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Self Managed Superannuation Order Form

Personal Details
Instructing Business
Contact Person*
Address*
Street Address Address Line 2 City State Postal Code Country
Phone*
Email*
Enter Email Confirm Email

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Establishment Options
Establishment Options*
What type of establishment option would you like to use?
- Electronic Register : $550.00 (including GST and Disbursement of $165.00)
- Physical Register : $550.00 (including GST and Disbursement of $165.00)

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Name of Fund
Name of Fund*

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Is the Trustee a*
- Individual/s
- Corporation

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Individual/s Details
How many individuals?*
- One
- Two
- Three
- Four
First Individual
Name*
First Middle Last
Residential Address*
Street Address Address Line 2 City State Postal Code Country
Date of Birth*
DD slash MM slash YYYY
Is the individual also a member of the fund?*
- Yes
- No
Tax File Number*
Binding Death Benefit
Name of Beneficiary*
Relationship to Member*
Proportion of Benefit (%)*
Second Individual
Name*
First Middle Last
Residential Address*
Street Address Address Line 2 City State Postal Code Country
Date of Birth*
DD slash MM slash YYYY
Is the individual also a member of the fund?*
- Yes
- No
Tax File Number*
Binding Death Benefit
Name of Beneficiary*
Relationship to Member*
Proportion of Benefit (%)*
Third Individual
Name*
First Middle Last
Residential Address*
Street Address Address Line 2 City State Postal Code Country
Date of Birth*
DD slash MM slash YYYY
Is the individual also a member of the fund?*
- Yes
- No
Tax File Number*
Binding Death Benefit
Name of Beneficiary*
Relationship to Member*
Proportion of Benefit (%)*
Fourth Individual
Name*
First Middle Last
Residential Address*
Street Address Address Line 2 City State Postal Code Country
Date of Birth*
DD slash MM slash YYYY
Is the individual also a member of the fund?*
- Yes
- No
Tax File Number*
Binding Death Benefit
Name of Beneficiary*
Relationship to Member*
Proportion of Benefit (%)*

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Corporation Details
Company Name*
ACN*
Registered Office*
Street Address Address Line 2 City State Postal Code Country
Email*

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Directors of Trustee
How many Directors?*
- One
- Two
- Three
- Four
First Director
Name*
First Middle Last
Residential Address*
Street Address Address Line 2 City State Postal Code Country
Date of Birth*
DD slash MM slash YYYY
Is the director also a member of the fund?*
- Yes
- No
Binding Death Benefit
Name of Beneficiary*
Relationship to Member*
Proportion of Benefit (%)*
Tax File Number*
Second Director
Name*
First Middle Last
Residential Address*
Street Address Address Line 2 City State Postal Code Country
Date of Birth*
DD slash MM slash YYYY
Is the director also a member of the fund?*
- Yes
- No
Binding Death Benefit
Name of Beneficiary*
Relationship to Member*
Proportion of Benefit (%)*
Tax File Number*
Third Director
Name*
First Middle Last
Residential Address*
Street Address Address Line 2 City State Postal Code Country
Date of Birth*
DD slash MM slash YYYY
Is the director also a member of the fund?*
- Yes
- No
Binding Death Benefit
Name of Beneficiary*
Relationship to Member*
Proportion of Benefit (%)*
Tax File Number*
Fourth Director
Name*
First Middle Last
Residential Address*
Street Address Address Line 2 City State Postal Code Country
Date of Birth*
DD slash MM slash YYYY
Is the director also a member of the fund?*
- Yes
- No
Binding Death Benefit
Name of Beneficiary*
Relationship to Member*
Proportion of Benefit (%)*
Tax File Number*

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Specific Instructions
Specific Instructions

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Terms and Conditions*
1. Prices quoted are effective 1 July 2023. All prices are GST inclusive. Prices subject to change at any time. 2. By submitting this form you acknowledge that you have performed the relevant due diligence to ensure the proposed company name does not conflict with an existing company or business name or registered trade mark. The Corporate Services division of Coulter Legal makes no representation or warranty that the proposed company name will not breach any third party's intellectual property or other rights. Should you require any advice in this regard please contact us. 3. It is the responsibility of the instructing party at all times to ensure that the information provided is accurate. 4. If new documents have to be prepared as a result of errors in the information given then a further fee will be charged in accordance with the time taken to rectify the error. 5. The Corporate Services division of Coulter Legal does not offer any legal advice in the process of drafting the documents requested. If the instructing party requires legal advice then they may make an appointment with one of our Commercial Lawyers. 6. The documents received will be in a standard form prepared by our Commercial Lawyers at Coulter Legal. 7. All documentation will be prepared on the instructions contained in this order form. The Corporate Services division of Coulter Legal has provided no advice to the parties in relation to establishing the particular entity. 8. The Corporate Services division is not licensed to provide Financial Product ("FP") advice under the Corporations Act 2001 (Cth) and you should consider taking advice from the holder of an Australian Financial Services Licence before making a decision on an FP.
- I accept the above terms and conditions
Phone
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Corporate Services

Corporate & Commercial
Bare Trust Order Form
Business Name Registration Order Form
Company Order Form
Corporate Services Price List
Discretionary Trust Order Form
Self Managed Superannuation Order Form
Unit Trust Order Form

Geelong

Level 1, 235 Ryrie Street
Geelong VIC 3220

T: 03 5273 5273

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Barwon Heads

Shop 4/50 Hitchcock Avenue
Barwon Heads VIC 3227

T: 03 5254 1877

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Melbourne

Level 14, 114 William Street
Melbourne CBD, VIC 3000

T: 03 9070 6201

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Robe

PO Box 47
Robe SA 5276

T: 08 8763 7400

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Torquay

1/9 Bristol Road
Torquay VIC 3228

T: 03 5264 8728

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T: 03 5273 5273

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