Issued July 2022

Partial withdrawal
i Use this form to:
• Request a partial rollover from your super or pension account (including transition to retirement and term allocated pension) to
another superannuation fund.
• Request a partial cash withdrawal from your super account.

You can type directly into the form and print before signing. Alternatively, print and complete in block letters using a blue or black pen.
Place a cross in boxes where applicable.

Important information BT privacy policy

The information collected on this form is governed by the BT privacy
• Please ensure sufficient cash is available in your account to policy, which is available online at bt.com.au. You should read this
process this request. Should any investments need to be sold to policy before completing this form. This policy is reviewed and may be
fund this withdrawal or rollover, ensure this is completed prior to amended from time to time.
submitting this form.

• For one-off pension payments from your pension account or lump

sum withdrawals (from super or pension) when accessing
1 Adviser details
unrestricted non-preserved benefits, please speak with your
adviser. For Term Allocated Pension (TAP) accounts, limits apply in Dealer group name
relation to the amount of pension payments you can receive and
there are only limited circumstances where you can rollover or
make a lump sum withdrawal from your account. Refer to the
Panorama Super TAP Terms of a Category document for further
information, or contact your financial adviser or Panorama Support.

• Temporary residents can generally only access their preserved Adviser full name
super benefits if they become permanently incapacitated, have a
terminal medical condition, or have departed Australia
permanently and their visa has ceased. Refer to the Panorama
Super Additional Information Booklet for further information, or
contact your financial adviser or Panorama Support.

• To close your Panorama Super account, use the ‘Super account

2 Member details
closure’ form and speak with your adviser or contact Panorama
Support on 1300 881 716. First name
• Do not use this form to close your Panorama Super account, to
request a transfer to a KiwiSaver scheme, or to request a lump Brent
sum payment because you:Do not use this form to close your BT
Super Invest account, to request a transfer to a KiwiSaver
Last name
scheme, or to request a lump sum payment because you:

- Have a terminal medical condition Carter

- Are permanently incapacitate
- Satisfy severe financial hardship condition Account number
- Satisfy compassionate grounds condition
- Were a temporary resident and have departed Australia 403064470
- Were a lost member who is now found and your account
balance i less than $200 Account type

To withdraw part of your account balance for any of the above

reasons, contact Customer Relations on 1300 881 716.
✔ Super Pension

Preparing for life in retirement Tax file number (TFN)

To help you plan for the lifestyle you want in retirement, our Retirement
Hub offers calculators, tools and support to get you started. And if you
have a financial adviser, they can work with you to make sure you are
getting the most out of your super in retirement. You can visit our Your TFN is required for a rollover to a self-managed super fund (SMSF).
Retirement Hub at bt.com.au/retirement. It is not mandatory to provide your tax file number (TFN), but if you do
not, the rollover to an SMSF will be rejected.

Panorama Super is administered by BT Portfolio Services Limited ABN 73 095 055 208. BT Funds Management Limited
Page 1 of 6
ABN 63 002 916 458 is the trustee and issuer of Panorama Super, which is part of Retirement Wrap ABN 39 829 542 991.

Pension
 Issued July 2022

Partial withdrawal

3 Residency status Fund address

If you are requesting a cash withdrawal, this section is mandatory.

Certain conditions apply to temporary residents.
Important: you can only select one option below Suburb State Postcode

I am an Australian citizen, New Zealand citizen or permanent

✔ resident of Australia.
I am currently or have previously been in Australia on a Electronic Service Address (ESA) Alias
temporary resident visa.* Mandatory if rolling over to an SMSF
Visa subclass

Fund ABN or SFN

If you have selected this option, please speak with your adviser
or contact Panorama Support on 1300 881 716 to ensure you
are completing the appropriate form.
* A temporary resident visa is a visa issued under the Migration Unique Superannuation Identifier (USI)
Act 1958 that allows a person to remain in Australia during a This is not required if rolling over to an SMSF
specified period; until a specified event happens; or while the
holder has a specified status. You may be restricted to certain
conditions of release if you are or were a temporary visa holder.
Member number
This is not required if rolling over to an SMSF
4 Withdrawal details
Partial withdrawal amount
Specify the gross amount before income tax Please advise us of the preservation components that the partial
withdrawal is to come from. If you do not make a nomination, your
$ 1750 transfer will be pro-rated across your components.

Please ensure sufficient cash is available in your cash account. Unrestricted non-preserved amount
This withdrawal is a:
$
Important: you can only select one option below
Restricted non-preserved amount
Rollover. Go to section 5.
$
Cash withdrawal - funds will be deposited into your primary
✔ linked bank account.
Preserved amount
Select a withdrawal payment option
Important: If you select cash withdrawal you can only select $
one option below
For a rollover to another institution: Where possible, Panorama will
Lump sum payment - Go to section 6. make the payment via SuperStream. Otherwise, the payment must be
made by cheque and sent directly to the institution.
Income payment* - Go to section 7.
For a rollover to a self-managed super fund (SMSF): We will need
your bank account details for this rollover to proceed. This account may
*Maximum limits apply to Transition to Retirement (TTR) and TAP accounts. be with any Australian bank, building society or credit union.
Your tax file number is required. The rollover will be rejected if this form
5 Rollover instructions is submitted without your TFN in section 2.

Note: for TAP accounts, you can only rollover to another TAP or a If you are rolling over to an SMSF (option not available to TAP
complying income stream which meets the pension and annuity accounts), you must also provide a copy of a bank statement
standards specified under superannuation law such as a lifetime issued within the last 3 months, confirming your SMSF BSB and
income stream or life expectancy income stream. account number. This document will require certification. See
Provide details of the superannuation fund for the rollover section 8 ‘Proof of identity’. The requirement to provide a
certified copy of a bank statement is not applicable if you are
Fund name
transferring to an SMSF which invests through the BT Panorama
investment platform.

Panorama Super is administered by BT Portfolio Services Limited ABN 73 095 055 208. BT Funds Management Limited
Page 2 of 6
ABN 63 002 916 458 is the trustee and issuer of Panorama Super, which is part of Retirement Wrap ABN 39 829 542 991.
 Issued July 2022

Partial withdrawal

Name of financial institution

Important:
Withdrawing your superannuation benefit may impact any
BSB Account number insurance you currently have, and may result in losing your
insurance cover. If you want your insurance to continue you will
need to leave sufficient balance in your account to fund future
premiums. This information is intended as a guide only and does
SMSF account name
not constitute advice. Before making a withdrawal you should
speak to your financial adviser about the impacts this could have
on your insurance entitlements.

6 Reason for withdrawal 7 Personal tax deduction notice

Generally, you are not allowed to withdraw preserved money from a For accounts in accumulation phase only.
super fund until you reach preservation age and retire, or if you are Do you wish to claim or vary a tax deduction on personal
rolling over to another super fund, RSA or ADF. Your financial adviser contributions made in the current or previous financial year?
or the Administrator can assist with the special circumstances under
which you can withdraw your preserved money. Important: you can only select one option below

Please indicate which of the following scenarios applies to you. I do not intend to claim a tax deduction for personal
contributions made to my account prior to this partial
Important: you can only select one option below withdrawal, or I have completed and/or varied a deduction
notice for the personal contributions I intend to claim as a
✔ I am aged 65 or over. deduction.
I intend to claim a tax deduction for personal contributions
I am withdrawing an unrestricted non-preserved amount. made to my account prior to this partial withdrawal and have
not completed a deduction notice, or I need to vary a previous
deduction notice.
I am withdrawing a restricted non-preserved amount.
You must have left the service of the employer who had (or any A deduction notice can be completed or varied online at
panorama.com.au on the Rollovers & contributions page.
associates who had) at any time contributed to your Panorama
Super account. You must also provide a Separation Certificate
issued by Centrelink or written confirmation on the Company/
Business letterhead, confirming cessation of employment. Important:
I have reached my preservation age , have ceased
1
If you do not complete a personal tax notice before your partial
employment and do not intend to ever work more than 10
withdrawal, your ability to claim a tax deduction for personal
hours per week.
contributions previously made to your account will be limited.
I have ceased a gainful employment arrangement on or Your ability to vary any previous deduction notices you may have
after reaching age 60. provided will also be limited.
Date employment was ceased2 (dd/mm/yyyy)

8 Proof of identity

Note: This section is mandatory if your request is for a rollover to an SMSF.

1
To determine your preservation age refer to the Panorama See the ‘Completing proof of identity’ section for more information.
Super Additional Information Booklet.
I have attached a certified copy of my primary photographic
2Contributions and investment earnings after the date you identification document.
ceased employment will not be accessible until you meet one of
the other criteria or meet the same criterion again. Or
I have attached certified copies of both:

• A primary non-photographic identification document, and

• A secondary identification document.

Panorama Super is administered by BT Portfolio Services Limited ABN 73 095 055 208. BT Funds Management Limited
Page 3 of 6
ABN 63 002 916 458 is the trustee and issuer of Panorama Super, which is part of Retirement Wrap ABN 39 829 542 991.
 Issued July 2022

Partial withdrawal

9 Declarations & acknowledgements *Lifetime income streams must meet the standards of sub-regulation
1.05(2), 1.05(3), 1.06(2) or 1.06(3) of the Superannuation Industry
(Supervision) Regulations 1994 (SIS Regulations). Term certain
I declare that all details given on this form are true and correct. In income streams (including life expectancy income streams) must
addition I acknowledge and confirm that: meet the standards of sub-regulation 1.05(9) or 1.06(7) of the SIS
Regulations. Term allocated pensions (market linked income
• I am aware I may ask for information about any fees or charges
streams) must meet the standards of sub-regulation 1.05(10) or
that may apply, or any other information about the effect this
1.06(8) of the SIS Regulations or sub-regulation 1.07(3A) of the
rollover or cash withdrawal may have on my benefits, and have
Retirement Savings Account Regulations 1997.
obtained or do not require such information.

• I understand I will be unable to redeem any investment in a Full name (please print)
suspended fund or funds (ie a fund with suspended transaction
on a full or limited basis, which may also have suspended Brent Gordon Carter
issuing prices).
Member signature Date (dd/mm/yyyy)
However, I agree that the rollover or cash withdrawal will
proceed in relation to all other investments.
30/01/2023
For a cash withdrawal

I agree to ensure there are sufficient funds available in the Cash Account Additional information/declarations
above the minimum balance to process this withdrawal. I understand this
instruction will not be acted on if there are insufficient funds. We are authorised to collect your TFN under the Superannuation
Industry (Supervision) Act 1993. If you supply us with your TFN, we
shall provide it to the trustee that you have nominated to receive your
For a rollover superannuation benefits.
I consent to my tax file number being disclosed for the purposes of If you do provide your TFN to us, it will be used for lawful purposes
consolidating my account. I discharge Panorama BT Portfolio Services only. These purposes may change in the future as a result of
Limited and BT Funds Management Limited (including their authorised legislative change.
agents) (together, the Providers) of all further liability in respect of
benefits paid and rolled over to the fund nominated in section 5 of this Checklist
form. I request and consent to the rollover of superannuation as Have you provided your account details in section 2?
described above and authorise the superannuation provider of each
✔
fund to give effect to this rollover.
✔ Have you provided details of your residency status in section 3?
If signing under a power of attorney, I verify that at the time of signing, I
have not received notice of revocation of that power. ✔ Have you provided an amount in section 4?

I and any person claiming through me release and indemnify the

Have you confirmed that sufficient funds are available to cover
Providers against all losses and liabilities arising in connection with all ✔ the withdrawal and any other payments due – including pension
actions, claims, proceedings, costs and demands, arising directly or and fees?
indirectly in connection with the Providers acting on the information or
instructions provided under, or associated with, this form (unless the Have you selected the rollover or cash withdrawal option in
liabilities are a direct result of the gross negligence, wilful default or ✔ section 4?
breach of duty of the Providers).
Have you indicated whether you wish to claim or vary a tax
If my account is a TAP, I also acknowledge and confirm the following; deduction for personal contributions in section 7?

I acknowledge that I wish to commute my Panorama Super – TAP and

✔ Have you signed and dated this request in section 9?
rollover the proceeds to another super fund or RSA provider for the
purposes of purchasing another TAP or complying (lifetime or life
expectancy) income stream. Have you attached certified proof of identity documents? (Only
required if you are rolling over to an SMSF.)
I confirm that the proceeds from my Panorama Super TAP are being
transferred directly to purchase another TAP (i.e. a market linked income If you have a TAP, have you confirmed that your withdrawal or
stream) or complying income stream and that the income stream being rollover is an allowable commutation?
purchased meets the relevant pension and annuity standards specified
under superannuation law*.

Panorama Super is administered by BT Portfolio Services Limited ABN 73 095 055 208. BT Funds Management Limited
Page 4 of 6
ABN 63 002 916 458 is the trustee and issuer of Panorama Super, which is part of Retirement Wrap ABN 39 829 542 991.
 Issued July 2022

Partial withdrawal
If you are rolling over: • Notice issued by the Commonwealth, State or Territory
Have you provided the address of the rollover institution in government within the past 12 months that records the provision
section 5? (Fund registered address is required for SMSFs.) of financial benefits and contains your name and residential
address. For example, a letter from Centrelink regarding a
Have you provided the fund ABN and ESA or USI in section 5?
government assistance payment.
(ABN and ESA are required for SMSFs.)
• Notice issued by the Australian Taxation Office within the past
If you are requesting rollover to an external SMSF, have you:
twelve months that contains your name and residential address.
A. Completed all member details in section 2 For example, a notice of an ATO assessment.
B. Completed section 5, and
• Notice issued by a local government body or utilities provider
C. Attached certified proof of SMSF bank account details. within the previous three months. For example, a rates notice from
local government.
Completing proof of identity
Have you changed your name or are you signing on behalf
You must provide documentation with this partial withdrawal request when
of another person?
rolling over to an SMSF to prove you are the person to whom the super
entitlements belong. If you have changed your name or are signing on behalf of the
Proof of identity is only required if your request is for a rollover to an SMSF. applicant, you will need to provide a certified linking document. A
Note: For rollovers to an APRA fund via SuperStream no proof of linking document is a document that proves a relationship exists
identity is required. between two (or more) names.
Your identification documents may be verified by the fund through an
The following table contains information about suitable linking documents.
electronic service provided by the Government of Australia.

You can submit this form by: Purpose Suitable linking documents

mail: BT Panorama,
GPO Box 2861, Adelaide SA 5001 Marriage certificate, deed poll or change
Change of name of name certificate from the Births, Deaths
and Marriages Registration Office

Acceptable documents Signed on behalf of

Guardianship papers or Power of Attorney
the applicant
The following primary and secondary identification documents may be
used.

Either Certification of personal documents

A certfied copy of any one of the following primary photographic All copied pages of original proof of identity documents (including any
linking documents) need to be certified as true copies by any individual
identification:
approved to do so.
• Driver’s licence issued under state or territory law
The person who is authorised to certify documents must sight the
• Passport issued by the Commonwealth that has not expired within original and the copy, ensuring both documents are identical, and
the past two years all pages have been certified as true copies by writing or stamping
‘Certified true copy’ followed by their signature, printed name,
Or qualification (eg Justice of the Peace, Australia Post employee) and date.
Any one of the following primary non-photographic identification The following persons can certify copies of the originals as true and
documents: correct copies:

• Birth certificate or birth extract issued by a State or Territory of

Australia • A person enrolled on the roll of a State or Territory Supreme Court
or the High Court of Australia as a legal practitioner
• Citizenship certificate issued by the Commonwealth
• A judge of a court
• Pension card issued by Centrelink that entitles the person to
• A magistrate
financial benefits
• A Chief Executive Officer of a Commonwealth court
And
• A registrar or deputy registrar of a court
Any one of the following secondary identification documents: • A Justice of the Peace
• A notary public officer
• A police officer

Panorama Super is administered by BT Portfolio Services Limited ABN 73 095 055 208. BT Funds Management Limited
Page 5 of 6
ABN 63 002 916 458 is the trustee and issuer of Panorama Super, which is part of Retirement Wrap ABN 39 829 542 991.
 Issued July 2022

Partial withdrawal

• An agent of the Australian Postal Corporation who is in charge of an

office supplying postal services to the public

• A permanent employee of the Australian Postal Corporation with

two or more years of continuous service

• An Australian consular officer or an Australian diplomatic officer

• An officer with two or more years of continuous service with one or

more financial institutions

• A finance company officer with two or more years of continuous

service (with one or more finance companies)

• An officer with, or authorised representative of, a holder of an

Australian Financial Services Licence (AFSL) having two or more
years continuous service with one or more licensees

• A permanent employee of the Commonwealth with two or more

years continuous service

• A permanent employee of the State or Territory, or State and

Territory authority with two or more years continuous service

• A member of the Institute of Chartered Accountants in Australia,

CPA Australia or the National Institute of Accountants with two or
more years continuous membership

Panorama Super is administered by BT Portfolio Services Limited ABN 73 095 055 208. BT Funds Management Limited
Page 6 of 6
ABN 63 002 916 458 is the trustee and issuer of Panorama Super, which is part of Retirement Wrap ABN 39 829 542 991.