Application for Consent Orders Kit - Community Law

SUPERANNUATIONIf you have a superannuation interest! attach a completed Superannuation Information Form when a splitting order is soughtIf you have more than one superannuation interest! attach a completed Superannuation Information Form for each interest when a splitting order issought! attach a list of the interests! include the details required in 50-53 for each interest! insert the total value of all interests in Item 54 on this page50Name ofeligiblesuperannuationplanAPPLICANTNameRESPONDENTName51Type ofinterestaccumulation interestpartially vested accumulation interestaccumulation interestpartially vested accumulation interestdefined benefit interestdefined benefit interestself managed fundself managed fundretirement savings accountretirement savings accountsmall superannuation accountsmall superannuation accountpercentage only interestpercentage only interestapproved deposit fundapproved deposit fund525354Specify thecurrent agreedgross value ofthe interest insuperannuationHas the agreedvalue in ItemYes52 beencalculated inaccordance with the Family Law(Superannuation) Regulations2001? (Complete only if section90MT (2)(a) of the Act applies tothe superannuation interest)Total grossvalue of allsuperannuationinterestsFINANCIAL RESOURCES55$ $Yes$ $Interest in anytrust or any otherGIVE DETAILSGIVE DETAILSfinancialresources (forexample, doyou have anexpectation ofreceiving money$ $from a personal injury claim orCourt case or from a deceasedestate?)Signature of applicantSignature of respondent15