ALEXANDER FORBES FINANCIAL SERVICES (PTY) LTD
Registration number: 1969/018487/07 | FAIS licence number: 1177
Registered Pension Fund administrator (24/472)
Institutional fund administration – Member
Telephone: 0860 896 768 Email: 2PotClaimsAF@[Link]
Savings pot withdrawal form (manual)
You can also submit a savings pot claim form electronically using AF Connect. If you do so, your claim will be processed faster and more efficiently.
[Link]
Why do I need to complete this form?
You are still employed or a member of the fund but you want to withdraw cash from your savings pot.
Name of fund
Name of employer / paypoint (if applicable)
Things to consider before withdrawing
● You are allowed one cash withdrawal in a v year (March this year to February next year)
● You can withdraw any amount from your savings pot, as long as it is more than R2 000.
How does this benefit me? How does this NOT benefit me?
● You’ll have money to help you through financial ● Withdrawals from your savings pot will reduce your
difficulties. lump sum cash available when you retire.
● The money will be deposited directly into your ● All withdrawals will be taxed at your marginal tax
bank account after the claim has been processed rates. The withdrawal amount will be included in your
and the South African Revenue Services has issued a annual income and you won’t benefit from any tax-free
tax directive. amounts.
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Section 1 | About you (the member)
Fill in the details below
(You need to complete all the sections below. If there is any information missing, it may delay the processing and payment of your claim.)
Your name(s)
Your surname
Identity or passport number Date of birth
Employee number (if applicable)
The details you include in the above section must be accurate. Your name, surname and ID or passport number must match your
identity document. Alexforbes checks this information with the Department of Home Affairs and any errors or discrepancies may delay
the processing and payment of your claim.
Residential address
Unit number Complex name
Street number Street or farm name
Suburb City or town
Country Code
Postal address (Tick yes if your postal address is the same as residential address) Yes
Code
Contact details
Please give us your personal (not professional) contact details.
Cell Home
Email
Tax details
Income tax number Don’t know your tax number? Get it from SARS with this code: *134*7277#
Country of residence for tax purposes*
Note: *Please click here to complete a Withholding tax on interest (WTI) form if your country of residence for tax purposes is not
South Africa.
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Section 2 | Withdraw from my savings pot
I would like to withdraw some of my savings:
How much would you like to withdraw? R .
(Where you request an amount that is higher than what is available in your savings pot, the available amount will be paid out.)
I would like to withdraw all of my savings
Please give us your own personal bank details and not someone else’s.
Account holder’s name
Name of bank
Account number Branch code Cheque or Savings
Savings claim fee and tax disclaimer:
Alexforbes will deduct a transaction fee from your savings pot claim and will apply for tax on your net claim amount.
Alexforbes will provide SARS with the value of your pensionable salary or other income information provided to us by your employer.
Alexforbes will not verify the information provided by your employer and Alexforbes will not be responsible for any incorrect information
provided to us by your employer. SARS will decide how much tax must be deducted at your marginal rate. Alexforbes will deduct that
amount from your net claim amount. At the end of the tax year when you do your tax filing, you may have to pay in extra tax to SARS or
SARS may give you a refund if the correct marginal tax was not levied by SARS when your claim was processed.
SARS may issue an IT 88 (for arrears tax owing to SARS). This means that SARS could deduct more tax from your claim.
For guidance on IT 88 and marginal tax please visit the SARS website on [Link]
Section 3 | Your declaration (the member)
Please read and sign that you agree with the following:
1. I understand my options and the tax implications.
2. I’m responsible for any loss suffered if I provide incorrect information.
3. I made my own decision or got financial advice.
4. My claim will be processed in line with the fund rules.
5. If applicable, any permissible deductions or suspensions in terms of section 37D of the Pension Funds Act, will be applied to my benefit.
6. Once I have submitted my claim form, I cannot change it.
7. My decision may be shared with my employer for record keeping. (if applicable)
8. If you provide us with an instruction that is not legally binding, we will not be able to action the instruction and this form will be rendered null and void.
9. I understand that the recommended channel for Savings Claim submissions is AF Connect and that I must email the manual form to:
2PotClaimsAF@[Link]
Full name
Sign here ______________________________________
Date
Personal information, privacy and security
Find out how we protect your personal information, privacy and security. ([Link]
We own the copyright in this document
You may not copy, store, retrieve or reproduce this document without our express written permission.
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