Super Savings

Departing Australia Superannuation

Payment (DASP) additional information
Are you eligible to complete this form?
Please note: If you’ve entered Australia on an eligible temporary resident visa you may be eligible to withdraw
your Super Savings account as a Departing Australia Superannuation Payment (DASP) once you have
If you have ceased work left Australia. You can apply to claim your account, subject to withholding tax if you:
due to sickness or injury, are not a citizen of Australia or New Zealand or a permanent resident of Australia, and


call us on +61 7 3333 7400 have left Australia and your visa has either expired or been cancelled.


before proceeding.

Verifying your immigration status

Applying quickly and easily online
Using the Australian Taxation Office’s (ATO) online facility is the easiest way to claim your benefit and
there is no fee to have your immigration status verified. A link to the ATO’s online application system
can be found by visiting australianretirementtrust.com.au/dasp
Complete the ATO’s online application. Take note of Australian Retirement Trust’s fund
ABN 60 905 115 063, you’ll need this for your application. If you’re eligible, the ATO will contact us
directly. If you’re experiencing issues with the ATO’s online application system you can contact the
ATO on +61 2 6216 1111 or email them at [email protected]
If your account balance is $5,000 or more, you will also need to:
• Provide certified proof of identity (for full information about certified proof of identity refer to page 3).
• A bank statement that is less than 12 months old, showing the bank name/logo and address, your
name as the account holder (both first and last names), the date of the statement and the BSB and
account numbers. Note this is not required for cheque payments.
• Complete and return the attached form.
What if I don’t want to apply online?
If you do not want to use the ATO online facility you may need to pay a fee to have your immigration
status verified.
You will need to complete the attached form, provide certified identity documents (for full information
about certified proof of identity refer to page 3) and provide proof of your immigration status.
If your account balance is less than $5,000 you must:
• Provide a certified copy of your passport showing the departure from Australia stamp, and
• A certified copy of your expired or cancelled Australian visa.
OR
• Provide Form 1194 - Certification of Immigration Status and/or request to cancel a Temporary
Resident visa from the Department of Home Affairs (a fee is payable when you lodge your
application). A link to the DIBP form can be found by visiting immi.homeaffairs.gov.au
If your account balance is $5,000 or more you must:
• Provide Form 1194 - Certification of Immigration Status and/or request to cancel a Temporary
Resident visa from the Department of Home Affairs (a fee is payable when you lodge your
application). A link to the DIBP form can be found by visiting immi.homeaffairs.gov.au

Page 1 of 7
 The following describes important things to remember when completing
Completing the each section of the form:

attached form
1 Personal details
If you are not applying through the Ensure you include your residential address. Legislation states we may not be able to process your
claim without it (a PO Box is not a residential address).
ATO’s online application system,
Ensure you confirm when your last employer contributions are made to Australian Retirement Trust.
if your balance is over $5,000,
or you are applying through an
agent you need to complete the 2 Claiming a tax deduction
attached form. Carefully consider if you want to claim a tax deduction before sending us this form. To claim a tax deduction
for years prior to 2017-18 you must have been self employed. Visit ato.gov.au for more information.

3 Your overseas residential address

Ensure you provide us with your overseas residential address.

4 Visa information
Ensure you provide us with details for all visas you have held while working in Australia.

5 Payment details
Provide us with the details of the account you would like us to pay to. Refer to page 3 or go to ato.gov.au
for details on tax.

6 Proof of identity
For full information about certified identification, please refer to page 3.

7,8 Checklist & Authorisation and declaration

Use the checklist to double check everything is complete. Then read the statements and sign.
Mail your completed form and any required documents to GPO Box 2924 Brisbane Qld 4001.
We’re unable to accept faxed or scanned copies.
Once we receive your completed documents and confirm you are eligible to access your super,
we will pay your benefit less any withholding tax.

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 Important information

This form is to be used if you are not applying through Providing your Tax File Number (TFN)
the ATO’s online application system, if your balance is Under the Superannuation Industry (Supervision) Act
over $5,000, or you are applying through an agent. 1993, your superannuation fund is authorised to collect
your TFN, which will only be used for lawful purposes.
Proof of identity requirements (a)
These purposes may change in the future as a result of
You can get your documents
legislative change. The trustee of your superannuation
certified before you leave Australia.
fund may disclose your TFN to another superannuation
If you need more information about
provider, when your benefits are being transferred,
proof of identity requirements,visit
unless you request the trustee of your Superannuation
australianretirementtrust.com.au/id for
fund in writing that your TFN is not to be disclosed to
further details.
(b)
any other superannuation provider. However giving
What is an acceptable identification document? your TFN to your superannuation fund will have the
To verify your identity please attach a certified copy of: following advantages (which may not otherwise apply):
A. Your current driver’s licence, current passport or (c) (d) • Y
 our superannuation fund will be able to accept
current national identity card that contains your all types of contributions to your account/s.
photo, name and EITHER residential address OR
00000000 0 0000

• T he tax on contributions to your superannuation

date of birth (please copy and certify both
account/s will not increase.
front and back sections if relevant), OR (e)
• O
 ther than the tax that may ordinarily apply, no
B. Your birth certificate, Australian birth extract,
additional tax will be deducted when you start
Citizenship certificate or current Department of
drawing down your superannuation benefits; and
Human Services pension or health care card AND a
current rates, electricity or gas notice (no more than Your benefit claim cannot be processed if • It will make it much easier to trace different
3 months old) or assessment from the Australian the person certifying the documents doesn’t superannuation accounts in your name so that
Taxation Office (no more than 12 months old) or a provide the required information. you’ll receive all your superannuation benefits
financial benefits notice from the Commonwealth, when you retire.
Who can certify your ID if you live overseas?
a state or a territory (no more than 12 months old) If your benefit claim is submitted from outside What if I don’t claim within six months?
showing your name and current residential address. Australia, we can only accept certified ID that are If you do not claim your super within six months
What if you don’t have a passport or drivers signed by one of the following people: of leaving Australia, or within six months of the
licence? 1. Police officer of an overseas force. cancellation or expiry of your visa if later, the ATO will
If you’re unable to provide a passport or drivers instruct us to transfer your balance to the ATO. If this
license, you must provide a certified copy of: 2. A Notary public. occurs, you should claim your super money from the
3. Judge of a court in an overseas jurisdiction. ATO. As Australian Retirement Trust adopts the ASIC
Your citizenship certificate issued by a government class order relief that provides disclosure exemption
OR your birth certificate 4. Magistrate in an overseas jurisdiction. for former temporary residents, information regarding
AND 5. An Australian consular officer or an Australian the transfer of a member’s benefits and significant
A notice that: diplomatic officer (within the meaning of the event notices may not be provided to a member whose
Consular Fees Act 1955). benefit has been transferred. If you are applying to
a) w
 as issued to you by the ATO within the previous the ATO to claim your benefit and require information
12 months such as a tax assessment, AND We also require evidence of the certifier’s status.
about the transfer, please contact us. For more
Examples of what is acceptable include:
b) c ontains your name and your residential information on accessing your benefit when you leave
address, AND • Police Officer: Details of their police badge number. Australia, please call the ATO superannuation line on
• Judge or Magistrate: Certificate of their 13 10 20 (within Australia) or email DASPmail@ato.
c) r ecords a debt payable to or by you by or gov.au (outside Australia).
to (respectively) the Commonwealth under appointment to their position.
Commonwealth law relating to taxation. For a full list of who can certify, including Tax treatment
overseas certifiers, please visit Tax free component – Nil
What do we mean by certified?
We understand you’ll want to provide us with copies australianretirementtrust.com.au/id Taxable component: Taxed element –
of your ID documents, rather than the originals. for more information. 35% for non-working holiday maker
That’s fine, but you must have them ‘certified’ within Have you recently changed your name? Taxable component: Untaxed element –
the last 12 months. This means the certifier must: If you have changed your name and you have not 47% for non-working holiday maker
1. Sight the original and the copy to make sure both previously let us know you will need to provide a
Taxable Component: Taxed and Untaxed
documents are identical, and certified copy of your marriage certificate, deed poll
element – 65% for working holiday maker
or change of name certificate, decree nisi or other
2. Write or stamp ‘certified true copy of original receiving contributions on a 417 or 462 visa
document satisfactory to us.
document’ on each page, and *Please note that we reserve the right to request additional
Important notes on identification: information before processing any transfers to SMSFs. We may
3. Sign and print their name, qualification (e.g. • We reserve the right to request additional also contact you by telephone to confirm the details of this transfer
Justice of the Peace, Australia Post employee), information to verify your identity before paying request. Our information requirements for these payments reflect
and the date on each page of the document. your claim. the unique regulations and risks pertaining to SMSFs as well as
How your proof of identity document should the Australian Retirement Trust Trustee’s obligation to ensure that
• We can’t accept documents which have expired. transfers to these funds are compliant.
look. (See example above right.) If an expired document is received, we’ll not
a) C
 opy of the document that identifies you. be able to process your claim until suitable Warning – illegal early release schemes Superannuation scams
identification has been provided. or early release schemes which offer to give you early access to
b) ‘Certified true copy’ written or stamped and your superannuation, often through a self-managed super fund
signature of authorised person. • If you’re providing a document that is not in and/or for a fee, are illegal. You cannot legally have access to the
c) Authorised person’s stamp and registration English, you’ll also need to provide an English ‘preserved’ part of your super until you reach your ‘preservation’
number (if applicable). translation prepared by an accredited translator. age (ranging from 55 to 60 years of age, depending on when you
For further information on this, please call us were born) or meet a condition of release, such as compassionate
d) Name, qualification and phone number of on 13 11 84 or +61 7 3333 7400 (if overseas). grounds. If you do access your super early for an illegal reason, you
authorised person. may be subject to legal action and heavy penalties (including tax). If
• If signing on behalf of the member, certified you receive one of these offers or want independent advice, please
e) Date of authorisation that is no more than 12 copies of Guardianship papers or proof of Power contact us or the ATO and report that you have been approached by
months old. of Attorney are required. an early release scheme.

For further details refer to the Proof of identity requirements at australianretirementtrust.com.au/id

Please keep these important information pages for your records.

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Page 4 of 7
 Super Savings
Departing Australia Superannuation Payment
(DASP) additional information
 This form is only to be completed if you are not applying through the ATO’s online
application system, if your balance is over $5,000, or you are applying through an agent. 13 11 84 |australianretirementtrust.com.au
Reply Paid 2924 Brisbane Qld 4001
Note: When completing the ATO online application, please enter our Australian Business Number (ABN) 60 905 115 063 in the
Superannuation fund details section.
Important: Please provide us with as much information as possible. Please tick boxes where appropriate. Use BLOCK letters and dark ink
when completing this form and ensure it is signed and dated. This form and supporting documentation need to be returned to Australian Member number
Retirement Trust GPO Box 2924 Brisbane QLD 4001*DENOTES MANDATORY FIELD.

1 Member details
Title First name* Middle name

Last name* Date of birth (DD/MM/YYYY)* Gender*

M F

Street Address / PO Box*

Suburb /Town* State* Postcode* Home phone number Daytime phone number*

Personal email address Mobile phone number

Residential street address (if the same as above leave blank)* Suburb /Town* State* Postcode*

Other/previous names
Note: If you have changed your name, you’ll need to provide a certified copy
of a linking document. Please read the important notes on identification.
Tax file number (TFN) details
If you’re not sure if we have your TFN you can add it below. You don’t have to provide your TFN, however if we don’t have your TFN, you may pay more tax than you need to.
Before you supply your TFN, please read the TFN section on page 3 of the Important information pages. If we do have your TFN you don’t need to provide it again.
My TFN

Turn to page 3 to learn how you can avoid extra tax by providing your TFN.

2 Claiming a tax deduction

From 1 July 2022, if you’re aged over 67, you’ll need to meet the Work Test1 in order to claim a tax deduction on voluntary after-tax contributions. This eligibility requirement will be assessed by the
Australian Taxation Office (ATO) when you submit your income tax return. The contribution you’re claiming a tax deduction on must have been received by Australian Retirement Trust prior to the
28th day after the end of the month you turned 75 years old.
Do you intend to claim a tax deduction? Relevant Financial Year (YYYY/YYYY)
If Yes, and you intend to claim a tax deduction for contributions you paid to Australian Retirement Trust, you will need to let
YES us know using the online form in Member Online before submitting this form or complete a Notice of intend to claim a tax /
deduction form from ato.gov.au to submit with this withdrawal request. Please also indicate the relevant financial year here:
NO If No, go to Section 3

Please note: If you intend to claim a tax deduction for voluntary after-tax contributions paid to your Super Savings account, it’s important you let us know BEFORE we make your payment.
If you close your account, income tax laws don’t allow us to complete any future requests for tax deductions. If you make a partial withdrawal or transfer, the maximum amount you can later claim
a tax deduction for is the reduced contribution amount remaining with us. If you intend to claim a tax deduction, you can let us know by completing the online form in Member Online or send us a
completed Notice of intent to claim a tax deduction form from ato.gov.au and we’ll send you confirmation to include with your tax return. To claim a tax deduction for years prior to 2017–18 you
must have been self employed. Visit ato.gov.au for more information.
You must work at least 40 hours over a period of 30 consecutive days, during the income year the contributions were made (or during the previous financial year, under a one-off exemption available to members with a ‘total
1 

superannuation balance’ under $300,000).

3 Your overseas residential address

Under current legislation we require your overseas residential address.
Street address*

Suburb / Town* State* Postcode* Country

 Please continue over page

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FRM-W-G0105-0722
 4 Visa information Working holiday maker

Please note if you have applied for a Certificate of Immigration Status from Department of Immigration and Border Protection (DIBP),
you don’t need to provide visa information as DIBP will provide this information to us in the certificate.
If you’ve held either of the following two visas you need to provide visa information so we can accurately assess your application:
• Working holiday visa (subclass 417)
• Work and holiday visa (subclass 462)
List details for all visas you have held while working in Australia (including bridging visas), starting with subclass 417 or 462 visa.

Visa subclass Visa type

Effective from Effective to

Day Month Year Day Month Year

/ / / /
Visa subclass Visa type

Effective from Effective to

Day Month Year Day Month Year

/ / / /
Visa subclass Visa type

Effective from Effective to

Day Month Year Day Month Year

/ / / /
Visa subclass Visa type

Effective from Effective to

Day Month Year Day Month Year

/ / / /
Visa subclass Visa type

Effective from Effective to

Day Month Year Day Month Year

/ / / /
Visa subclass Visa type

Effective from Effective to

Day Month Year Day Month Year

/ / / /
Visa subclass Visa type

Effective from Effective to

Day Month Year Day Month Year

/ / / /

If you have held more visas while working in Australia, write the details on a separate page and include it with this application.
The visa information you provide may be checked against information held by the DIBP. Your application may take longer if your information
does not match information held by DIBP.

 Please continue over page

Page 6 of 7
 5 Payment details
If your payment is approved we will pay directly into your Australian bank or credit union account. Please also be aware that money can’t be paid into a credit card account,
third party account or an overseas account.
Please complete the sections below for the account you would like us to pay to and provide proof of your account.

Financial institution* Name on the account*

BSB number* Account number*

AND I have attached:

a copy of a document prepared by my Australian bank or credit union showing my BSB number, account number, account name and address,
and is no more than 12 months old.
Important: For us to pay your benefit into your Australian bank or credit union account we require you to provide a document from them, such as a statement or online statement. The
document must be current and no more than 12 months old and show your BSB, account number, account name and address. A copy of the original document can be accepted and doesn’t
need to be certified. Your claim cannot be processed via direct transfer without this.
Money cannot be paid into a credit card account, third party account or an overseas account. We will take care to ensure your money is paid in accordance with the details you have
provided. However, we accept no responsibility for any loss which occurs as a result of incorrect account details you provide us.
If the bank or credit union rejects the payment of your money, or if you don’t provide proof of your account, we’ll pay you by cheque and may take longer than
payments made electronically.

6 Proof of identity*

For balances OVER $5,000 you must provide your proof of identity to I’ve attached a certified copy of my proof of identity (if applicable)
Australian Retirement Trust before your benefit will be paid.
All copies of ORIGINAL proof of identity documents must be certified as true copies by someone approved to do so and no more than
Certification 12 months old. More information about acceptable proof of identity documents and who can certify them is provided on page 3.

7 Checklist

Before we can pay your benefit, please make sure you have:

Completed the ATO’s online application if you are applying online.

When completing the ATO online application, please enter our Australian Business Number (ABN) 60 905 115 063 in the Superannuation fund details section. If
you’re not applying using the ATO’s online application system or are applying offline please refer to page 1 for requirements.

Completed all mandatory sections of this form.

Attached your proof of identity and bank documents (if applicable).

Certified proof of identity is only required if your balance is more than $5,000. All documents and document certifications must be in english or be translated
by an accredited translator.

Please note: Providing us with your tax file number (TFN) in section 1 is not mandatory, however additional tax may be deducted from your
Important payment if you’ve not provided your TFN. Contact the Australian Taxation Office (ATO) on 13 10 20 for more information about tax on
your payment. Please refer to page 3 for more information of the tax treatment of DASP claims.

Authorisation and declaration

8
Sign this form and return to Australian Retirement Trust:
By signing this request form I am making the following statements: Member to sign here*
• I declare I have fully read this form and the information completed is true and correct.
• Where the full balance of my account is paid from Australian Retirement Trust, I hereby release Australian Retirement Trust from any further liability
to me or my executors, administrators or dependants in respect of my participation in the fund and request and authorise the termination of my
membership in the Fund. I understand that by doing this my insurance cover if any will end.

• I am aware of taxes that may apply. Full name (print in BLOCK letters)*
• I was a temporary resident of Australia and I am not an Australian or New Zealand citizen or permanent resident of Australia.
• I have made an online application to the Australian Taxation Office (ATO) to release my superannuation benefit.

Date (DD/MM/YYYY)*

Please return the form to

Australian Retirement Trust
Reply Paid 2924 Brisbane Qld 4001

We are committed to respecting the privacy of personal information you give us.
If you would like a copy of Australian Retirement Trust’s Privacy Policy, visit australianretirementtrust.com.au/privacy or call 13 11 84.
Australian Retirement Trust Pty Ltd ABN 88 010 720 840 AFSL No. 228975 Trustee of Australian Retirement Trust ABN 60 905 115 063

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