information as necessary to complete the transfer of my investment.

My Investment allocation details

Refer to pages 20 – 22 of The Law Retirement KiwiSaver Scheme Investment Statement for choosing your KiwiSaver investment Fund.

Allocation of regular contributions. Please tick one to select portfolio:

 Balanced Fund Dynamic Fund

Identity Verification Form:

The Financial Transactions Reporting Act 1996 requires deposit takers to verify the identity of all new investors. Please upload a copy of either your passport, drivers license or birth certificate.

Under 18 year olds:
Parent/Guardian: if you are under the age of 18, all parents and guardians will need to supply their identification as below and please also upload a true copy of your birth certificate.

Upload here: If you are transferring from another KiwiSaver Scheme, please sign the copy of your ID and write next to your signature: “please accept this signature confirmation that I wish to transfer my current KiwiSaver Scheme to The Law Retirement KiwiSaver Scheme”

Disclosure & Declaration

Declaration: (all boxes must be ticked for the application to be successfully submitted)

Click here to download The Law Retirement KiwiSaver Scheme Investment Statement *

I have downloaded and read the Law Retirement KiwiSaver Investment Statement, setting out a summary of my rights, obligations and benefits as contained in The Law Retirement trust deed.

I have read the terms and conditions stated in the Investment Statement. I agree to be bound by the provisions of the Trust Deed and hereby apply to become a member of The Law Retirement KiwiSaver Scheme.

______________________________________________________

Email/facsimile – I authorize The Law Retirement KiwiSaver Scheme administrator or any other company related to The Law Retirement KiwiSaver Scheme to provide information relating to my investments via email or facsimile and to act on instructions regarding my investments received via email, facsimile or via the secure login on the Administrators website. The email address and/or facsimile number that The Law Retirement KiwiSaver Scheme may provide information to and act on instructions from are detailed in this application form (or as otherwise notified to The Law Retirement KiwiSaver Scheme in writing from time to time).

______________________________________________________

Liability Limitation and Indemnity – I acknowledge that The Law Retirement KiwiSaver Scheme does not accept any responsibility or liability whatsoever for any damage, costs, expenses, losses or liabilities incurred by any person as a result of The Law Retirement KiwiSaver Scheme administrator acting on any instructions from an authorized signatory or an authorized email address or facsimile number. I agree to indemnify in all respects and hold harmless The Law Retirement KiwiSaver Scheme against damage, costs, expenses, losses or liabilities which may arise by reason of The Law Retirement KiwiSaver Scheme accepting or acting on instructions from an authorized signatory or, an authorized email address or facsimile numbers.

______________________________________________________

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Click here to join The Law Retirement KiwiSaver Scheme or transfer from an existing Scheme.
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